Tricky fillings

A man suffering severe dental pain presented as an emergency at his dental practice.

He was given an appointment with his dentist, whose examination of the patient revealed that he required root fillings of two molar teeth. However, the dentist also noted that both teeth had very curved roots and so she explained that in her opinion it would be best to refer him for specialist treatment. The patient said he could not afford the cost of specialist treatment and asked his dentist to try and do the root fillings. 

The dentist found herself in a dilemma. She wondered whether she should agree to do the difficult procedure – especially as the patient offered to sign a form saying he would accept responsibility if the treatment was unsuccessful. Fortunately, the dentist called our freephone advice line. 

How we helped

The dento-legal adviser who supported the member was able to point them to paragraph 7.2.2 of the GDC's guidance Standards for the Dental Team (2013) which states: 'You should only deliver treatment and care if you are confident that you have had the necessary training and are competent to do so. If you are not confident to provide treatment, you must refer the patient to an appropriately trained colleague.' 

The dentist was also advised that if her patient signed a form saying he accepted responsibility for the treatment it would indicate that she thought the treatment was inappropriate. This could harm any chance there may be of defending any claim made against her and may also leave her vulnerable to criticism if the patient made a complaint to another organisation, such as her primary care organisation or the GDC.

The dentist was also advised that if she was in any doubt about a particular course of action she could always consider getting a second opinion. 

Learning points

We suggest that you do the following:

  • Always act in your patient's best interests and never be pressured into carrying out treatment which you think is beyond your capabilities or is inappropriate.
  • Never agree to a patient signing a disclaimer or any other form which says the patient is accepting the responsibility for the treatment.
  • Don't be afraid to seek the advice of more experienced colleagues such as your trainer or your practice principal.

Our advice

Dental practitioners cannot sign away their responsibilities.

As a recently qualified dentist it is natural to feel some level of anxiety when first practising. It can help if patients are informed when they are to be treated by a newly qualified dentist. In most circumstances patients will show understanding, and it could avert any complaints about ‘nervousness’.

Knowing your competency levels – and not being afraid to admit them – is essential at all stages in your dental career, as this case illustrates.

This guidance was correct at publication . It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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