1. Ensure you make communication a key feature of your work

Guild’s claims analysis suggests that poor communication is a feature in almost all treatment-related complaints. Patients don’t often complain specifically about poor communication. However, when an incident is investigated, poor communication is quite often a factor. Dentists must continually focus on their communication with patients, patient’s families where relevant, colleagues and other health professionals. Good clinical skills alone aren’t enough to make someone a safe and effective dentist.

2. Ensure there’s been an adequate assessment prior to treatment

Assessment before treatment seems like an obvious step. However, it’s not uncommon to see claims where the assessment hasn’t been thorough enough, leading to treatment that’s inappropriate or ineffective. The assessment shouldn’t be rushed, and details of the assessment and findings are to be recorded in the clinical record. Dentists must be sure they don’t make assumptions or fall into routines. Remember, poor assessment usually leads to poorly selected treatment.

3. Manage patient expectations

It’s important that patients have realistic expectations regarding their likely treatment outcomes. Unrealistic expectations are rarely met. Unmet expectations will often lead to patients being dissatisfied with treatment and more likely to complain. It’s the responsibility of the dentist to be sure a patient’s expectations are realistic before treatment begins. Dentists must remember that in most cases, patients won’t have the clinical knowledge and understanding they have. They should never assume a patient understands their treatment or what’s likely to happen post-treatment; there must be a conversation to ensure this understanding.

4. Be sure patients have given their informed consent to treatment

Patients must be given the opportunity to provide their informed consent to treatment before being treated. Informed consent requires a conversation between the treating dentist and patient about recommended and alternate treatment options as well as the benefits and risks for each of those options. Informed consent should include informed financial consent which is a discussion about the expected costs of treatment. Details about the consent discussion need to be recorded in the clinical record. Signing a generic form at reception prior to seeing the dentist is not informed consent.

5. Maintain adequate clinical records

Clinical records are a history and evidence of what took place, and they serve numerous purposes. They assist with ongoing clinical care, as no dentist can remember how they’ve treated every patient in every consultation. They also assist as evidence if a dentist’s treatment is questioned by a patient, regulator, or private health insurer. And finally, they’re necessary for meeting the expectations of the Dental Board of Australia (the Board).

6. Only treat within your individual scope of practice

All dentists should understand their own individual scope of practice. This isn’t just based on practitioner divisions within dentistry, but also an individual’s education and experience. According to the Board’s Guidelines for Scope of Practice document, “You must only perform dental treatment that you have been educated and trained in, and that you are competent in”. Therefore, when a clinical situation is outside a dentist’s scope of practice, they need to refer the patient to someone suitably qualified.

Dentists are expected to use their professional judgement to assess their scope of practice. To assist with this, the Board has created a reflective practice tool. This tool, and the Scope of Practice document, can be found at dentalboard.gov.au/Codes-Guidelines/Policies-Codes-Guidelines

7. Don’t be coerced into treating against your better judgement

There’ll be occasions when a dentist is asked to do something they don’t believe is in the best interests of the patient, such as when a patient is asking for a particular type of treatment which isn’t clinically indicated. Dentists need to be sure they use their professional judgment when deciding on treatment and not allow themselves to be convinced to do something that isn’t appropriate. They must remember that they’re responsible for, and need to be able to justify, their clinical decisions and actions.

8. Maintain infection control standards

Guild regularly sees complaints alleging a dental practice’s infection control standards are below the standard they should be. And what might be surprising is that these complaints are often lodged by patients, not just health professionals. Dentists and their colleagues must be sure they understand and adhere to the guidance provided by the Board. It’s also vital to ensure their knowledge and practice is current.

9. Adhere to advertising requirements

Ahpra’s expectations regarding advertising are explained in the Guidelines for Advertising Regulated Health Services document which can be found at ahpra.gov.au/Resources/Advertising-hub. There are numerous complaints continually being lodged with Ahpra alleging health professionals are breaching these guidelines. Dentists need to be aware these guidelines specify what’s required under the National Law and non-compliance is a criminal offence for which hefty fines can be imposed.

10. Know and adhere to all Ahpra requirements

As a health professional registered with Ahpra, it’s a dentist’s responsibility to make themself aware of what’s required. This means making the time to seek out and read the numerous codes and guidelines found on the Ahpra website (ahpra.gov.au). Some of these documents detail what’s considered best practice while some information refers to the law. Not knowing this information is no excuse for not adhering to it.