David Lauder, dento-legal adviser at the Dental Defence Union (DDU), explains how you should communicate with patients whose treatment was started elsewhere.

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It is becoming more common for dental professionals to encounter patients who require follow-up care after receiving treatment elsewhere. This might be due to the patient undergoing treatment overseas. However, in some cases it can be due to organisations disbanding - this was recently the case with the direct-to-consumer orthodontic company Smile Direct Club announcing it was winding down its operations and informing patients midway through treatment to contact a local dentist for support.

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Communicating with patients

The basic principles of effective communication are the same regardless of what treatment is being provided or where the patient previously accessed care. You should:

  • Conduct your own assessment of the patient and explain your findings in language and terms the patient can understand. Avoid jargon or large amounts of clinical information when explaining treatment options

  • If, after carrying out your assessment, you think the care needs of the patient are beyond your expertise, discuss referral options with the patient. Make a referral if the patient agrees to this and keep good records of the discussions you had with the patient

  • Look out for signs of anxiousness or confusion about treatment. Take time to reassure the patient and provide further explanation

  • Take reasonable steps to help patients who have particular communication needs. For example, if a patient doesn't speak fluent English, consider making arrangements for a translator

  • Make a full record of consent discussions in the patient's notes

  • If possible, give them more information to take away.

If the patient had previously approached you and you had warned against getting the treatment they have started, you need to decide if there is sufficient trust in your abilities for there to be a good working relationship between you and the patient.

Communicating with the previous practice

If it is possible to do so, consider asking for consent to contact the previous dentist or dental care professional if you need more details or clarification about the care provided. Details of any verbal communication should be accurately noted in the patient's records. If necessary, consider requesting written copies of the records from the previous dental professional.

If the patient raises concerns about previous care, advise them that these should be directed to the dental professional or organisation who provided that care.

The benefit of seeking previous records and information requires careful assessment on an individual patient basis, especially if you want dental records and information about treatment provided by a firm in administration or outside the UK, as it may be problematic for you to obtain the information in a usable format.

Treatment options

Be clear and transparent about the possible costs when explaining the different treatment options, and whether treatment will be provided under the NHS or privately. This includes any referrals you might need to make.

It's also vital to check that the patient's expectations of what can be achieved are realistic. If the patient raises concerns about previous care, advise them that these should be directed to the dental professional or organisation who provided that care.

While questions or queries from the patient regarding your findings should be answered honestly, avoid making any subjective and inflammatory comments about care provided previously by other dental professionals.

For more information or advice, DDU members can contact our dento-legal advisers on 0800 374 626 or visit: https://www.theddu.com/guidance-and-advice.