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Common dentolegal queries

  • Q
    Who owns a denture that is yet to be paid for?
    01 September 2015

    Generally speaking, the ownership of any item of dental treatment passes to the patient at the time the appliance is fitted. This is, however, not always the same time as the treatment is completed. It follows then that during the various stages of denture construction, a denture itself still belongs to the clinician.

    Once it is fitted, however, the patient then owns that denture, irrespective of whether or not a fee has been paid. Before demanding the outstanding fee, it is wise to check that the patient is happy with the denture. Allow them to express any dissatisfaction they may have and deal with this before deciding if you want to pursue the fee.

    If the situation cannot be resolved, you may want to acknowledge that no fee has been charged and leave the denture with the patient as gesture of goodwill, to potentially mitigate an escalation of the patient’s dissatisfactions.

  • Q
    When an orthodontist refers a patient back to me to extract healthy teeth as part of their treatment plan, can I decline and ask them to carry out the extractions themselves?
    25 August 2015

    Removing teeth for orthodontic purposes is very much part of what a referring dentist would be expected to do. Whether it is fair or not, the patient’s own dentist would normally be expected to provide any extractions requested within an orthodontic treatment plan.

    It may well be that you have a colleague who would be happy to carry out the extractions on your behalf. To expect the patient to see another practitioner simply because you are refusing to provide this service may be considered an inconvenience and could possibly even stretch to being a breach of contract if the extractions were associated with NHS treatment.

    To withdraw from providing a particular form of routine treatment may not be considered reasonable and in any of your patients’ best interests. Extractions would be considered part of mainstream dentistry and you should not decline to provide this element of treatment that is also in the best interests of the patient you originally referred.

    If you are uncertain about the reason for the extractions, you may wish to clarify this with the orthodontist.

  • Q
    How should I respond to a negative comment about me that has appeared on the NHS Choices website?
    18 August 2015

    An adverse comment placed on a website, be it NHS Choices or the practice’s own website can be upsetting, especially as it sits in the public domain for anyone to see.

    With regard to an adverse post left on NHS Choices, the website does have the advantage of allowing the practice to post a response. Whilst there is no requirement to respond to posts on this website and indeed it would be inappropriate to respond to a complaint in this way, it is advisable that a practice responds to such posts with a simple acknowledgment of the comments made and an invitation to the patient to make contact with a named person to discuss their concerns ​directly. This reassures both the patient who made the post and any other patients, potential patients and any others reading it that the practice takes patient feedback seriously and is keen to learn from patient experiences and to improve the service they offer. A suggested response is:

    Dear [name],
    I am sorry to read your comments posted on the website on [date] and to learn that you are unhappy with the service you received from the practice.

    We value patient feedback and welcome the opportunity to investigate and respond to any concerns. I would invite you to contact [named person] so we can fully investigate your concerns.

    I look forward to hearing from you.
    Yours sincerely

    Many practices have protocols for routinely reviewing posts left on NHS Choices and see them as an opportunity to improve services. Some practitioners also wish to thank those who have left positive feedback.

    A similar approach could be taken to comments placed on practice owned websites which have facilities for this, and sites such as Facebook. Practitioners could also consider inviting satisfied patients to leave positive reviews. These may be helpful in themselves and can also have the effect of balancing out and indeed outweighing any negative comments.

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