As is the case with any new patient you take on, so long as you are in the correct grade of membership to reflect the scope of your practice (eg if you are a general practitioner treating patients with implants, or continuing orthodontic treatment, then you are in the appropriate SP grade), you can request help or assistance from Dental Protection if needed. 

When you take over the care of a patient, you are not taking over liability for past treatment, however you are responsible for all treatment going forward. If the patient was mid-way through a course of treatment with a previous dentist - for example, fitting crowns or dentures that had already been constructed - then you would need to be sure that the preparations on the teeth or dentures was of an appropriate standard before you continued with the treatment. If you have any concerns with the existing preparation, then you should amend or remake as needed. If you proceed with the existing treatment, you are accepting that it is of an appropriate standard.  Similarly, if you do not agree with the pre-existing treatment plan, you will need to amend it and proceed as you see fit, as it will be your responsibility from that point forward. 

The importance of good communication with members of the public who attend your open day cannot be overestimated. They should be made fully aware of the nature and limitations of the examination which is to take place both verbally and perhaps more usefully in written form.

Since there are a number of techniques which serve as an adjunct to visual examination, and which may show up an early abnormality, patients should be advised of the scope and limitations of your examination depending on the technique you are proposing to adopt.

Members of the public who agree to an examination of their mouth should be taken through the consent process before they are examined. They should be reminded of the scope and nature of your examination and whether you will be carrying out a full examination of their teeth and the gingival tissues.

They should also be made aware at the outset that they may have to provide a medical history as well as a social history which may provide markers for an increased incidence in oral cancer. All this information should be documented in a clinical record for each person you examine. The record should also include personal details such as their name, address, date of birth, etc, together with the results of your examination, which should note both positive and negative findings. The records should be retained in the usual way. If you are using a special examination form this is part of the records and should be retained in the usual way.

Your duty of care to each person you examine extends to whatever was agreed to be the nature of your examination – hence the importance of defining any limitations at the outset. It would also be desirable to advise patients of the importance of seeing a dentist on a regular basis, especially if they fall into a high risk category.

In the event of you discovering a suspicious lesion, you will need to discuss with the patient how this should be followed up, stressing stress the importance of referral to a specialist and the need to involve their doctor and also their current dentist (if they have one). A clinical photograph is often helpful to demonstrate the area of concern. In preparation for the open day you should identify the most appropriate referral pathway for your area.

From a risk management perspective, you should look for ease of printing all relevant patient record information, ideally with a single click. Many current computer systems do not easily print out the whole record. It is also important to be able to print out historical information, such as earlier dental charts and periodontal records.

Many systems currently only print out the most recent chart. As well as the accurate chronological reproducibility of the complete patient record you might also want to consider the ability to print out individual patient treatment plan summaries and pricing that can be offered to the patient to sign at the time of the initial examination.

In addition the system needs to back up to a remote site to ensure data can be restored following an unexpected system failure or service interruption.