3. ‘’I hated every single minute of training
but every time I till myself suffer today
and live tomorrow as a champion’’
Mohamed aly
05/01/15 easy way to pass exams
4. • Teaching is best when it’s about “helping
people learn rather than telling people what
you know,“
Harvard Graduate School of Education
Prof: Eleanor Duckworth.
05/01/15 easy way to pass exams
6. GDC
• It the regulatory body of the dental profession
• Rules:
Protect patients
Promotes confidence in dental professionals
Sets standards of dental practice & conduct
Assure the quality of dental education
Assure professionals are up to date
Helps pts. With complaints about dental professionals.
05/01/15 easy way to pass exams
7. GDC
• The GDC:
Eight dentist
four DCP
12 lay people
• Was set up in 1956
• Dentist can be entitled:
Dentist
Doctor
Dental surgeon
Dental practitioner
Specialist!!!!
maxillofacial surgeon !!!
05/01/15 easy way to pass exams
8. Registration in GDC
• Temporary registration...
• IQE vs. ORE.....[ILITS]
• Vocational training !!
05/01/15 easy way to pass exams
9. Continuing professional
development CPD
05/01/15 easy way to pass exams
For dentists
250 hs of CPD is a must over 5 ys
75 hs should be verified
Core subjects !!!
10 emergency, 5 infection control, 5 radiation protection
For DCP
150 credit hours over 5 years
60 credit hours should be verified
10. Ethics
• Role of dentist
• Role of therapiest
• Role of hygienist [nerve block, infiltration,
restore or extract]
• Role of nurse [x-ray, referral, rubber dam ]
• Role of technicians .....
GDC guidlines [scope of practice.....]
05/01/15 easy way to pass exams
11. Standards Guidance
General Dental Council
1)Standards for Dental Professionals
2)Principles of Patient Consent
3)Principles of Patient Confidentiality
4)Principles of Dental Team Working
5)Principles of Raising Concerns
6)Principles of Complaints Handling
05/01/15 easy way to pass exams
12. • Consent
• Confidentiality
• Breaking of confidentiality
• Keeping records
• Complaint
• Negligence
05/01/15 easy way to pass exams
21. Putting patients’ interests first and acting to
protect them
• You have an urgent and important meeting with your bank
manager about your house mortgage, but you also have a
patient in acute pain who has an appointment at the same
time. There is no other dentist available. Can you rebook the
patient?
• GDC Rule 1.1 states: Put patients’ interests before your own
or those of any colleague, organization or business.
If the patient put in a complaint to the GDC, it would be hard
to defend cancelling them.
05/01/15 easy way to pass exams
22. Putting patients’ interests first and
acting to protect them
• You are having a really busy day. Is it OK to
leave writing up the notes until the end of the
day, when you have more time to do it
properly?
• GDC Rule 1.4 states: Make and keep accurate
and complete patient records, including a
medical history, at the time you treat them.
Make sure that patients have easy access to
their records.
05/01/15 easy way to pass exams
23. Putting patients’ interests first and
acting to protect them
• A patient needs Root Canal Treatment on a difficult
upper molar, which you think might be too hard for
you. You recommend they see a specialist, but they say
they can’t afford it, and they really want you to do the
RCT on the NHS. What should you do?
• GDC Rule 1.3 states: Work within your knowledge,
professional competence and physical abilities. Refer
patients for a second opinion and for further advice
when it is necessary, or if the patient asks. Refer
patients for further treatment when it is necessary to
do so.
05/01/15 easy way to pass exams
24. • This is a common and very difficult situation in
NHS dentistry, due to the shortage of
specialists willing to work at NHS pay rates.
However, if you do the RCT despite knowing it
was beyond your ability and it fails, you could
be in trouble. If you refuse to do the RCT, the
patient may complain anyway. Their
complaint may not succeed, but it will spoil
your life for a few months or years.
05/01/15 easy way to pass exams
25. Putting patients’ interests first and
acting to protect them
• A patient has made a really unfair complaint against you,
when you have done your absolute best to treat them. Can
you tell them to go and find another dentist, and have
nothing more to do with them?
• GDC Rule 1.5 states: Give patients who make a complaint
about the care or treatment they have received a helpful
response at the appropriate time. Respect the patient’s
right to complain. Make sure that there is an effective
complaints procedure where you work and follow it at all
times. Co-operate with any formal inquiry into the
treatment of a patient.
• Even if you know you are in the right, or that the complaint
is simply malicious, you must follow this rule.
05/01/15 easy way to pass exams
26. Putting patients’ interests first and
acting to protect them
• You have retired from dentistry, and have no
outstanding complaints against you. Do you still need
indemnity insurance?
• GDC Rule 1.6 states: Make sure your patients are able
to claim any compensation they may be entitled to by
making sure you are protected against claims at all
times, including past periods of practice.
Before retirement, you must check that your insurer
covers claims that may arise after you have retired.
Some might want an extra fee for this, and some
include it automatically as part of their “package”
05/01/15 easy way to pass exams
27. Putting patients’ interests first and
acting to protect them
• You have placed a large posterior amalgam. The
patient asks how long it will last. You reply that some
amalgams have been known to last up to 40 or 50
years. Is this OK?
• GDC Rule 1.10 states: Do not make any claims which
could mislead patients.
• Although what you said is true, it could be taken as
misleading. You should add that you expect it to last
for (x) years, but there are many reasons for early
replacement etc., – that is, fully inform the patient.
05/01/15 easy way to pass exams
28. Putting patients’ interests first and
acting to protect them
• Your colleague and friend of many years has developed
Multiple Sclerosis, but is determined to keep working as long
as possible to financially secure his family. You notice that the
quality of his dentistry is worsening. What should you do?
• GDC Rule 1.7 states: If you believe that patients might be at risk
because of your health, behavior or professional performance, or
that of a colleague, or because of any aspect of the clinical
environment, you should take action. You can get advice from
appropriate colleagues, a professional organization or your
defense organization. If at any time you are not sure how to
continue, contact the GDC.
• It may be a tough decision, but to do nothing could put your own
registration at risk
05/01/15 easy way to pass exams
29. Putting patients’ interests first and
acting to protect them
• For years you have referred suitable cases to an
excellent implantologist colleague. She wants to thank
you by giving you a small fee for each future referral.
As a caring dentist, you know that you will not be
swayed or influenced by this. Should you accept this
arrangement?
• GDC Rule 1.9 states: Never ask for, nor accept, any
payment, gift or hospitality, or make or accept any
referral, which may affect or appear to affect your
professional judgment.
05/01/15 easy way to pass exams
30. • The key here is the words “appear to affect”.
While you may know that you are not
influenced, it may appear to others that you
could be, which might put your registration at
risk. You should politely decline.
05/01/15 easy way to pass exams
31. Putting patients’ interests first and
acting to protect them
• Each year, your dental lab sends you a large
box of chocolates at Christmas time. Should
you ask them to stop?
• A small Christmas gift is a common practice
with labs, and it would seem unreasonable
that your professional judgment would be
affected by this.
05/01/15 easy way to pass exams
32. Putting patients’ interests first and
acting to protect them
• You are out shopping at the weekend, and one of
your patients sees you and starts asking about a
toothache he is having. Can you say you are not
at work now, and they should book an
appointment for next week?
• GDC Rule 1.2 states: Follow these principles
when handling questions and complaints from
patients and in all other aspects of nonclinical
professional service.
05/01/15 easy way to pass exams
33. • If the patient put in a complaint to the GDC,
this would be hard to defend. However, if you
gave them the phone number of an
emergency service, or (if less urgent) you
explained that you can not do the detailed
examination necessary outside the surgery to
give proper advice, and they understood this,
there should be no problem.
05/01/15 easy way to pass exams
35. Respecting patients’ dignity and
choice
• You are about to restore a tooth, but at this stage you do not know
what will be needed – this will only become apparent when you
have deconstructed the existing restoration. The patient wants to
know how much it will cost. Can you just tell them that you
honestly don’t know yet?
• GDC Rule 2.4 states: Listen to patients and give them the
information they need, in a way they can use, so that they can
make decisions. This will include:
• communicating effectively with patients
• explaining options (including risks and benefits)
• giving full information on proposed treatment and possible
costs.
05/01/15 easy way to pass exams
36. • You must explain the cost of all the possible
outcomes, e.g. simple restoration, RCT,
Crown, necessity of a surgical extraction, costs
of replacing the tooth if extraction is needed.
05/01/15 easy way to pass exams
37. Respecting patients’ dignity and
choice
• A patient has broken your newly fitted crown by
falling over while drunk. He wants a free
replacement. You are tempted to tell him where
to “get off”. Can you?
• GDC Rule 2.1 states: Treat patients politely and
with respect, in recognition of their dignity and
rights as individuals.
You can politely insist that the replacement must
be paid for, but you must avoid irritation or
sarcasm (however difficult that might be!).
05/01/15 easy way to pass exams
38. Respecting patients’ dignity and
choice
• You have a patient who always has very bad body odor.
Can you ask them only to attend appointments at the end
of the day, although you know this is difficult for them?
• GDC Rule 2.3 states: Treat patients fairly and in line with
the law. Promote equal opportunities for all patients. Do
not discriminate against patients or groups of patients
because of their sex, age, race, ethnic origin, nationality,
special needs or disability, sexuality, health, lifestyle,
beliefs or any other irrelevant consideration.
• People with bad body odor are not specifically protected by
law. However, “fairness” applies to all patients.
05/01/15 easy way to pass exams
39. Respecting patients’ dignity and
choice
• You have a patient who you really like, and
they like you. The treatment has been
completed and they are now dentally fit. The
patient asks you on a date. Can you accept?
• GDC Rule 2.5 states: Maintain appropriate
boundaries in the relationships you have
with patients. Do not abuse those
relationships.
05/01/15 easy way to pass exams
40. • According to the GDC rule. Some years ago a
UK doctor was struck off for dating and then
marrying a patient. The complaint was made
by the patient’s ex-husband
05/01/15 easy way to pass exams
41. Respecting patients’ dignity and
choice
• A patient needs a crown for an upper incisor. They
want gold, which you feel is aesthetically
unacceptable. Should you insist on providing ceramic
or nothing?
• GDC Rule 2.2 states: Recognize and promote patients’
responsibility for making decisions about their
bodies, their priorities and their care, making sure
you do not take any steps without patients’ consent
(permission). Follow the GDC guidance ‘Principles of
patient consent’.
05/01/15 easy way to pass exams
42. • “Doctor Knows Best” is no longer an
acceptable ethical framework. If the gold
crown functioned clinically as well (or better)
than the ceramic crown, the patient’s choice
should be respected.
• What if the patient wants to replace a ceramic
crown with a gold crown? Will you do it?
05/01/15 easy way to pass exams
44. Protecting the confidentiality of
patients’ information
•
Your record cards have a red sticker on the front
to alert you if a patient has an infective disease,
and a yellow sticker if they have another relevant
medical condition. Is this OK?
• GDC Rule 3.2 states: Prevent information from
being accidentally revealed and prevent
unauthorized access by keeping information
secure at all times.
05/01/15 easy way to pass exams
45. • It could be interpreted that, if other people’s
records were visible e.g. at the reception desk,
you are breaking this rule. The meaning of
warning stickers is unlikely to be a secret
confined only to Practice staff.
05/01/15 easy way to pass exams
46. Protecting the confidentiality of
patients’ information
• As part of a marketing scheme, you plan to send
tailored birthday cards to your patients, saying for
example “Happy 30th Birthday Angela Jones”. Is this
OK?
• GDC Rule 3.1 states: Treat information about patients
as confidential and only use it for the purposes for
which it is given.
Under this rule, the patient’s date of birth was given to
you for dental reasons. The patient may not wish
others in her house to know how old she is.
05/01/15 easy way to pass exams
47. Protecting the confidentiality of
patients’ information
• You have an elderly patient with bilateral cataracts who
you see driving away badly from your practice. You know
they have poor eyesight as they could not see their new
dentures in the mirror. Should you keep this knowledge
confidential?
• GDC Rule 3.3 states: In exceptional circumstances, it may
be justified to make confidential patient information
known without consent if it is in the public interest or the
patient’s interest. You should get appropriate advice
before revealing information on this basis. Follow the GDC
guidance ‘Principles of patient confidentiality’.
05/01/15 easy way to pass exams
48. • The important thing is to get advice before
breaching confidentiality. When seeking
advice (e.g. from your Defense Organization),
you should describe the circumstances, but
not identify the patient in any way.
• Failure to act appropriately could put your
registration at risk.
05/01/15 easy way to pass exams
50. Co-operating with colleagues in the
interests of patient
• Your Practice has a hygienist, but you the
dentist don’t want to send her any patients as
you have to pay a fee for using her. Is this OK?
• GDC Rule 4.1 states: Co-operate with other
team members and colleagues and respect
their role in caring for patients.
05/01/15 easy way to pass exams
51. • If you believe the hygienist does a better job
of motivating, instructing, and scaling etc.,
that is, the patient gets better treatment, then
you should not refuse referral because of your
own financial interests. The patient’s interests
come first.
There may be valid reasons for keeping the
patients to yourself, but those reasons must
be in the patient’s interest.
05/01/15 easy way to pass exams
52. Co-operating with colleagues in the
interests of patient
• You give your own nurse a special bonus
cheque each year for working with you. Is that
OK?
• GDC Rule 4.2 states: Treat all team members
and other colleagues fairly and in line with
the law. Do not discriminate against them.
• It is doubtful that the bonus will give rise to a
hearing at the GDC. It is pretty certain that it
will cause resentment in your Practice.
05/01/15 easy way to pass exams
53. Co-operating with colleagues in the
interests of patient
• You are an associate dentist, and due to a downturn in Practice
profitability you have been given a month’s notice to quit. Your
boss asks you to help with a surgical extraction that is beyond his
ability, but within yours. The extraction is booked for next week.
You reckon that he will need to learn to cope when you are gone,
and suggest he refers the patient. Is this OK?
• GDC Rule 4.3 states: Communicate effectively and share your
knowledge and skills with other team members and colleagues as
necessary in the interests of patients. In all dealings with other
team members and colleagues, make the interests of patients
your first priority. Follow the GDC guidance ‘Principles of dental
team working’.
05/01/15 easy way to pass exams
54. • The key here is whether your behavior is in
the patient’s best interest, which it is not. You
should agree to help.
05/01/15 easy way to pass exams
56. Maintaining your professional
knowledge and competence.
• As a dental nurse who takes radiographs, you
work in a tightly controlled environment to a
dentist’s precise prescription. Do you also have
to know the details of the laws that govern
radiography?
• GDC Rule 5.4 states: Find out about laws and
regulations which affect your work, premises,
equipment and business, and follow them.
The answer to this question is – yes.
05/01/15 easy way to pass exams
57. Maintaining your professional
knowledge and competence.
• You are a recently qualified dentist, and have
completed your DF1 training. The DF1 year gave you
all the CPD points required for the 5 year cycle. Can
you stop your CPD until the next cycle starts?
• GDC Rule 5.1 states: Recognize that your qualification
for registration was the first stage in your
professional education. Develop and update your
knowledge and skills throughout your working life.
This implies that you must continue CPD evenly
throughout your career, even if you have “ticked the
box” regarding minimum requirements.
05/01/15 easy way to pass exams
59. Be trustworthy
• Someone has insulted your mother and girl friend, and
made inferences about your ancestry. You get very
angry and hit them. Are you in trouble with the GDC?
• GDC Rule 6.3 states: Maintain appropriate standards
of personal behavior in all walks of life so that
patients have confidence in you and the public have
confidence in the dental profession.
• If you are convicted of assault in court, the GDC will be
informed and your registration could be at risk.
05/01/15 easy way to pass exams
60. Be trustworthy
• You have been offered a DVD in the pub which
you think may be a pirate copy. This has nothing
to do with your work. Is the GDC interested in
whether you buy it or not?
• GDC Rule 6.1 states: Justify the trust that your
patients, the public and your colleagues have in
you by always acting honestly and fairly.
05/01/15 easy way to pass exams
61. • This rule says “always” – meaning whether it
has to do with your work is irrelevant. If you
are convicted of handling or receiving stolen
goods (which includes “Intellectual Property”),
the GDC will be informed and your
registration may be at risk.
05/01/15 easy way to pass exams
62. Be trustworthy
• You have been asked by a dental supplier to
give a paid lecture on one of their products, to
say how good it is. Should you refuse?
• GDC Rule 6.2 states: Apply these principles to
clinical and professional relationships, and
any business or educational activities you are
involved in.
05/01/15 easy way to pass exams
63. •
If you believe the product is good, that is fine.
You must not however give an unbalanced
view: you must find out all the evidence about
how the material performs, and include that
in your presentation.
05/01/15 easy way to pass exams
66. Consent
• No treatment can be carried out on a patient
without their valid informed consent for the
specific treatment to be undertaken !!!!!
• Pts. have a right to choose whether or not to
accept your advice or treatment
• Types of consent :
Implied: only if ............
Verbal consent: most common
Written : TTT under GA or sedation, long TTT plans
05/01/15 easy way to pass exams
67. Consent
• The patient as ‘gatekeeper’
• Using this ranking of principles, in a sense it is
the patient who becomes the ‘gatekeeper’ to
dental services..............
05/01/15 easy way to pass exams
68. Consent
If there is any doubt about the pts.’ mental ability
to understand the ttt fully...........
No TTT should be undertaken
Don’t miss: in the case of G.A the pt. Should
be informed about the risk of death even if
he is very anxious......
05/01/15 easy way to pass exams
69. • A 38 years old patient with severe dawn syndrome
came to clinic requiring extraction of wisdom tooth,
what is the best treatment describing the consent
• a) The best thing is to obtain parent's consent
• b) if he can understand the procedure &
complications ,he can give the consent
• c) he may understand the procedures &
complications but his special needs precludes cons.
• d) if the tooth needs extraction, do it on your behalf
05/01/15 easy way to pass exams
70. Consent
• Who can give consent ???
Patients more than 16 .................
Patients less than 16 ....................
Parents only if less than 16............
But....
Frazer/gillick competence consent :
Achild under 16 could give valid consent to medical ttt without
parentral knowledge or agreement .......provided the child had
mental capacity ( intelligence, maturity & understanding) to give
consent
05/01/15 easy way to pass exams
71. Consent
• Frazer/gillick competence consent:
For gillick consent to be valid :
The child must have capacity
The proposed ttt must be in the child’s best interest
(conslutate with a collegue)
Every reasonable effort must be made to persuade the
child to involve his parents
05/01/15 easy way to pass exams
72. Consent
• Brother/sister/uncle etc. .........
• Local authority.....
• Patients who lack capacity
No consent [even at emergency...]
If the child is in their care under an
emergency protection
circumstances...
No one else can give consent,
Opinion from colleague, 2
consultants opinions in case of
major cases.............
Necessary TTT should be provided
that is in the patient best interest...
05/01/15 easy way to pass exams
73. Consent
• Remember that the age for giving consent is:
16 for normal patient
18 for patients who lack capacity
05/01/15 easy way to pass exams
74. Remember.........
Under the UK disability discrimination ACT,
any service providor must not use any
reason related to patients disability as an
excuse to treat them less favourably ....
05/01/15 easy way to pass exams
76. • A patient can give informed consent only when they have received
and understood an explanation of what is proposed.
What does the explanation have to include?
• The GDC says you must find out what your patients want to know,
as well as telling them what you think they need to know. Examples
of information which patients may want to know include:
• why you think a proposed treatment is necessary;
• the risks and benefits of the proposed treatment;
• what might happen if the treatment is not carried out;
• other forms of treatment, their risks and benefits,
• whether or not you consider the treatment appropriate.
• the (estimated) cost of the treatment
• the nature of the contract (e.g. NHS or Private).
05/01/15 easy way to pass exams
77. • Do you have to tell the patient about things not
on the GDC list ?
• Yes: it is your responsibility to find out what the
patient wants to know, and provide the
information. A patient might claim that consent
was not “informed” if for example they did not
know that a treatment would take many more
visits than they thought, or that they would be
seeing multiple dentists/specialists. You must
find out what is important to the patient.
05/01/15 easy way to pass exams
78. • What do you understand by the term Restricted
Consent?
• This is when a patient agrees to part, but not all of a
treatment plan. This can cause some difficulty for the
dentist, as complex plans tend to be staged.
• An example might be that a necrotic dark incisor
requires a Root Filling and a veneer. The patient may
refuse the root filling but consent to the veneer.
• Dentists must document such cases very carefully and
meticulously, while respecting the rights of the patient
to have the treatment of their choice.
05/01/15 easy way to pass exams
79. •
A 16 year old patient consents to a dentally necessary
extraction. They understand the necessity, risks,
consequences etc. The parent refuses. Can you legally
do the extraction?
• Patients with capacity aged 16 and over can consent
on their own behalf.
Clearly it is better to make all attempts to reach an
agreement with all parties in these circumstances.
05/01/15 easy way to pass exams
80. • What about the opposite case? A 16 year old
patient refuses a necessary extraction just
before you are about to start, but the parents
have given informed consent. What do you
do?
05/01/15 easy way to pass exams
81. • For more info please check:
• The DH ‘’department of health’’ guidelines
named [reference guide to consent for
examination or treatment]
05/01/15 easy way to pass exams
83. Confidentiality
• Protect the
confidentiality of
patient
information
• Treat information
about pts. As
confedintial and
only use it for the
purpose each is
given for
05/01/15 easy way to pass exams
84. Confidentiality
• Your duty:
is to prevent information from bieng
accedenally revealed and prevent unauthorised
access by keeping information secure at all times
When to break confidentiality ?
In exceptional circumstances [protect the public ] ONLY
Or with pts. informed consent....
05/01/15 easy way to pass exams
86. Confidentiality
• Third parties..........patient consent is a must !!!
other healthcare professionals participating in
the care of the patient
insurance companies seeking information in
relation to injury claims, for example
solicitors acting for the patient or for others.
05/01/15 easy way to pass exams
87. Confidentiality
• The following situations may permit disclosure
without consent:
• Where there is a legal or statutory requirement; this
can include:
certain infectious diseases (of which HIV is not one)
serious injury or dangerous occurrences
certain Acts of Parliament
When ordered from the court, not court officer!
Disclosure may be justified in the public interest even If it
affects just one member of the public
05/01/15 easy way to pass exams
90. Neglicance
• Neglect= carelessness
• Any failure to exercise reasonable skill & care
• How to avoid to be a neglicant......records
• How to know if a dentist is neglicant or not ??
Bolam principle test :
A doctor is neglicant if he acted in accordance with the practice
accepted as proper by a reasonable body of medical men skilled
in the particular part
Bolithio...........
05/01/15 easy way to pass exams
92. Dental record
Clinical notes
Medical history questionnaire
Photograph
Investigation results
Consent forms
Copies of TTT plan
Copies of refferal letters
o Should be stored in a safe place
o Should be retained as long as possible(min 11ys)
o For children should be kept until they are 25 or for
11 years [which longer]
05/01/15 easy way to pass exams
94. NAI
• If you felt that the injuries are incosistent
with the history.....
Susbect child abuse ..
What else..............
Discuss your suspicious with a collegue
If justified....... Call pts. GMP
Call the local child protection advisor
If afraid refer to hospital.....[ nurse]
05/01/15 easy way to pass exams
98. complaints
NHS complaints procedure:
Local resolution
Concilation through health Board
Independent review
ombudsman
Audit !! Peer review !!
05/01/15 easy way to pass exams
99. complaints
• Time limit:
Local resolution... A full response should be provided
within 10 days in practice and 20 days in hospital.
1ry response within 3 days [acknowledgment ]
Complaints must be made < 12 months after the event or
< 6 months after he realized that there’s a problem
05/01/15 easy way to pass exams
101. Fitness to practice
• Fitness to practice officer is the frst to see the case
• Then it is refeered to the investigating committee
• If this comitee decided that the case is serious it
referres the case quickly to one of three
committees :
Professional conduct
Professional performance
Health cmmittee
At any stage of investigation the case may be referred to the interm
orders committee
Wolf act
05/01/15 easy way to pass exams
102. • Please don’t forget :
–Sedation rules
–General anesthesia rules
–Chaperone and escort in TTT
05/01/15 easy way to pass exams
104. Ethics
• A 10 years old male patient comes to your
clinic with his UR2 avulsed. He said that he
was playing and hit in the door
• He comes with his grandmother who quickly
put the avulsed tooth in milk
• His parents is not at home....
• Discuss your management!!
05/01/15 easy way to pass exams
105. Ethics
• Mr. jack’s lawyer attendes to the practice
requesting his records?
• What will you do ?
Patients have the rights to access their
records but ......... Protect your self !!!
05/01/15 easy way to pass exams
106. Ethics
• While performing endodontic treatment for
lower right first molar, a file breaks inside the
canal............
• Life span of the file determine neglicance..
• Advise about TTT, removal, complete endo or
referral.....
• Failure to advise pts is considered neglicance
• If pt is not satisfied advise him to call complaint
advisor No
05/01/15 easy way to pass exams
107. Ethics
• Nivas who is 15ys old child comes to your
practice alone having toothache that disturb his
sleep...
• What will you do ?
• Pain.......it is an emergency
• Try to contact parents..
• Consultate with a colleague (pt. Best interest )
• Consider gillik competence consent
05/01/15 easy way to pass exams
108. Ethics
• You have just opened your private new dental
practice..... Mr. Davis is a dentist in a neighboring
practice...
• You noticed that his work result is very disappointing
and his patients start to come for you to treat...
• You are aware if he work in another post...
• What to do ....
Contact MR Davis
Local dental advisor
GDC [ fitness to practice officer]
Police station!!!!!
05/01/15 easy way to pass exams
109. Ethics
• A 15 ys old female come with her mother, they request
crowns for her upper laterals as the teeth are out of line
• You see that orthodontic TTT may allow for aligment without
peparation
• Mother agreed with you but the patient insists and says
‘’ NO I am not waiting 2 ys for ortho ‘’
No treatment... Not in patient best interest
Advise her to seek another opinion
Consent refusal .........
05/01/15 easy way to pass exams
110. Ethics
• While you are in your practice your
receptionist received a call from the police
asking for records
you should know why they need...
It should be a good reason for breaking
confidentiality
If not ask him for court order....
05/01/15 easy way to pass exams
111. Ethics
• You are a principal in the dental unit in the tian-gin
hospital, recently you discovered a bad smell comes
out from one of your dentists
• You now knows that he is an alcohol abuser ... You
warned him several times but without benefit
• Discuss ?
Suspense.........
Fitness to practice officer
The case finally will come to the ‘’ professional
conduct.....’’
05/01/15 easy way to pass exams
112. Ethics
• Mr Boil is 31 ys old , he is a regular dental attender at
your practice since 1996. his girlfriend Sara also is your
patient.
• He came to you to extract his LR8 as you planned 2
weeks ago, but unfortunatly after extraction you
couldn’t stop bleeding and transfer him to near
hospital.
‘’He is a HIV +ve ‘’ disaster
would you tell his GF ?
No..... Dentists cann’t tell about HIV or cancer !!
Advise him to do so
Tell his Gp to do so
05/01/15 easy way to pass exams
113. Ethics
• Norwegian fresh graduate dentist wants to
practice dentistry in UK[his 1ry dental
qualification is from Yugoslavia]
• How can you advise him?
• A dental care professional wants to improve their
position in your clinic.......
• How can you advise?
05/01/15 easy way to pass exams
114. Ethics
• Mrs fiona jones come back to you 2 days after
extracting her UR2, she is very angry.......
• She said ‘’ I went to another dentist near to my
house and he told me that you extracted a
permenant tooth insead of the baby tooth ‘’
• She want to do a complaint !!!
• Appology !!show Sembassy!!
• Discuss treatment options including from implant
to denture
• Inform her that she won’t afford any extra fees
• Or offer refund......
• If not satisfied..................
Call Complaint advisor
05/01/15 easy way to pass exams
115. Ethics
• Mrs. Fiona jones come to you, she is 17 years old pt., she was very
angry ........
• She told you that she went to the hospital and a fresh graduate
dentist extracted her permanent upper front lateral and he didn’t
fully inform her that it is a permanent tooth...
• She want to do a complaint.......
• Sembassy “ I understand that this is hurt u.........”
• You cannot judge his work....
• She should seek his opinion, you don’t know what he faced or
diagnosed.........[also to allow for local resolution..]
• Always be supportive to other college.
• Explain Complaint procedure...........
05/01/15 easy way to pass exams
116. Ethics
• 15 years male with learning difficulty & epilepsy come to
your practice alone
• He is irregular attender and he has broken his central’s
crown horizontally and also you suspect root fracture
• You see that extraction is your best option here..........
• His mother has arthritis and she is house bound since 7
years
• We have 2 problems................
• Judge learning difficulty for gillik consent.....
• Temporary dressing to relieve pain....
• Try telephone verbal consent
• If not applicable seek 2nd
colleague opinion
05/01/15 easy way to pass exams
117. Ethics
Treatment without consent is a battery if pt. is
under 18 and lack the capacity to give
consent !!!!
However ............
in the case of adult patients, despite misconceptions to
the contrary, no such proxy consent is available either at
common law or under the Mental Health Act
05/01/15 easy way to pass exams
118. Ethics
• You received a call from the manager of ‘’old ages care
house’’ he told you that he has an emergency situation
and requested you to come
• When you go there you found Mr. Carr who was your pt.
for the last 20 years, he is in severe pain from un-restorable
broken LL6 requiring extraction
• The problem that he recently diagnosed as alzahimar
patient with sever dementia
• He didn't’ recognize you and refused the TTT.
• Dementia !!! Consent issue
• Patient best interest.........
• Consultation.............
05/01/15 easy way to pass exams
119. Ethics
• You are a new member in a dental practice and
in your first day the principal told you to perform
panorama for every new patient?
• No justification...........
• U should be aware if the nurse has received
training
Discuss & Advise him
Local advisor
GDC
05/01/15 easy way to pass exams
120. Next session
• Evidence based
• Infection control
• Waste disposal
• Practice management
• Recall
• Key facts in diagnosis
• Audit and peer review
05/01/15 easy way to pass exams
