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Ask Dental Protection

We receive hundreds of enquires every week, and we publish some of the frequently asked questions on this page. These may not always provide the complete answer in your own situation, and members are invited to contact us for specific advice.
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  • Q
    I have elderly patients who come to me privately but who are eligible to receive free NHS prescriptions. I have been asked several times if I can provide them with an NHS prescription. It seems such a reasonable request.
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    03 March 2015
     An NHS prescription can only be written for a patient who is receiving an NHS course of treatment or treatment of an urgent condition under the NHS. If any of your patients are being treated on a private basis, and they require a prescription-only medicine, this must be prescribed on a private basis or dispensed at the practice.

     
    It is important when dispensing medication that the appropriate records are kept of the drugs dispensed and dosage, etc.

    Dental Protection has produced a risk management module – Drugs and Prescribing – which provides risk management and generic advice on prescribing in practice. This is available to members from our new Prism e-learning library [internal to Prism page].

  • Q
    Why should I explain my infection control procedures to patients?
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    10 February 2015

    Patients are likely to be a lot more aware of infection control issues following the recent publicity surrounding a look back exercise involving 20,000 dental patients in the UK. If the cost of their dental care increases, patients are likely to be more critical in their choice of dental care provider. Choice and quality are two of the most important components of consumerism.

    Patients who have come to appreciate the steps that are being taken by a practice to ensure their safety will be far less likely to move to another practice where it is not immediately obvious that the same standards of infection control apply.

    Many of those patients who move from one practice to another never tell the original practice why they have left. They often have unspoken concerns and dissatisfaction and these can include doubts over infection control and the quality of care generally. A visible infection control policy and a willingness to explain to patients what is being done for their safety, and why, can address concerns and reinforce the patient’s decision to stay with the practice.

    A deliberately high-profile and visible commitment to infection control can also help to justify a patient’s perception of value, especially if they have just agreed to pay privately for their dental care.

    There are many different ways to get the point across – a poster in the waiting room or a page on your website can outline the basic principles. You can also reinforce the message every time you open bagged instruments from the steriliser or a new set of instruments by mentioning that they have just been sterilised. Disposable, single use items can also be pointed out to patients instead.

    It is paradoxical that patients may be questioning standards of cross infection control in dentistry at a time when they are generally higher and safer than ever before.

    Topics of inadequate infection control make good stories and help sell newspapers. Take the initiative and get your own story out there first.

    With the help of the rest of the dental team, share the evidence of your own infection control measures with patients before they even have to ask. Whether it is new gloves or the large quantity of disposable item that are used – each of these topics can be turned to a marketing advantage. 
  • Q
    I am a hygienist with a Diploma in Dental Hygiene and want to print some business cards. Can you advise me please?
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    10 February 2015

    The General Dental Council’s advice indicates that however a clinician is being promoted, either inside or outside of the practice, the wording of that promotional material must be legal, decent, honest and truthful. Business cards would be regarded as promotional material and therefore must comply.

    Assuming that your Diploma in Dental Hygiene has been registered with the GDC, you are entitled to use the shortened version of this diploma on your business cards. Similarly, if you have any additional advanced qualifications (BA, BSc, etc.), these may be included too. However, you need to be careful not to potentially mislead patients by including details of qualifications that are unrelated to dentistry.

    It would also be advisable to indicate that you are a dental hygienist as part of your job title, simply to avoid any misunderstanding.

  • Q
    The practice owner has told me to economise the use of local anaesthetic by using it only in those cases where the patient will be in extreme pain. How can I decide what I should do?
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    13 January 2015

    Most patients have an expectation that their dentistry will either be pain-free or that any pain will be managed effectively. Therefore, the provision of a local anaesthetic for a given procedure will initially involve a discussion with the patient about the nature of the procedure being contemplated and what they may expect.

    This is an issue of consent. As a clinician, you should not impose your views and provide treatment without local anaesthetic simply because you have considered the matter (as requested by the practice owner) and concluded that the procedure will not be painful and does not require local anaesthetic. It is incumbent upon clinicians to respect patient autonomy and an individual’s right to make decisions about their treatment and this would extend to a decision about local anaesthetic.

    In any case, the patient’s medical history initially needs to be checked and updated before considering the type of local anaesthetic to be administered.

    Our advice booklet on consent is available here 
  • Q
    I work for a trust and one of my patients died unexpectedly. Can I assume the barrister for the Trust will represent me at the inquest?
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    08 January 2015
    The barrister will have been instructed by the Trust's solicitors to protect the Trust's own position and its interests. It may be that questions will be asked at the coroner's inquest about the role of the theatre or nursing staff who were responsible for the deceased's care. The barrister will normally be instructed to deal purely with the reputation of the Trust and other members of staff and may not be there to protect your own position particularly if there is a conflict between you and the Trust about the events leading up to the death of the patient.

    In cases like this, Dental Protection’s solicitors have instructed an experienced barrister to work with our solicitors, the dento-legal adviser and the consultant to prepare for the Inquest. The barrister would normally attend the Inquest and look after the interests of the consultant oral and maxillofacial surgeon during the hearing, especially where the consultant’s care of the patient is likely to be subject to detailed investigation by the coroner and/or the deceased’s family.

  • Q
    I have not paid my GDC annual retention fee. Can I still treat patients?
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    05 January 2015

    The Dentists Act requires that the ARF is paid in full on or before 31 December (for dentists) and there are no exceptions. Continuing to practise or to have an interest in the ownership of a practice while unregistered would be the illegal practise of dentistry and/or unlawful involvement in the business of dentistry and could in both respects result in a criminal prosecution and invalidate any professional indemnity held by the dentist in question.

    You will need to stop working and apply to the GDC for the restoration of your original registration . This involves providing a character reference and a health declaration. It is likely that processing an application for restoration will take some time, and you should make appropriate arrangements for the care of your patients in the meantime.

  • Q
    My practice principal and I belong to a different defence organisations. He told me I need to join his organisation because my dental nurse will not have access to indemnity when I'm supervising her. Is that true?
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    02 December 2014

    No, it certainly isn't true. A dental member who is working in general or specialist dental practice could be held to be vicariously liable for the negligent acts and omissions of a dental nurse working under their direction and supervision, even if they are not the actual employer of the dental nurse.

    What makes our approach different from that of other defence organisations is that we offer several categories of membership in which an employer/practice owner can provide access to indemnity for 10 full-time equivalent registered dental nurses or dental technicians employed by them in respect of negligence claims, whether or not they are working with them or directing/supervising them at the time of an adverse incident. We believe this flexible approach is fairer to practice owners, associates and dental nurses alike.

  • Q
    Are there any limitations in the role of a treatment co-ordinator if the individual is not registered with the General Dental Council?
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    01 December 2014

    Some practitioners use the services of a treatment co-ordinator to provide the patient with information about their treatment and to answer their questions, although it would still be for the dentist and treating clinician to obtain consent rather than another member of the team. For obvious reasons, the treatment co-ordinator would not be in a position to provide any clinical advice.

    The role of the co-ordinator can sometimes be helpful in showing patients information about various treatment options which have already been discussed with the dentist. A treatment co-ordinator usually has more time to spend with the patient and some patients are more inclined to ask questions of a treatment co-ordinator than they are to ask questions of the dentist. However, there may be other patients who do not want to discuss any aspects of their possible treatment with anyone other than the dentist.

    If a patient brings a civil claim in negligence, a lack of detailed contemporaneous records of the consent process may mean a claim that could otherwise be defended has to be settled.

    Any practitioner planning to use a treatment co-ordinator will need to work closely with them to ensure there is no potential for miscommunication or misunderstanding and that everyone is aware that the ultimate responsibility for taking the patient appropriately through the consent process lies with the treating practitioner.

    Find out about the benefits of DPL Xtra, our practice rewards programme that takes a team approach to dentistry and offers risk management education for all team members. Practices subscribing to DPL Xtra receive a range of free and discounted risk management material from Dental Protection and leading providers such as Croner and schülke. Since the purpose is to lower your risk, team members in a practice which subscribes to DPL Xtra will receive free or discounted individual membership.
  • Q
    Can I take pictures of patients with a camera phone and send them to colleagues/specialists for an opinion or advice?
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    25 November 2014

    While it is tempting to capture various intra-oral situations with a handheld mobile camera phone, it is important to appreciate that the making of that image creates a record. This electronic record has the same quality of confidentiality as all other records and should be managed accordingly.

    Can you be sure that only the intended recipient will see the image? Unless there is encryption software on the phone, confidential material could be available to anyone who accesses the device especially if it is lost or stolen.

    The images, even on high resolution camera phones, may not be sufficient to make a diagnosis and may even lead to misleading advice being given. There is also the issue of storage since as a record it will require the same degree of permanence as other records. It cannot therefore simply be deleted.

  • Q
    My colleague says there is no requirement to undertake CPD every year and is prepared to do it all within the last six months of her five-year cycle. Can you reassure me on this subject?
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    18 November 2014

    The General Dental Council’s requirement is that registrants undertake a set amount of CPD within a five-year period and therefore if that registrant wishes to undertake all of that CPD in the last six months, then he or she is perfectly entitled to do this. That is not to say, however, that such an approach would be wise as this is an awful lot of CPD in a very short period of time. Simply trying to find courses that cover the core subjects within this brief window of opportunity might well be difficult. 

    Undertaking CPD in this way is not within the spirit of the GDC’s advice. Some patients might be alarmed if they knew the treating clinician held this view and was likely to be somewhat out of date at a given point in time.

    The role of the hygienist has changed significantly over the last few years and is likely to do so again. Your hygienist colleague is likely to be a long way behind the times and the provision of her treatment might well suffer accordingly.