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.

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.