DTUK1810

July 12-18, 201022 United Kingdom EditionEducation T he confident approach of the professional can go a long way towards influencing the eventual out- come of a treatment. If noth- ing else, the dentist’s positive attitude allows the patient to accept a period during which the tooth settles down after treatment. But if treatment be- comes a little more complicated than expected, that same confi- dent approach should extend to sharing this information with the patient. Consider a case of endodon- tic treatment on a lower first mo- lar. The dentist separated a file in the early stages of the procedure without the apical two thirds of the mesio-buccal canal having been instrumented in any way. The dentist completed the en- dodontic treatment without any comment to the patient about the separated file or the possible fu- ture implications. The tooth never settled down, in spite of frequent prescri- ptions of antibiotics. The dentist offered no explanation to the pa- tient, when they asked why the tooth was not responding. Even- tually another dentist extracted the tooth while the patient was on holiday. A better explanation The second dentist explained the need for an extraction and also informed the patient about the broken file. A settlement was agreed with the patient, not because the file had separated during treatment, but because the dentist failed to discuss and document the presence of the file in the records. The implications that a separated instrument has on the prognosis for a tooth will depend on its position, its effect and whether or not the canals can be effectively sealed. The equipment and techniques for resolving such a situation, where the treatment of choice is the re- moval of the separated instru- ment, are often best achieved by referral to a specialist endodon- tist if available. It is imperative that patients are fully informed about the risks of any treatment that they are about to undertake, and are given the option of seeing a spe- cialist if appropriate. This is par- ticularly important if the treat- ment might exceed the dentist’s skill and experience, and ability to deliver an acceptable standard of care. In the absence of a local spe- cialist, dentists should consider making a referral to a more ex- perienced colleague. Any discus- sions about a referral and the patient’s decision should be care- fully documented in the records. Watch out for another Learn- ing Curve from Dental Protection in future editions of Dental Trib- une UK. DT Learning Curve With more than 4,500 new cases opened every year, there is a wealth of experience within Dental Protection from which all of us can learn DM Indesign.indd 1 29/10/09 13:35:27

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