Welcome to our September 2018 newsletter. In this edition we share some facts about how your diet can affect your oral health. We also write a little about facial beauty and how we can help smooth out unwanted wrinkles. As usual, we also have our question of the month and our team updates too!….
Welcome to our August 2018 newsletter. In this edition we write a little about how smoking affects your teeth. We also explain a little about the cosmetic dental services we offer and how we can transform your smile. As usual, we also have our question of the month and our team updates too!….
Welcome to our July 2018 newsletter. In this edition we share some valuable facts regarding children’s teeth and how to care for them. We also share a little about tooth whitening, and how it can help give you a confident smile. As usual, we also have our question of the month and our team updates too!….
Welcome to our June 2018 newsletter. In this edition we share some interesting facts about sugar content in energy drinks. we also share a little about dental implants, and how they can solve the issue of unwanted gaps. As usual, we have our question of the month and our team updates too!….
Welcome to our May 2018 newsletter. In this edition we share information about how to maintain a happy, healthy smile. we also share a little about what we do to give people their dream smile. As usual, we have our question of the month and our team updates too!…
Welcome to our April 2018 newsletter. In this edition we share information about sugar and how it could be affecting your teeth, we also explain how removable aligners could be the solution to your dream smile. As usual, we have our question of the month and our team updates too!…
Welcome to our March 2018 newsletter. In this edition we share some information about oral hygiene, we also take a look at implants. As usual, we have our question of the month and our team updates too!
Welcome to our February 2018 newsletter. In this edition we discuss sugar and its impact on children’s oral health. As well as explaining a little about tooth whitening, and we also share a little of our usual team news and other monthly updates…
Welcome to our January 2018 newsletter. In this edition we share some fun facts and explain more about dental implants. As always, we are committed to helping you achieve, and maintain, a happy healthy smile. Enjoy this month’s update….
The question of consent arises increasingly at the heart of complaints made under the NHS Complaints Procedure, and complaints to the General Dental Council on matters on professional ethics and conduct. In order, both to understand the information provided, and to give the necessary authority
for consent, a patient must be competent. Competence in this context means the patient’s ability to understand the explanations given about:
- The nature and purpose of a procedure
- It’s likely effects and risks
- Any alternative treatment and how these alternatives might compare
Only if a patient is competent to consent, can the patient’s consent be considered valid.
The key problem I have found is that we as healthcare professionals are encouraged to believe that providing information to a patient alone is sufficient for the purposes of obtaining a valid consent. Unfortunately, this is no longer true.
Therefore, a standard consent form is not enough as it is not specific to that individual’s treatment. It also only confirms some of the details of the information provided, but tells us nothing about the communication process, the questions asked, the replies given and the level of understanding achieved by the time the consent was eventually given.
Any consent should include the following:
- The purpose of the treatment
- The nature of the treatment
- The likely effects and consequences of the treatment
- Risks, benefits, limitations and possible side effects
- Alternatives and how they compare
- Costs involved & any potential future costs for maintenance or complications
“As we can see, the cornerstone of a correct consent process is effective communication.”
Many dentists hold the firm, but mistaken belief that they have secured proper consent by obtaining the patients signature on a consent form. This in no way means that the patient has understood or accepted the treatment, and the quality of consent can never be determined solely by a signature.
An excellent method to see if the patient has understood all the above is to ask them to explain it back to you. Once this has been done and the patient has been given the opportunity to ask questions, then this should all be documented. So, the records should accurately and sufficiently reflect the details of the communication process. They should allow you to demonstrate many months or years from now what information was given to the patient.
As well as consent being specific, time should also be given to the patient to consider the treatment options.
Regarding the last point, what I do at the consultation appointment, after an Examination, is that I go over the general points that need to be discussed with every patient. These would include IPR (in crowded cases), Decalcification, Compliance, Retention & Relapse (showing pictures of what a fixed and Essix retainer looks like), Pain, Bite, Root resorption, Approximate Time & Cost, not forgetting how often they need to attend.
I would use intra and extra oral photographs of the patient displayed on a screen to explain the problem and in which direction the teeth would move to achieve the solution. Not with the patient supine and with a mirror in their hand.
Then impressions or a scan of their teeth are taken and an appointment is made a week later to discuss specific points for that patient. This is done with the help of CONFIDEX™ for Six Month Smiles.
The general consent form would be then given to them to read over to make sure that they fully understand it at the comfort of their own home and can ask questions on anything they don’t understand on the next appointment a week later.
Here we can discuss the IPR in terms of where, when and how much will be carried out. A video simulation of the predicted tooth movement can be shown to the patient so that they can visualise the result. This may show any black triangle creation that can be addressed. If any auxiliaries will be required like elastics, power chain, lingual buttons.Will bite guards be needed? The exact cost can be determined along with the exact treatment time. Compliance, Retention & Relapse, Pain, Bite Issues & Root resorption.
To make sure that the patient has understood this I would ask them to explain it back to me and then document this.
A letter then goes out to the patient and it starts by saying, “this is a written record of the discussion we have had…”
The fee breakdown is on a separate sheet of paper with various payment options that the patient can decide upon. This is then signed and returned. Only when we have this do we Approve the CONFIDEX™ and the Indirect Bonding Trays start getting manufactured.
I find that by using the above method, not only does the treatment progress smoothly as the patient is more aware of everything that is happening during the treatment and there are no nasty surprises, but the patient is much more likely to accept the treatment plan as you are building a more trusting relationship with the patient from the word go by involving them fully in all the decision making.