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DARDS


Retraction cord or equivalent material Other slightly sloppy habits we can get into include failing to use retraction cord, or an equivalent, if needed during crown preparations with inevitable resultant poor margins and poor fi t of restorations. This might not prove problematic for a year or two but patients are likely to remember how much they paid for their crowns and expect them to last.


Matrix bands Wedging matrix bands is another technique that can often become a distant memory of dental school. This easy and quick method helps ensure a decent profi le for restorations and stops your toes curling with embarrassment when you have to report on your bitewings and comment on that blob of amalgam clogging up the interproximal areas!


History Don’t forget to check medical histories at each appointment. It’s really easy to get sloppy over this one but many patients have medical histories that need careful handling. It’s at best embarrassing to be called by the local pharmacist to say you’ve prescribed penicillin to an allergic patient and at worst downright dangerous. And don’t wait until you’ve extracted a couple of huge molars to discover that your patient is on warfarin or bisphosphonates.


Non-clinical issues Not all problematic sloppy habits relate to clinical work. Other common causes of patient complaints concern the fi nancial side of dentistry. It’s an important requirement that


patients receive a treatment plan and an estimate of their treatment costs. Any estimate should be clear as to whether charges are for private or NHS work. Without a clear plan and estimate in place, there is scope for confusion or even disagreement once treatment is completed.


Dental records Another recurring issue is dental record keeping. Indemnity organisations are always banging on about this, but it’s true to say that if it’s not in the records then the assumption is you didn’t do it. Memories fade and the only way to be sure of what you did and didn’t do is to write it down. Don’t get sloppy with your records – take a note of what you discussed with the patient, particularly if the treatment is complex or expensive; record the options you discussed and record what warnings you have given to the patient concerning likely prognosis of treatment. If things go wrong with treatments, and occasionally they will, tell the patient and make a note in the records that they have been informed. The most important advice when considering cutting


corners is to ask yourself if you are changing your practice for the benefi t of the patient or for your own fi nancial or other benefi t. And you know what my next piece of advice will be… if it’s not for the benefi t of the patient then it’s not the right thing to do. So don’t rush to forget everything they taught you in dental school and perhaps consider enrolling on a rubber dam course instead!


Claire Renton is a dental adviser at MDDUS


“There is no defence for a swallowed fi le during a root canal with no rubber dam in place“


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