Liability Implications Associated With Jousting in Dentistry
Marcy A. Metzgar
March 2026
Reading time: 4 minutes

Definition
In dentistry, jousting refers to a dentist being critical of another dentist’s treatment and assuming
the patient received inadequate care. In turn, this perspective by one dentist may motivate a patient to allege malpractice against the dentist that provided the care.
Closed Claims Analysis
To illustrate how jousting can turn into malpractice claims, an analysis of MedPro Group dental cases closed between 2015 and 2025 (with at least $50,000 total dollars paid in expense and indemnity) indicated that jousting accounted for 19 percent of all cases and 17 percent of total dollars paid.1 Below are details of this claims analysis:
- Jousting claims outpaced the average growth of all cases year over year (average growth over year was 12 percent).
- Jousting claims were noted most often in implant cases (29 percent), extraction cases (21 percent), and crown/filling cases (19 percent).
- Jousting was noted most often in conjunction with documentation-related factors (46 percent of all jousting cases involved documentation); additional related factors included informed communication (27 percent), informed consent (22 percent), and patient selection issues (22 percent).
Possible Outcomes
As the case analysis above shows, jousting can produce many negative outcomes. Further, patients may recall their previous experience in a subjective — not objective — manner, so dentists may not hear all the facts. The subsequent dentist may only hear part of the story as well, so they should consider communicating with previous dentists to get more facts and see previous dental records. Documentation in the previous dentist’s records regarding the patient’s cooperation and compliance may be enlightening and prove useful in terms of treatment planning, patient education, and informed consent.
If a subsequent dentist makes assumptions and asserts to a patient that a previous dentist provided subpar care, the patient may seek retribution by filing a lawsuit. If the patient asserts a claim against the previous dentist, then the dental records from both dentists will be examined during the litigation process. The subsequent dentist may also be identified as a material witness in a court trial, or a plaintiff’s attorney may try to use the subsequent dentist’s criticism as expert testimony.
Not only can a subsequent dentist become part of a lawsuit, but jousting behavior can strain the professional relationship between the dentists and may have a negative effect on both dentists’ professional reputations. Further, the previous dentist may not have the opportunity to explain the care rendered, which can lead to loss of practice and finances.
Jousting also may change the way a patient perceives dentistry and pursues dental care. They may lose faith and trust in dentistry as a result and discontinue treatment, which may affect their health.
Ethical Perspective
According to the American Dental Association (ADA) Code of Ethics, “Patients should be informed of their present oral health status without disparaging comment about prior services.”2 Therefore, jousting is considered unethical.
It is incumbent upon every dentist to conduct themselves in an ethical and professional manner and to always do and say what is in the best interest of the patient’s health. However, treating new patients with previous negative experiences can present challenges, so it is best not to speculate or guess when discussing previous treatment. Although a dentist’s clinical skills and decisions are essential to patient safety and satisfaction, other unknown variables may have played an important role in the patient’s care and outcomes.
Strategies to Consider
To avoid the liability implications associated with jousting, following are some strategies dentists can use:
- Be wary of multiple opinions and patients with a long history of previous dentists.
- Ask the patient to describe the previous treatment and recommendations received, including any medication prescribed and how they were taken. Be cautious of patients who will not reveal the previous dentist’s name nor give permission to contact that dentist.
- If a patient asks whether a previous dentist provided inadequate care, do not comment on that treatment and instead specify what you found upon examination and your recommendations.
- Do not document anything in the patient record that reflects criticism of the previous dentist’s treatment. Simply state what can be substantiated.
- Follow dental ethical guidelines including the ADA Code of Ethics mentioned previously.
- Be thoughtful toward your fellow colleague/dentist and don’t perceive the situation as a competitive one.
- Be sure to practice thinking rationally and morally. Be more diligent and practice optimum restraint in selecting your words, especially about fellow dentists.
- Be sure to practice thinking rationally and morally. Be more diligent and practice optimum restraint in selecting your words, especially about fellow dentists.
- Maintain the best interest of the patient as the top priority, but not at the expense of the dentistry profession and professional ethics.
In Summary
Many dentists have seen situations of past dental care that seemed inappropriate and ineffective. They have also heard patients relay unsupported, critical comments about another dentist’s care. Yet, these situations might not reveal all the facts or details about the patient’s previous treatment. Thus, dentists must exercise caution in what they say to patients and what they document to avoid criticism that could potentially lead to malpractice allegations, loss of patient confidence, professional strain, and unethical behavior.
Resources
For more information, please see the module on jousting in MedPro’s Dental Risk Focus continuing education series at www.medpro.com/jousting-in-dentistry-od. This program reviews two case studies and offers .5 hour of continuing dental education (CDE) credit.
Endnotes
- MedPro Group dental cases closed with >/= $50,000 total dollars paid (expense + indemnity), 2009-2022.
- American Dental Association. (n.d.). ADA principles of ethics and code of professional conduct. Retrieved from https://www.ada.org/en/about-the-ada/principles-of-ethics-code-of-professional-conduct/justice
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This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.
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