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Talk 'risk factor' with patients

Dental professionals advised to fully explore expected outcomes and risks of a procedure with patients before beginning a course of treatment

The advice arises as a result of a study of 415 complaints notified to the Dental Defence Union (DDU), of which over a third of cases (174) arose because patients felt their treatment was unsatisfactory and were generally dissatisfied with the outcome.

The analysis, which appears in the latest DDU Journal, looked at complaints notified in the first quarter of 2013. The most common treatments with which patients were dissatisfied were the fitting of a crown (35 cases), fillings (30 cases), ill-fitting or broken dentures (22 cases), root canal work (17 cases) and orthodontic treatment (13 cases).

Along with dissatisfaction about treatment, the other common reasons for complaints included:

• Failed/delayed diagnosis, most often of dental decay (60 cases)
• Communication/rudeness (50 cases)
• Fees/charges (18 cases)
• Adverse incident during treatment (14 cases)
• Adverse reaction (10 cases).

DDU dento-legal adviser Debbie Herbst, who conducted the analysis, said: 'While a few of the complaints about unsuccessful treatment were due to a technical failure of the treatment provided, many were due to the patient not fully appreciating what to expect from the outcome.

'It's important to check patient's understanding and to manage their expectations accordingly, before starting treatment. Such discussions should be recorded in the patient's records.

'If a complaint arises, it is important to provide a professional response which clarifies the treatment provided, responds to the points the patient has raised and apologises if the patient has been inconvenienced or distressed.

'If something has gone wrong, it's important to explain what steps will be taken to prevent it happening again and it may help to offer a goodwill gesture, such as a full or partial refund. In the DDU's experience, most complaints are resolved locally by the practice in this way.'

The vast majority of complaints in the study were against dentists (405) with only 10 complaints being made against other members of the dental team, most commonly hygienists.

'It will be interesting to see if direct access has any effect on the professionals involved in complaints in future years,' said Ms Herbst.

Nearly a fifth of the cases (70) were against newly-qualified dentists, including two cases where the dentist had been carrying out root canal treatment. The DDU advised newly-qualified dentists not to attempt treatments outside their competence.

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