The scene

A DDU member called the advice line after seeing a patient who was complaining of pain stemming from three teeth. The member had examined the patient and taken X-rays, which had revealed some slight recession but nothing otherwise abnormal.

Despite this, the patient had become quite distressed about the pain they were experiencing and had demanded the member immediately extract the three teeth in question. The member was adamant this wasn't the right course of action, but wanted advice on how to proceed while acting in the patient's best interests.

DDU advice

The DDU's dento-legal adviser (DLA) reassured the member that they were right to act in the patient's best interests, and reminded them of the need for all treatment to be sensible, reasonable and in line with current accepted practice and teaching.

The adviser also pointed to the GDC's Standards, which says that as well as providing patients with treatment that is in their best interests, dental professionals, "may need to balance their oral health needs with their desired outcomes." In this case, the patient's desire to have three of their teeth extracted - unnecessarily, in the member's opinion - wasn't compatible with what the member felt was in their best interests, so therefore the member should decline to provide the treatment requested.

Rather than simply declining, however, the DLA advised the member to consider offering the patient a second opinion, which could help them better understand their options, the reasons for treatment (or, as in this instance, for not being treated) and be more confident about the eventual outcome.

As ever, the adviser also counselled the member to make full and complete records of all the discussions with the patient and the advice given, in the event their decisions were ever scrutinised.