Ensuring Proper Patient Consent

Patient consent is a fundamental principle of quality dental care, and it permeates all areas of treatment. Valid consent must of course be voluntary and patients must have the capacity to freely make their decision.

They must also be informed and have a thorough understanding of their dental situation and any proposed treatment. This requirement is the subject of much discussion and debate within the profession, particularly as it can be a highly subjective issue, and on a day–to-day basis is exceedingly time consuming. As a result, the patient’s right to self-determination is at the root of many problems in dental and medical ethics. Consent, or the lack of it, has become an increasingly common problem in negligence litigation, and ‘Fitness to Practise’ cases.

Indeed, the recent changes to the GDC’s Standards for Dental Professionals stands to highlight the importance of acquiring patient consent, and the process through which this should be done. An increased emphasis has been put on improving patient understanding, and documenting any conversations had with the patient about dental conditions and potential treatments.

While the concept of informed patient consent is, and always has been, an important issue in the dental profession, it often presents somewhat of a ‘grey’ area. After all, how much is enough information? And does the concept of ‘consent’ actually exist? A patient can withdraw their consent at any time during the treatment, so is consent absolute once acquired, or is it up to the dentist to demonstrate via robust note-taking? Not only does the practitioner need to inform the patient and provide proof that they did so, they then need to acquire consent with a signature based on the information delivered, to demonstrate the patient’s consent to proceed.

The most effective way to start on the road to acquiring consent is to provide a thorough outline, in a manner in which the patient can understand – an explanation of what the problem is, what treatment options are available, what the proposed treatment entails, and of course the main benefits and risks associated with the procedure(s).

Written treatment plans are paramount to the consent procedure, as is an engagement with the patient at every juncture and at every level. Tools such as animations of proposed treatments are extremely helpful, as are patient information leaflets. Inviting questions from the patient is crucial, and the fact that these questions have been asked and responded to are paramount.

In the rare (and worrying!) event that a patient requests no information, or fails to engage with their treatment plan, it is important to highlight that consent is an on-going process and that details are available to them at any time.

And following research with safeguarding professionals, it is recommended that if a patient fails to engage with a treatment plan, or give an indication to the dentist that there are any elements to their treatment that they fail to understand, that the dentist should, under no circumstances, commence treatment.

Such a situation should also be recorded accurately to show exactly what was said in order to protect the professional against potential complaints at a later date. Essentially, it is crucial that no assumptions are made and that the patient clearly understands their position.

Pricing is another area that can affect the integrity of consent, and so all possible treatment costs should be covered in detail before any procedures begin.

When treating children or patients who are unable to provide consent for themselves, the appropriate guardian or carer should be informed about treatment instead.

It is also important to record why one particular treatment was recommended over any other, making contemporaneous notes about the individual circumstances for the patient, and how this was communicated to them. 

Once all this is covered, it then becomes important to ensure accurate records are kept of every discussion. These documents should demonstrate how treatment was explained, what information was given and the indications that the patient gave to the dentist to show that they fully understood the proposed treatment plan. It is also crucial to note that consent does not just apply at a higher level of treatment planning, and the patient is required to consent every single time that the dentist lays hands on them!

Documenting thoroughly that the patient was happy to be treated at each appointment is absolutely paramount.

Despite the many uncertainties regarding this area of dentistry, it is obviously crucial that informed consent is sought for all treatment. Failure to do so can lead to severe consequences for the professional, which can be detrimental to their career.

Any patient who undergoes treatment without feeling adequately informed, has the right to make a formal complaint against their practitioner. In most cases these are claims of negligence, and if they reach the GDC they often come under the ‘Fitness to Practise’ bracket.

With a 44% increase in the number of such cases brought to the attention of the GDC in the last year, it has never been so important to ensure informed consent from each and every patient.

This is where innovations such as the SafeSeen Touch are invaluable – designed specifically to ensure practices are compliant and empowered to seek full, informed patient consent, the device offers a complete compliance suite. As a compact and portable tablet, it can be used to not only provide patients with information about treatments and aid communication, but also to record consent through convenient eSignatures.

Dr Ian Hunt, Clinical and Managing Director of Maple Dental Care Ltd says:

“Indeed the GDC directives make it important to get consent and a new medical history each time we meet a patient. It is one area where we generate a lot of paperwork, so I feel the device will enable our patients to check their own details, change anything that needs updating and then sign it there and then.”

No matter how long you have been working in the dental industry, what you specialise in or how many patients you see, it is crucial that you acquire the correct patient consent every single time. Modern technologies such as the SafeSeen Touch are available to help make your life easier, so can go back to doing what you do best, and focusing on your patients.

For more information, please contact Chloe Booth on 07825 201657 or email This email address is being protected from spambots. You need JavaScript enabled to view it.