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Are we gaining valid consent for dental extractions? A retrospective audit on restorability assessment at one dental institution

British Dental Journal (2024)Cite this article

Abstract

Introduction This paper explores the widely relevant topic of obtaining valid consent in dental practice, focusing on assessing restorability of teeth planned for extraction. The General Dental Council stresses discussing treatment options, benefits and risks for informed decision-making. The study evaluates if pertinent factors, including tooth structure, endodontic status, periodontal health and patient considerations, are considered before consent.

Aim To ensure restorability has been assessed and all options communicated with patients for completeness of the consent process before tooth extraction.

Objective To assist clinicians in their systematic assessment of a tooth's restorability and provide a framework for contemporaneous documentation.

Materials and methods A two-week retrospective audit of oral surgery outpatients at a dental hospital in London was conducted, analysing the frequency of restorability discussions and patient involvement in decision-making. A simplified restorability guide and educational interventions were introduced to target the set standard of 100% of consenting clinicians to discuss restorability with patients.

Results Results from two audit cycles show a significant increase in documented restorability discussions and consideration of patient factors.

Discussion The study recognised restorability assessment subjectivity, thus creating a simplified tool for clinicians. Patients may lack awareness of restorability options, consequences of edentulism, future costs and tooth replacement considerations, emphasising the importance of documented discussions.

Conclusion Educational interventions and a simplified restorability guide proved beneficial and showed significant improvement in communication with patients regarding restorability and gaining valid consent. Further consideration should be given to barriers patients face when opting for tooth extraction of their restorable teeth, including discussions regarding long-term consequences.

Key points

  • Apply guidance on assessing restorability to everyday factors.

  • Consider non-clinical factors in patient history when assessing teeth.

  • Formulate simple restorability guides for use in practice.

  • Identify that local education on this topic has led to increased clinician knowledge and improved patient outcomes and demonstrate the same in their practice.

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Author information

Authors and Affiliations

  1. Dental Core Trainee 2, Oral Surgery and Maxillofacial Surgery, Eastman Dental Hospital, 47–49 Huntley St, London, WC1E 6DG, UK

    Melody Shirazi

  2. Dental Core Trainee 1, Restorative Dentistry, Eastman Dental Hospital, 47–49 Huntley St, London, WC1E 6DG, UK

    Jasleen Batra

  3. Oral Surgery Consultant, Eastman Dental Hospital, 47–49 Huntley St, London, WC1E 6DG, UK

    Maria Devine

Authors
  1. Melody Shirazi
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  2. Jasleen Batra
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  3. Maria Devine
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Contributions

Melody Shirazi: corresponding author, project design, data collection, data analysis, writing the paper. Jasleen Batra: project design, data collection, data analysis, writing the paper. Maria Devine: project design and editing/proofreading.

Corresponding author

Correspondence to Melody Shirazi.

Ethics declarations

The authors declare no conflicts of interest.

Ethical approval was not required for this service evaluation/audit. The approval of the institution's clinical governance committee was gained. No consent to participate was required for review of clinical notes to evaluate the standard of the current service.

Data availability

Data available upon request.

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Shirazi, M., Batra, J. & Devine, M. Are we gaining valid consent for dental extractions? A retrospective audit on restorability assessment at one dental institution. Br Dent J (2024). https://doi.org/10.1038/s41415-024-7175-4

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  • DOI: https://doi.org/10.1038/s41415-024-7175-4

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