Hannah Burrow discusses how to keep compliant, even during routine treatment.
In the surgery, not every treatment a clinician provides will be a radical procedure using cutting-edge techniques and equipment. Much of the care that patients need is considered fairly routine, requiring preventive measures and minor restorative procedures to correct small and developing problems. However, it is important that all necessary steps are taken, even in the most straightforward of cases, to ensure that patients receive the care they need. Clinicians should not become complicit, and keep a comprehensive record of each appointment. The profession has become an increasingly litigious environment in recent years, making record keeping more important than ever for protecting dental professionals should a patient make a claim.
A common treatment type
As mentioned, the majority of day-to-day treatments that general dentists provide are likely to include minor restorative procedures. Dental fillings, for example, are very common in the UK, with an estimated 90.2 per cent of adults having at least one filling.
As you are aware, dental fillings can be made out of a number of materials, including amalgam and composite, and are used to restore teeth which have been affected by decay or damage. Because dental fillings are so common – becoming routine in many practices – some dentists may be less diligent than if they were providing a more complex procedure. It is important to maintain a good understanding of the potential risks and complications that may occur following a dental filling, and know how best to approach each unique scenario.
While this is a very common treatment type, there are still a number of factors to consider when providing fillings. Patients may experience ongoing issues following the procedure for a few reasons, including unshaped or rough fillings which have an overhang, fillings which are too large and where a crown may have been more appropriate, and if they experience food-trapping around the edge of the filling. If carried out incorrectly, patients may experience lasting pain, and possibly restoration failure.
It is important to be aware of these issues, and understand how to properly avoid them, to reduce the risk of secondary caries and the need for more extensive restorative treatment. It is important to undertake even the most routine treatment solutions systematically and logically, to minimise errors and ensure that it goes smoothly at each stage. Should the situation change at any stage of planning or provision, requiring a change of course, clinicians should assess their abilities and consider the best option for the patient. This may mean referral is necessary, for example, if it becomes apparent that the infection is deeper than first thought, requiring root canal treatment. Clinicians should ensure that the procedure is always carried out properly, using the correct materials, and that a filling is the most suitable course of action for the patient.
Keep a comprehensive record
Dentistry as a profession is becoming an increasingly litigious environment, with much importance being placed on comprehensive record keeping to protect dentists should a patient raise a concern. While a clinician may have acted in the patient’s best interests, if there is not a complete and accurate record of each conversation, instruction, and treatment carried out, it may be assumed that it didn’t happen. This makes it incredibly important to detail every stage of the process in the patient’s clinical notes.
While note-taking is vital, it is also very time consuming and repetitive, meaning that it can take away from time spent with patients, or eat into the clinician’s time both in and outside of work. Because of this, it is important to find a solution which allows clinicians to balance their administrative and clinical duties while ensuring that their clinical notes are complete and accurate.
To keep comprehensive clinical notes, many clinicians use Kiroku, the digital note-taking platform, which uses dynamic templates to keep bespoke notes without missing out on vital information. The clickable templates prompt the dentist to include information relevant to the case, so that they don’t have to worry about missing anything. Kiroku has curated a number of stock templates for a wide range of appointment and treatment types, including one specifically for providing fillings.
By taking steps to ensure that clinicians are working within their abilities and making comprehensive records of each appointment and treatment, no matter how routine it may be, they are able to more effectively protect themselves from litigation should a patient raise a concern. By using solutions which assist with this, clinicians can have the peace of mind that they have not missed any essential information.