Introduction
Sir, I am a dental patient and a junior doctor. On a daily basis in my job, I help patients make informed decisions about investigations and treatment. Over the past two years I've had several visits to different dentists following root canal treatment when an instrument was fractured in the root of the tooth. This has now resulted in me having the tooth extracted and I am awaiting implant treatment. These events have sadly made me lose confidence in the dental profession. I do not feel that any clinical error has been made. In fact, I would completely understand what has happened if only I had been made aware that these complications could occur. Patients have the right to refuse or consent to treatment and need to have enough information to help make that decision. Without informing patients of potential complications, dentists leave themselves open to complaints. Guidance on patient consent has been produced by the General Dental Council.1 This states that for consent to be valid a patient must have received enough information to make a decision. The following information is suggested:
- Why you think a proposed treatment is necessary
- Risks and benefits of the proposed treatment
- What might happen if the treatment is not carried out
- Alternative treatments.
Not once were the risks of a root canal described to me. After realising the instrument had been fractured, I was simply prescribed antibiotics and discharged without being informed about any possible repercussions. I waited 18 months thinking I was just imagining the pain I was experiencing before finally consulting a different dentist to be told there was an abscess at the base of the root. Once again, no information was given to me about the possible complications of an extraction. One might argue that if I did not have the root canal treatment I would have lost the tooth anyway, therefore the dentist was acting on the ethical principle of beneficence. That would be like offering a patient sight-saving cataract surgery and not telling them about the rare possibility of blindness as a complication of the operation. We must respect patients' autonomy; it is our moral and legal obligation to ensure patients are adequately informed before consenting to treatment. By notifying patients of potential problems, they will be better prepared to deal with them if they arise and will not lose confidence in the ability of the professionals who treat them.
