Dentists need to make sure their patients are always up to speed with what is happening with their care. By doing so, they can avoid problems down the line – ensuring there are no gaps between a patient’s expectations and the reality.

All dentists are acutely aware of the importance of consent, but this post will add as a timely refresher of why it is important and how to obtain consent to avoid issues.

The importance of consent for dentists

When carrying out any form of care or treatment dentists require consent because:

• It is spelled in law that this is obtained before a dental practitioner is allowed to touch a patient
• It is needed in order to respect a patient’s right to ‘self determination’
• It makes life easier and allows you to mutually arrive at the right outcome
• Treatment is voluntary. Patients can, if they wish, withdraw from a treatment at any time and so it is vital that they are always happy with the course of action.

It is important to recognise that the Care Quality Commission will look at this. John Milne, Senior National Dental Adviser for the CQC, explained: “We review the practice’s systems and processes for obtaining consent. We may ask dental practitioners and other dental care professionals to describe how and why they ask for consent. We may look at an example of a dental care record to support what we are told.”

How to obtain consent

The consent of a patient must be ‘informed’ – that means that you must give them enough relevant information to ensure they are basing their decision on the available facts and aren’t just agreeing ‘because you told them to’.

When explaining a course of action, a dentist must:

• Explain the risks and benefits of the treatment in question in terms that could easily be understood by the patient
• Outline any possible alternative treatments and the pros and cons of these
• Explain the cost of each possible treatment
• Give the patient time to weigh up everything you have told them
• Keep a record of when and how consent is given, if necessary

Consent for dental treatment involving children

The issue of consent for treatment is complicated slightly when involving children. There are two factors here – their age and whether or not they are ‘competent’ to make a decision.

It is possible for children under the age of 16 to consent to their own treatment if they have the ‘intelligence, competence and understanding’ to be able to know what their treatment will involve. This is called being ‘Gillick competent’.

If an under-16 is not ‘Gillick competent’, then consent should be obtained from their parent or guardian.

If they are over 16 but still under 18, the patient can give consent – even though they are not an adult in the eyes of the law – and this cannot be overridden by their parents. This is a matter than can – and has been – challenged by the courts, so requires caution where there might be a dispute between both parties.

Consent and mental health

Dentists also have to bear in mind whether or not an adult has the mental capacity to give their consent.

The Mental Capacity Act 2005 sets out a two-stage process for identifying this. Firstly, this involves being aware of any conditions that might well impact on the patient’s ability to consent (eg dementia).

Secondly, you need to determine if the patient can:

• Understand the information you give to them about their treatment
• Retain and remember this information
• Come to a decision based on the information presented to them
• Adequately relay a decision to you

If you have any queries over consent, we would be happy to talk to you. Get in touch today.

The standards that dentists need to set, achieve and maintain for themselves are spelled out clearly by the General Dental Council. We are keen to help and support dentists in their quest to keep up their high professional standards – and this post offers a quick refresher of the expectations laid out by the GDC in ‘Standards for the Dental Team’.

Standards for the Dental Team

The GDC’s Standards for the Dental Team applies to people in the following seven roles:

• Dentists
• Dental hygienists
• Dental nurses
• Dental therapists
• Dental technicians
• Clinical dental technicians
• Orthodontic therapists

Each of these people is expected to abide by the nine key principles set out by the Standards.

These are:

1. Put patients’ interests first
2. Communicate effectively with patients
3. Obtain valid consent
4. Maintain and protect patients’ information
5. Have a clear and effective complaints procedure
6. Work with colleagues in a way that is in patients’ best interests
7. Maintain, develop and work within your professional knowledge and skills
8. Raise concerns if patients are at risk
9. Make sure your personal behaviour maintains patients’ confidence in you and the dental profession

Let’s explore each of these in a little more detail to look at what they mean in practice.

Put patients’ interests first

Putting the interests of patients first means listening to what they have to say, taking into account their concerns and preferences and acting with honesty, respect and integrity at all times. It also means reflecting the culture and values of the individuals in your care as a dentist, making reasonable adjustments for people with disabilities too. It also means providing a safe and clean environment for treatments – and putting the needs of patients before financial considerations.

Communicate effectively with patients

This standard outlines that patients need a full and clear explanation of their treatment plan – before, during and after any procedures are carried out – so they are fully aware of the care they are receiving. They should also understand the cost implications of the work they are receiving.

Obtain valid consent

After you have communicated the care you intend to provide to a patient it is vital to obtain their permission to carry this out. (Check out our full guide to patient consent here)

Maintain and protect patients’ information

The records of patients need to be safely stored and kept confidential. They also need to be up to date, clear and accessible.

Have a clear and effective complaints procedure

Patients need to be able to expect that their complaints will be handled properly – and that they will be listened to if they raise any issues regarding the care that they have received. As a DDO set up by dentists for dentists, DDS is able to work closely with you to ensure that this is the case.

Work with colleagues in a way that is in patients’ best interests

This outlines the importance of working together as a dental team – and for each member of the dental team to know their role and where they fit in the team.

Maintain, develop and work within your professional knowledge and skills

Dentists need to be trained and qualified and to regularly refresh their skills and knowledge of the latest laws and working practices.

Raise concerns if patients are at risk

Dentists have a duty to raise any concerns they might have over – a fellow member of the team, the environment they are working in or the welfare of a vulnerable patient.

Make sure your personal behaviour maintains patients’ confidence in you and the dental profession

Dentists also need to behave in a way that gives patients trust and confidence both in you as a professional and in dentistry as a profession. This needs to be done by maintaining professional behaviour at all times.

To download the full ebook – and for more details of Standards for the Dental Team – visit the GDC’s website.

If any dentist has any questions or queries about how to abide by the standards, get in touch with DDS today and we would be happy to help.