With litigation against dental practitioners at an all time high, Martin Wanendeya from Ten Dental discusses the benefits of referring implant cases
Unfortunate as it may be, we simply cannot ignore the fact that more and more claims have been made against dental practitioners in the last few years than ever before. Indeed, we need only look over last year’s General Dental Council (GDC) hearings to see how many cases have been heard for the inadequate placement of dental implants.
These are a popular treatment choice with patients at the moment. Indeed, the UK is currently seeing approximately 130,000 implants placed every year (www. adi.org.uk, 2012) – a figure that will almost certainly increase in line with the continuing demand from patients.
While not a specialism recognised by the GDC, implant dentistry does require a high level of skill and training to be practised safely nonetheless. There are various different aspects, many of them surgical in nature, that necessitate a solid foundation of theoretical and practical knowledge. And truly, without this, no practitioner should attempt implant treatment at all.
Fortunately in the UK there are many very good courses available to practitioners from which they can acquire this understanding and hone their skills – taught by professionals who have devoted their careers to perfecting their own implant practice.
Providing a safe and ethical service
But even with the fundamental expertise, not all implant cases will be straightforward – and it would be imprudent to expect 100% success every time. Being able to recognise this is one of the first steps to providing a safe and ethical service. Equally, knowing when a case may be beyond our range of expertise, or outside our own professional comfort zone, is crucial to protecting ourselves and our patients. It is by no means a failing to step back from a treatment and, holding up our hands, say ‘I don’t think I can do this.’
In fact, such moments are fundamental to our professional development and represent important learning opportunities. But they can often be difficult to identify – particularly when we are learning and eager to put our knowledge to the test. Often, the decision can be an easy one: if the patient requires a bone graft and we are not qualified or experienced enough to provide one, the case must be passed on. More likely we will have to employ a little detective work to decide whether we should proceed.
Find a colleague
In this regard, there are many different criteria to taken into consideration. These can include ‘patient’ factors (which can encompass their expectations or relevant medical history), ‘mouth’ factors (from the condition of the mouth, occlusal or periodontal issues) and, of course, ‘tooth’ factors (bone height and width, existing infection and issues with the aesthetic zone).
A thorough exploration of all these factors will help us create an invaluable case overview – one that will help us determine whether it would be appropriate or even possible to carry out the treatment ourselves. If it isn’t, the next step is to find a colleague who can perform the treatment for us.
Rather than seeing this as ‘giving up’ on a case, we must consider it as a unique learning prospect. Indeed, having the support of an experienced peer – who will ensure that you are kept updated with all aspects of your patient’s progress, will actually provide a chance to improve your own capabilities.
Trust is key here. A referral partnership must be mutually beneficial, and seek to protect everyone involved and, as such, communication, honesty and openness are vital.
While not a specialism recognized by the GDC, does require a high level of skill and training
Referring to an experienced colleague will also inspire confidence in our patients and offer them crucial peace of mind. If referred to a practitioner they know we trust to do a good job, then they too will have confidence in the treatment. They will also realise that we are trying to provide them with the safest, most predictable treatment – for their own good – which will increase our reputation as ethical, conscientious practitioners.
By all accounts, GDC hearings can take a very heavy toll on practitioners – ruining careers and even lives (not to mention the effect the initial malpractice may have had on the patient). Conducting treatment that is beyond our skill is an unnecessary risk to take, one that can often result in a professional nightmare. But by understanding our limits and cooperating with our peers, the risk can be negated completely, ensuring we can continue to offer our patients safe and ethical dental treatment.