At the risk of stating the obvious, any investigation or treatment of a patient should only be prescribed by an appropriate GDC registered dental professional, working within their scope of practice, who has examined the patient and determined the need for the investigation or treatment.

It also requires informed patient consent, which involves giving the patient enough information to let them to make an informed decision on whether to go ahead.

But obvious or not, issues can still arise, so it's helpful to know what you can do to minimise the risks.

Background - GDC Scope of Practice and illegal practice

The GDC's Scope of Practice sets out the roles for each registrant group. Apart from dentists, only clinical dental technicians, dental hygienists and dental therapists can examine patients and plan treatments, within their training and competence.

The GDC can and does bring disciplinary actions against registrants who exceed their Scope of Practice, or knowingly allow others to do so. These can end up in a public fitness to practise hearing, with the dental professional's registration at risk.

The GDC also brings prosecutions for the illegal practice of dentistry, which is defined in the Dentists Act and is restricted by law to registered dental professionals working within their scope of practice.

The emergence of new special tests

In recent years dentistry has enjoyed an explosion in sophisticated technology, with new methods of investigation and treatment available that have transformed the way dentistry is delivered.

However, any special test should be an aid to diagnosis, and never an end in itself. It should follow a clinical examination of the patient, be prescribed by the examining dental professional, and only be provided if it is appropriate, necessary, in the patient's best interest, and with the patient's informed and expressed consent.

Special tests, such as radiographs and intraoral scans, should never be carried out routinely on all patients or groups of patients, and never simply because the expensive equipment involved is available in the practice. It is important that you can justify every test and investigation in terms of patient need - which might be different from what the patient wants.

Only dental professionals can prescribe special tests and formulate dental treatment plans, based on their clinical findings and investigations. The patient then has the right to either accept or reject the proposed investigation or treatment, having been given sufficient information about it.

Consent

The GDC's Standards for the Dental Team states that dental professionals must have valid consent before starting any investigation or treatment, and that discussions that take place during the consent process are documented, usually in the clinical notes.

Consent to an investigation or treatment can only be obtained by an appropriate dental professional, working within their scope of practice, who has clinically examined the patient and has the necessary knowledge to give the patient with full explanations and any warnings.

This means that patients shouldn't undergo special tests, such as radiographs or intraoral scans, as a matter of routine before seeing a dental professional for examination.

Example

The principles set out above apply more widely than might be expected. For example, a clinical photograph is wholly non-invasive, but its purpose should still be justified to a patient, and their consent obtained to taking it and to how it will be used in future.

Any such image becomes part of the clinical record and should be securely stored, in accordance with the practice's information governance policies and in line with GDPR/the Data Protection Act 2018.