Dentist Works Outside Scope In Providing Orthodontic Treatment 21HDC00656

Deputy Health and Disability Commissioner Dr Vanessa
Caldwell has found a dentist breached the Code of Health and
Disability Services Consumers’ Rights (the Code) for
orthodontic treatment provided over a two year period to a
12 year old female.

The dentist fitted braces on the
teen, which were subsequently removed and replaced with
aligners. Three years after completion of the treatment, a
specialist orthodontist expressed dissatisfaction with the
orthodontic treatment undertaken by the dentist and
recommended the teen have upper and lower braces and jaw
advancement surgery.

Dr Caldwell found the dentist
breached several Rights under the Code for failing to refer
the teen to a specialist at the outset, and undertaking
treatment he was not trained, or sufficiently experienced,
to provide.

The Dental Council of New Zealand (DCNZ)
standards, state that practitioners must practice within
their professional knowledge, skills and competence, or
refer to another health practitioner.

Dr Caldwell also
found the dentist in breach for failing to keep full,
accurate patient records that complied with the relevant
professional and ethical standards.

The DCNZ practice
standard on record keeping stipulates that practitioners
must create and maintain comprehensive, time-bound and
up-to-date patient records.

“The absence of clear,
well documented clinical records hindered my investigation
into the clinical aspects of this complaint,” Dr Caldwell
said. “In addition, more fulsome, detailed clinical records
would have assisted the dental practitioners who
subsequently provided treatment.”

The dentist did not
obtain adequate informed consent for the braces. Not only
was documentation of the informed consent process lacking,
but the informed consent discussion took place on the day
the braces were fitted. This did not allow adequate time for
the teen and her mother to consider the treatment and its
risks.

Noting that the dentist had completed a
detailed DCNZ education programme, Dr Caldwell made several
recommendations, outlined in the report, including that he
provide a written apology to the teen for the deficiencies
in care identified in the report.

The full report
of this case can be viewed on HDC’s website – see HDC’s ‘
Latest
Decisions‘.

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