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regarding prior care, and you should avoid speculation. Finally, there is the perennial risk that your corrective treatment will


fail. Working from the time-honoured ‘if you touched it you own it’ principle, the patient may decide that you are liable for the entire problem. Obviously, you are liable for your own clinical standards. If errors have occurred at your hands, you must fulfil your duty of candour and aim to identify a practicable and equitable solution. However, bearing in mind the likely difficulties in trying to fix existing dentistry that is of a poor standard, the patient’s decision to complain, though regrettable, may have been unavoidable. If so, any complaint can often be resisted if the records confirm that material risks were identified and explained before treatment commenced.


why not (and carefully document your discussion) and advise them of their right to seek a second opinion.


Complaints It is fair to say that disappointed patients are more likely to complain. They may accuse their dentist of creating a treatment plan that prioritises commercial interests. If so, it is worthwhile providing further clarifications and reassurances. If these are not sufficient, you should be able to successfully defend a complaint provided you have made a comprehensive and logical assessment and taken thorough notes. Alternatively, patients who are alleged victims of negligence at the


hands of a previous clinician may decide to pursue a claim against them. In these circumstances you may be asked for a report in the expectation that it will support the patient’s case. This can place dentists in a difficult position. You do, of course, have a duty of candour towards the patient, but you should avoid criticising the actions of other clinicians unnecessarily. You should simply disclose the records upon receipt of a written patient request. You should not provide a written report


Conclusion Most adults will receive dental treatment at some stage in their lives and the majority will be completed to an acceptable standard. Deficiencies can arise through wear and tear, possibly augmented by the patient’s poor cooperation and a penchant for deep-fried Mars bars (other confectionary is available). However, there will be occasions when all has not gone according to plan. Caries may have been missed. Root filings may be short. Crowns may not fit. If a patient who has received this type of treatment attends your practice, the likelihood of disagreement and clinical complications is usually increased. Therefore, it is important to proceed with particular care. Communicate diplomatically yet with complete transparency regarding your findings. Do not be bounced into injudicious comment or treatment planning. If necessary, take time to reflect, talk to colleagues, seek second opinions and, of course, call an MDDUS adviser.


Doug Hamilton is a dental adviser at MDDUS and editor of SoundBite


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