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Communication, Consent & Clinical Considerations in Dentistry

Date: November 3 - 2021

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As dental professionals we convey a great deal of information to our patients in what can be short appointments. The importance of obtaining informed consent from our patients is drilled into us all from our first days at university. As such, we may feel the need to cover all facets to educate our patients about their oral health and prescribed treatment plans to provide adequate information for patients to consider. However, this can run the risk of bombarding the patient, oversaturating their ability to retain and process the information conveyed, and potentially confuse them with dental terminology and jargon. Further to this, we can run the risk of ignoring financial, geographical and time barriers for patients in accessing dental care.

Key considerations for informed consent

The Australian Dental Association’s Guidelines for Consent for Care in Dentistry (2020) provides thorough and in-depth advice around the components of obtaining informed consent in dentistry. The key considerations dental professionals should consider in providing adequate information to their patients are:

  • Be sure to present the information in a manner understandable to the patient. Avoid using dental terminology. Consider their ability to interpret information and identify any specific factors which may impair this (hearing and/or vision impaired, reduced levels of literacy, cognitive impairments, cultural or language differences).

  • Allow sufficient time for the patient to reflect upon information provided and respond. Encouraging the patient to ask questions can ensure that a comprehensive understanding is achieved between the patient and practitioner.

  • Make sure to discuss any relevant findings, the nature of the condition, and its prognosis . Ensure discussion is had around any proposed treatments, investigations, diagnosis, likely outcomes, and any risks/consequences/adverse outcomes associated with refusal of care or acceptance of treatment options. Clinicians should aim to approach discussions with empathetic consideration of patient questions or concerns.

  • Financial consent: A discussion around the cost of treatment plans should be had with patients. If costs of the preferred option are prohibitive, clinicians should discuss alternative treatment options which are available.

  • Number of appointments required : As part of presenting a patient’s treatment plan, the number of appointments required should be advised in addition with a recommended recall/review period. Dental professionals should consider the impact taking leave from work for appointments may have upon their patient. Factors such as loss of income, any caregiving arrangements (i.e. young children, elderly parents, care of a family member with physical or cognitive impairment), travel time and distance to access care (especially for rural practices) may impact on a patient's ability to attend for care.

Overall, conveying information to patients in a manner they can easily comprehend will enable a better understanding of their dental treatment. Consideration of language, culture, and impairments can help avoid confusion. Communicating proposed investigations, treatments, as well as likely outcomes, including any possible risks/consequences/adverse events can help patients make an informed decision about their dental health. And finally, paying attention to the costs, in both expenses and time to be invested by the patient in attending the clinic to complete care, should be factored in, with appropriate strategies implemented to minimise the impact on their lives.

References

Australian Dental Association 2020, ‘Policy Statement 5.15 – Consent to Treatment (Including ADA Guidelines for Consent for Care in Dentistry)’, ADA Policies, viewed 25th October 2021 https://www.ada.org.au/Dental-Professionals/Policies/Third-Parties/5-15-Consent-to-Treatment/ADAPolicies_5-15_ConsenttoTreatment_V1

About the Author:

William 'CJ' Carlson-Jones is an Oral Health Therapist currently working part-time in private practice across rural South Australia and at the Adelaide Dental School providing clinical tutoring with the University of Adelaide. Completing his Bachelor of Oral Health and Graduate Certificate in Oral Health Science both from the University of Adelaide, CJ is currently undertaking a Master of Business Administration with aspirations to facilitate accessible, high quality dental care for all Australians. He is the Director of Finance for the Australian Dental & Oral Health Therapists’ Association (ADOHTA) and is a strong advocate for a team approach to dental care. He is a founding representative on the Colgate Advocates for Oral Health: Editorial Community.