Generally speaking, photographs provide an extremely useful record of the clinical situation. Not only do they show the shape, size and position of various teeth, but they also record the patient’s clinical condition, gingival status, oral hygiene, etc. What photographs are not good at, however, is reproducing the precise colour of the teeth and therefore they cannot be relied upon for shade matching. Many dentists find it useful to take a photograph of the teeth, prior to undertaking bleaching as it does allow them to produce a ‘before and after’ comparison. This often helps the patient realise just how much the colour of the teeth has improved during the bleaching treatment.

For a more precise colour record you could include the relevant shade guide tab alongside the teeth both before and after treatment to demonstrate that a change in colour has occurred. However, because of the variables in creating and viewing the image, the result should be interpreted with caution.

There is no legal requirement to take a photograph prior to starting a bleaching procedure, but since they can provide a useful addition to the clinical records they are to be encouraged. The photographs should be stored within the clinical record (on paper or in a digital format on the computer) along with details of the patient’s name, date of image and an indication of what it shows (ie, pre-bleaching).

Click here to see our position statement on tooth whitening.

Also, would I need to do this if I was visiting a nursing home with its own supply of emergency drugs?

When carrying out home visits for patients, you should make every effort to ensure that the patient will not be disadvantaged by having treatment carried out in an environment which is not a normal dental practice.

Consequently, you should always carry emergency drugs and oxygen, etc. If visiting a nursing home that has its own drugs and portable oxygen, it would be reasonable to accept that situation but always to ensure that the drugs are in date and adequate for emergency purposes.

Furthermore, I have been working without realising that my registration had lapsed and I have now requested a restoration form – is it okay to continue working in the meantime?

Carrying out the practise of dentistry or the business of dentistry when one’s name is not included in the Dental Council Register would be considered to be the illegal practice of dentistry under the provisions of the Dentists Act 1985. It is also a criminal offence. The purpose of having a Register is to reassure members of the public that the names of dentists and DCP's who appear in the Register are not only qualified but are also regulated by the Dental Council. 

It is imperative that, until your name has been restored to the Dentists Register, you do not carry out either the practise of dentistry or the business of dentistry. In addition to this, you need to be aware that whilst your name is not included in the Dentists Register, you cannot be indemnified. However, should a claim arise in relation to the advice and treatment that you provided during the time when you were practising without being registered, you may apply to Dental Protection for assistance. Dental Protection is a mutual organisation which means that it has the discretion to offer assistance if it considers there to be extenuating circumstances which contributed to your situation. However, this would need approval from the Board of Directors.

In the meantime you should ensure you have made the appropriate arrangements for the care of your patients. It is also important that you take all steps to have your name restored to the Dentists Register as soon as possible. This is not an automatic process and the application form requires you to enclose a letter setting out the reason why you were working as a dentist during the time you were not registered with the Dental Council. You should contact Dental Protection for assistance in relation to this.

The Dental Council takes the view that the onus is on the registrant to ensure that their registration is continuous. It is also the registrant’s responsibility to check that their application for renewal has actually been processed. Being unaware of lapsed registration is no excuse in the eyes of the Dental Council and the law.

Statistically speaking most dentists will receive at least one such letter in their working life. This does not mean that standards in dentistry are falling! Rather it means that patients are becoming more litigious and it is relatively easy for a patient to seek and obtain legal advice.

Dental Protection is aware that certain firms of solicitors have recently been approaching our members directly; even after having been advised that we are acting on behalf of the dentist concerned, and demanding that the original clinical records should be supplied direct to the firm in question, often within a very short time scale.

Members should immediately contact Dental Protection for advice if this happens and we will take up the communication on your behalf with the solicitors concerned. You should resist the temptation to contact the patient or to provide the patient’s solicitors with an explanation or the patient records. Instead you should send a short acknowledgement to the solicitors confirming that their correspondence has been passed on to Dental Protection. 

When writing to Dental Protection, you are asked to provide the following details:

• Your full name, address, qualifications and current daytime and evening phone numbers. Include fax and email address if relevant and indicate any preference you have regarding how, when and where we should communicate with you, bearing in mind any confidentiality considerations.
• Your MPS membership number (you will find this on your membership certificate).
• The name, age, gender and occupation (if known) of the patient.
• The full names of any other clinicians involved so they can be accurately identified.
• The date(s) and details of your personal involvement in dealing with the patient – symptoms, signs, investigations and treatments, as a plain factual narrative.
• The original records with the authors of entries identified. If the records supplied are not those which were made at the time in question, or if any entries have been added or amended more recently, it is important to make this clear to Dental Protection when you send them to us.
• It is often very helpful if an accurate transcript of the records is provided, visit by visit, to explain any entries on the record card which are unclear for any reason.
• Any radiographs, photographs, study models or other parts of the overall record which are relevant to the case.
• Due care should be taken to ensure the safe transit and security of these valuable records when sending them to Dental Protection. We will acknowledge safe receipt of such records.
• Please provide your written consent to the disclosure of copies of the records.
• The correspondence from the solicitors.

In order to protect your position, our solicitors will contact the patient’s solicitors confirming our interest on your behalf. From that point onwards the patient’s solicitors should correspond directly with Dental Protection and you should receive nothing further directly from them. However, if you receive any further correspondence from them, do please let us know.

The patient’s solicitors may take some time to investigate the claim. We will keep you updated as to any developments and you may also contact Dental Protection for an update when you wish.