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Information, consent and standard of dental care (10HDC00671)
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(10HDC00671, 26 June
Dentist ~ Crown ~ Preparation ~ Treatment plan ~ Information
~ Informed consent ~ Standard of care ~"Cooling off" period ~
Documentation ~ Rights 4(1), 4(2), 6(2), 7(1)
A woman complained about the treatment provided by two dentists,
and the information provided to her regarding her options for
treatment, the proposed treatment, and the treatment costs. The
woman consulted a dentist who recommended she have ceramic crowns
put on her back teeth (initially five teeth). During the initial
consultation, a second opinion was obtained from another dentist
within the practice. He confirmed the first dentist's diagnosis and
agreed with the treatment plan. The dentists stated that this was
on the basis that the woman had expressed a wish to have work on
her front teeth, to improve her appearance.
The woman was told that the cost of the five crowns would be
$7000. The dentists stated that the woman was also told that after
the crowns had been fitted, other molars and premolars would need
to be built up, and that she could then have veneers on her front
teeth. The woman denies being told this during this consultation.
She and her husband left to discuss the proposed treatment.
The woman, who lived in another city, returned the same day
having decided to proceed with the treatment. Two other patients
were rescheduled in order to commence the woman's treatment. The
first dentist began preparing the woman's teeth for the crowns.
Study models and diagnostic wax-ups were not made. The dentist
stated that the woman agreed to have a sixth tooth crowned,
although the woman denied this. The second dentist finished the
preparation and fitted temporary crowns on six teeth.
The woman consulted a dentist in her home town after losing part
of a temporary crown. She became increasingly concerned that she
had commenced a course of treatment that was unnecessary.
The woman returned to the practice a fortnight later to have the
permanent crowns cemented into place. A dispute arose with regard
to the information and standard of care provided at the first
appointment. It was agreed that the woman would not have permanent
crowns fitted that day but, as an interim measure, a new set of
temporary crowns was fitted. The woman completed her treatment at
another dental practice.
There were multiple discrepancies between the accounts of events
provided by those present.
It was held that the first dentist failed to give sufficient,
accurate or consistent information about the selected treatment and
its cost. As the woman was not provided with adequate information,
she was unable to give informed consent to the treatment. This was
exacerbated by the fact that treatment, which was extensive and
entailed considerable personal expense, was commenced on the same
day it was proposed, which did not allow the woman sufficient time
to consider the proposed treatment. The first dentist did not make
study models and diagnostic wax-ups, and her documentation was not
in accordance with professional standards. In these circumstances,
the first dentist breached Rights 4(1), 4(2), 6(2), and 7(1) of the
The second dentist should not have agreed to provide treatment
without first ensuring the woman had had sufficient time to
consider any information provided and give fully informed consent.
He should also have ensured that adequate planning and preparation
had taken place. In failing to do so, the second dentist breached
Rights 4(1) and 7(1).