Dentist Works Outside Scope In Providing Orthodontic Treatment 21HDC00656

Deputy Health and Disability Commissioner Dr Vanessa Caldwell has found a dentist breached the Code of Health and Disability Services Consumers’ Rights (the Code) for orthodontic treatment provided over a two year period to a 12 year old female.

The dentist fitted braces on the teen, which were subsequently removed and replaced with aligners. Three years after completion of the treatment, a specialist orthodontist expressed dissatisfaction with the orthodontic treatment undertaken by the dentist and recommended the teen have upper and lower braces and jaw advancement surgery.

Dr Caldwell found the dentist breached several Rights under the Code for failing to refer the teen to a specialist at the outset, and undertaking treatment he was not trained, or sufficiently experienced, to provide.

The Dental Council of New Zealand (DCNZ) standards, state that practitioners must practice within their professional knowledge, skills and competence, or refer to another health practitioner.

Dr Caldwell also found the dentist in breach for failing to keep full, accurate patient records that complied with the relevant professional and ethical standards.

The DCNZ practice standard on record keeping stipulates that practitioners must create and maintain comprehensive, time-bound and up-to-date patient records.

"The absence of clear, well documented clinical records hindered my investigation into the clinical aspects of this complaint," Dr Caldwell said. "In addition, more fulsome, detailed clinical records would have assisted the dental practitioners who subsequently provided treatment."

The dentist did not obtain adequate informed consent for the braces. Not only was documentation of the informed consent process lacking, but the informed consent discussion took place on the day the braces were fitted. This did not allow adequate time for the teen and her mother to consider the treatment and its risks.

Noting that the dentist had completed a detailed DCNZ education programme, Dr Caldwell made several recommendations, outlined in the report, including that he provide a written apology to the teen for the deficiencies in care identified in the report.

The full report of this case can be viewed on HDC’s website - see HDC's ' Latest Decisions'.

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