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A dentist contacted the advice line about a patient who had asked for a full clearance, and had subsequently been booked in to have all their teeth removed.
Our member was concerned that some of the teeth were salvageable and that it wasn't in the patient's best interest to remove all their teeth - even though the patient firmly stood by their decision.
The first principle of the GDC's 'Standards for the dental team' is to "put patients' interests first". This encompasses listening to patients and being sensitive to their needs, but also acting in their best interests.
The DDU adviser explained that the member should use their professional judgement and make their own clinical decision when considering the treatment plan and options for this patient. Treatment should be sensible, reasonable, in line with current teaching and practice and supported by a responsible body of opinion in the profession.
It's important to listen to patients and to consider their preferences and individual needs, but as in this case, patients do sometimes request treatment that the treating clinician feels is not in their best interest. Our adviser suggested the member take the following steps:
- make sure the patient is fully informed of the risks and benefits and likely outcomes of any proposed treatment
- discuss with the patient the risks, consequences, and potential outcomes of not following recommended treatment options
- make a clear record of these discussions on the clinical notes
if the member wasn't comfortable going ahead, to inform the patient that they would not be able to provide treatment which they don't consider to be in the patient's best interests. In this case, it may be helpful to offer to arrange a second opinion for the patient.
Our member was reassured and satisfied that they would be able to have a reasonable discussion with the patient about the nature and outcomes of the proposed treatment plan, and felt reassured they would be able to decline to treat the patient if that became necessary.
The first three principles of the GDC Standards all play a significant part in this dilemma. Listening to patients and acting in their best interest, communicating effectively, and obtaining valid consent are cornerstones in patient management - but is it important to remember that you do not have to provide treatment just because a patient requests it.
Get verifiable CPD
If you've read this article and the advice linked in the sidebar, you'll be ready to complete our assessment and get 45 minutes of verifiable CPD.
To get your CPD certificate you'll need to score at least 80% on the assessment. You'll also need to add your name, DDU membership and GDC registration number so they're included on your certificate.
Click here to take the CPD quiz.
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To get your verifiable CPD certificate, simply provide your contact details when asked and then score at least 80%. One of our dental liaison managers will then get in touch to discuss your requirements and provide you a quote for DDU membership.
This page was correct at publication on . Any guidance 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.