Standards, Guidelines and Advisories

The Royal College of Dental Surgeons of Ontario’s Standards of Practice set out legal, professional, and ethical obligations that apply to dentists practising in Ontario. Standards of Practice support dentists and protect the public by communicating the College’s expectations for the profession.

Dentists are obligated to maintain the standard of practice of the profession and must adhere to the expectations we set out in the documents below. A dentist who fails to comply with a RCDSO document and/or the generally accepted standard of practice of the profession may be acting in a manner that could result in allegations of professional misconduct.

Ontario dentists must, at minimum:

Familiarize themselves with, and have a clear understanding of, Standards of Practice and other documents that are applicable to their practice
Maintain their skills and knowledge through continuing education and the review of evidence-based literature
Reach out to the Practice Advisory Service if they are unsure how to meet relevant requirements.

Standards of Practice Terminology

Standards of Practice of the Royal College of Dental Surgeons of Ontario (RCDSO) set out legal, professional, and ethical obligations that apply to dentists practising in Ontario.

Within Standards, the following terms are used to communicate RCDSO’s expectations (examples are provided from RCDSO’s Standard of Practice, Consent to Treatment).

Must

When used in an RCDSO Standard , must means that the College requires dentists to comply. These provisions reflect mandatory duties and obligations, which sometimes reflect requirements set out in law.

Here is an example:

Dentists must respect the decision of the patient or their substitute decision maker to refuse, withhold, or withdraw consent to treatment.

This means that dentists cannot proceed with care in these circumstances, even if they disagree with the decision. This is a fundamental requirement that is also set out in law.

Advised

When used in an RCDSO Standard, advised means that dentists can use reasonable judgment when applying the Standard to practice. Advice of the College often reflects best practices, but applying RCDSO’s advice is at the discretion of the dentist.

Here is an example:

While consent can be either express or implied, dentists are advised to obtain express consent when the treatment:

is likely to be more than mildly painful;
carries appreciable risk;
will result in loss or impairment of a bodily function;
is a surgical procedure or an invasive investigative procedure; or
will lead to significant changes in consciousness.

This means that dentists are not required to obtain express consent in these cases, but it is good practice and in the dentist’s best interest to do so.

And

In an RCDSO Standard, the use of and in a bulleted list means that every component of the bulleted list must be considered collectively.

Here is an example:

When obtaining consent to treatment, dentists must ensure that it is:

obtained from the patient, if the patient has capacity to consent to treatment, or from the patient’s SDM, if the patient does not have capacity to consent to treatment;
related to the specific treatment being proposed;
informed;
given voluntarily and not under duress or coercion; and
not obtained through misrepresentation or fraud.

This means that dentists are required to ensure that every condition set out in this list is met when obtaining consent to treatment.

In an RCDSO Standard, the use of or in a bulleted list means that each component of the bulleted list must be considered independently.

Here is an example:

While consent can be either express or implied, dentists are advised to obtain express consent when the treatment:

is likely to be more than mildly painful;
carries appreciable risk;
will result in loss or impairment of a bodily function;
is a surgical procedure or an invasive investigative procedure; or
will lead to significant changes in consciousness.

This means that only one of the conditions set out in the bulleted list must be met for express consent to be advised.

Standards Review and Development Process

We are improving the way we develop and communicate expectations for Ontario dentists.

Visit this page for more information about how we review and develop our Standards of Practice, and for information about how you can get involved.

Standards of Practice

Guidelines

The Role of Opioids in the Management of Acute and Chronic Pain in Dental Practice

Practice Advisories

Best Practices

Orthognathic Surgery in Out of Hospital Facilities