9 February 2010
Q. A new patient arrives at the practice late on a Friday afternoon with a loose crown. There isn't a dentist available to see the patient. Although the hygienist/therapist has completed the course for temporary dressing placement/ crown recementing. Should the hygienist treat the patient?
This is a fairly common ethical dilemma for many hygienists and therapists who, for one reason or another, find themselves working without a dentist on the premises. Sadly, patients do not choose the time when emergencies occur, and in many situations they simply turn up. What we do not know in this case, is whether the patient has attended the surgery simply for convenience or because quite genuinely no other emergency treatment is available. The latter is an unlikely scenario because emergency dental treatment is always available out of hours through the NHS Direct listed clinics.
For the hygienist or the therapist, the decision should be quite clear. The GDC's guidance clearly indicates that DCPs may only work to the treatment plan of a dentist and in this situation that treatment plan would simply not be available.
The DCP could possibly argue that the GDC's guidance also indicates that clinicians must act in the patient's best interest but it is difficult to see how that best interest would be served by a DCP undertaking an item of treatment for a patient they have never seen before. If they did provide that treatment, even in an emergency, and the patient suffered harm as a result (ie. an abscess developed over the weekend) then the DCP would likely be held responsible.
Situations however are rarely that black and white. If you find yourself in this situation and have any doubt at all, it would be wise to pick up the telephone to your defence society and obtain their advice.