Periodontal disease has a wide spectrum of presentation, any of which can have an effect on the patient's dental well-being and overall quality of life. This sporadic but sometimes rapidly progressing condition can easily be missed in a busy general practice setting. It is essential that the correct diagnosis is made and our duty of care to the patient fulfilled. If the condition, along with the treatment options and appropriate advice, is not explained to the patient, the individual may well feel that he/she has been let down by the professional person trusted over many years.
Clinical Relevance: This article discusses the screening and referral of periodontal patients, taking into account the medico-legal challenges that are currently faced by general dental practitioners (GDPs).
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As dental health professionals, we have a duty of care to our patients. A breach of this can result in a claim of negligence. Should the matter progress to a court appearance, it is likely that the patient would be given credence over a practitioner whose notes were unable to support any recall of the events in question.
Periodontal litigation is on the increase;1 undiagnosed and untreated periodontal disease in particular. People are living longer, and more people are retaining their teeth into later life. Consequently, the overall potential periodontal risk is rising. But what drives patient claims? Failure to diagnose is the most common reason. A patient may potentially be unaware of the presence or extent and severity of the disease. Periodontal disease left untreated may result in tooth loss, which would then be grounds to seek a claim of clinical negligence. Therefore, failure to explain the implications and possible sequelae of the condition may also initiate a claim. This may occur when the patient sees a new dentist for the first time. Sometimes the patient attends a different dentist in an emergency situation. On other occasions, of course, a patient will seek a second opinion because he/she already has concerns about the treatment being provided by an existing dentist. It is therefore clear that accurate periodontal diagnosis and the communication of key messages to the patient is absolutely imperative. Furthermore, failure to document essentially means a failure to diagnose; good contemporaneous clinical records are fundamental.
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