Communication, Consent & Clinical Considerations in Dentistry

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.