As we settle into the new year, I want to take this opportunity to thank dentists from across the province for demonstrating your commitment to safe, ethical and quality patient care.

I believe the coming year will be filled with change and transformation for the College, the profession and patients.

Silver diamine fluoride (SDF) has been shown, in select cases and circumstances, to be beneficial in arresting cavitated carious lesions.

One of the core values at the foundation of RCDSO’s Code of Ethics is respect for patient autonomy. This means that dentists have a duty to understand and respect the rights of patients to make informed decisions, based on their personal values and beliefs. Dentists have a professional, legal and ethical obligation to involve their patients as full partners in the decision-making process.

Despite steady progress in the field of periodontology, periodontal disease remains the most common cause of adult tooth loss.

From time to time, patients may present to your office with demands for treatment that, as a dentist, you know are not in their best interest. Some may have exceedingly high expectations that you feel are unrealistic and cannot be achieved, while others may request treatment that is beyond your expertise or comfort to provide.

Providing dental treatment and oral care in a long-term care (LTC) facility can present unique challenges. Dentists who work in LTC facilities must still meet the standards of practice: they must ensure that the available physical facilities are adequate, keep dental records that adhere to the RCDSO’s guidelines, and obtain informed consent before initiating any treatment. Obtaining informed consent in LTC facilities can be particularly challenging and warrants careful analysis.

The College processed more than 600 complaints and inquiries last year, many of which have common themes. Communications issues are some of the most frequent matters that come before panels of the Inquiries, Complaints and Reports Committee.

Dentists have a legal and ethical obligation to obtain their patients’ informed consent prior to the start of treatment. Discussions about dental services also need to include information about the costs involved and the patient’s responsibilities regarding payment. It is prudent to advise patients if you intend to charge fees that are above the fees listed in the Ontario Dental Association’s Suggested Fee Guide.

Yes, tobacco use has been implicated in oral cancer and other conditions of the oral-facial complex such as periodontal disease. The provision of smoking cessation, including the prescription and/or recommendation for use of nicotine replacement products or other pharmaceutical aids, is considered within the scope of practice of dentistry.

The issue of informed consent to dental treatment is encountered frequently in complaints reviewed by the Inquiries, Reports and Complaints (ICRC) Committee.

In the course of your professional career, you will regularly encounter medically compromised patients. These patients have special medical and/or dental needs that could directly impact their medical condition. The following case from the Inquiries, Complaints and Reports Committee (ICRC) illustrates how difficult treatment decisions become when a patient is medically compromised.

A parent filed a complaint about the care of his minor daughter by a pediatric dentist. The father complained that the dentist:

• recommended unnecessary restorative treatment to be performed under a general anesthetic
• took advantage of him due to his dental insurance coverage
• failed to provide him with treatment options
• assaulted his young daughter.

Complaints Corner is designed as an educational tool to help Ontario dentists and the public gain a better understanding of the current trends observed by the College’s Inquiries, Complaints and Reports Committee. These scenarios are an edited version of some of the cases dealt with by the Committee. The law does not allow for either the dentist or the complainant to be identified.