Consent

Question 1

Principle 3 of GDC standards?
3.1

Answer 1

1 - Must obtain VALID consent before starting tx every visit
- Document consent in note every visit
- Make sure they know everything about tx I.g tx plan, risks, benefits of tx
- Must check and document they understood.
- Patient can withdraw consent any time and refuse tx, explain consequences and risks in future and they
- Obtain separate written consent involves GA and sedation.

Question 2

3.2 Principle

Answer 2

• Provide patient with sufficient time and information to make decision
• formation of information should be simple and easy to understand
• Help them to make decision by providing information by question and answers with parent/ carer / relative
• You must always consider where Pt are able to make decision about their care.
• Must check and document that patient have understood information.

Question 3

3.3 principle

Answer 3

• Make sure pt consent remain valid at each stage of tx
• check and inform tx progress every visit
• Specific consent - what you are going to do during appointment
• pt understood information
• document the discussion and consent.
• if there is change in tx or cost , must obtain patient consent for change and document it .

Question 4

Orthodontic Therapist consent
GDC OUTCOME (2011 updates 2023)

Answer 4

• Orthodontic therapist are able to take consent once they fully understand tx plan, risk benefits, alternative option including result of no tx.
• Orthdintist will make sure written consent given to OT with full understanding of tx plan, alternative options, risk and benefits including result of no tx.
• if OT doesn’t feel competent or full understand tx plan or during consent cannot answer , should discuss with orthodontist m.

Question 5

What is principle of consent to tx?

Answer 5

Person must give their permission Prior to any type of treatment received.

Question 6

To make a consent valid. What 3 factors need to be considered?
Factors of consent ?

Answer 6

VVIC
- Valid
- Voluntary - decision made by patient without any pressure
- informed- full information and tx plan, risks and benefits given to pt including no treatment option.
-Capacity- Pt must be capable of giving consent. Must understand full information I.g age , mental capacity.

Question 7

What ways do patient consent?

Answer 7

Implied - Book appt and turn up, sit in chair

Expressed - Verbally or written express they happy to go ahead with tx.

Informed - signing consent form with all options risks, benefits, advantages disadvantages, given and letting them know or it’s inform consent.

Question 8

Who can consent ?

Answer 8

• Anyone over age of 16 with mental capacity
• Under 16 if Gillick competent
• A parent of child

Question 9

Gillick Competency 1985

Answer 9

• Lawful to provide Contraceptive advice and treatment to girl under 16 subject to certain guideline
• in certain circumstances a child under age of 16 could now give consent in their own right.

Question 10

Fraser guidelines

Answer 10

1- girl with understand advice
2- professionals cannot persuade her to inform parents that seeking contraceptive advice
3- she is likely to begin or continue having sexual intercourse with ot without contraception
4- unless she receives contraceptive advice or tx her physical or mental health or both are likely suffer
5- her best interests require him to provide her contraceptive advice, tx both with or without parent consent.

Question 11

Filling out consent form .

Answer 11

Provide all options of tx for best result including no tx

Question 12

Benefits of treatment includes?

Answer 12

-Asthetic
- Function
- Preventing damage to other teeth

Question 13

Orthodontic Risks
- Root Resorption

Answer 13

• Root resorptions -90% of fixed pt apical root resorption of 1-2 mm
• Pipette shaped or blunt roots
• teeth Previously involved in trauma

Question 14

-GINGIVITS

Answer 14

• Diffuculty in cleaning due to fixed/ removable apliances present
• Nearly All patient have gingivitis during tx
• May result in increase gingival inflammation.

Question 15

• Periodontitis

Answer 15

• Patient are predisposed if previous periodontal disease existed
• Reduced access for cleansing when fixed appliances are fitted
• Poor OH may cause apical migration of periodontal attachment and alveolar bony support.
• Trauma suspectible

Question 16

• Decalcification

Answer 16

• 2-96%
• Positive correlation between oral hygiene and caries incidence in fixed appliances
• White spot lesion can occur within 8weeks

Question 17

When WSL can occur?

Answer 17

8 weeks

Question 18

Soft tissues

Answer 18

• Traumatic Ulceration due to wire and bracket

Question 19

Loss of vitality

Answer 19

• After previous trauma
• Excessive forces may result reduced blood supply to pulp and possibly pulp dead.

Question 20

Pain

Answer 20

Patient vary in pain level

Question 21

Premature debone / early tx

Answer 21

• Finish due to Poor OH
• damage to root / enamel
• Patient withdraws consent

Question 22

Relapse

Answer 22

• Not wearing retainers at the end of tx

Question 23

Ankylosis

Answer 23

• Mainly with ectopic canine - unable to move

Question 24

Loss of space for bridge

Answer 24

• Not wearing retainer to hold space

Question 25

Camouflage Patient

Answer 25

- Still may have OJ - Space left posterior to premolar after molar extractions

Question 26

Copies

Answer 26

- Both party sign - copies given to patient - scanned in system

Question 27

3 level of consent

Answer 27

- level 1 tx primary use - Level 2 Education secondary use - Level 3 advertising secondary use

Question 28

What is contemporous notes ?

Answer 28

- Notes taken at same time event happened in same details .

Question 29

What is the principle of consent

Answer 29

- A person must give their permission prior to any type of treatment received.

Question 30

To make consent valid - 3 factors need to be considered

Answer 30

- Informed valid - Patient must given full information about what treatment is involved, including benefits, risks, advantages and disadvantages. Alternatives treatment including no treatment. - Voluntary - The decision must be made by patient alone and they must not be placed under pressure. - Mental capacity - The patient must be capable of giving consent. They must understand the information given to them and they can use it to make an informed decision.

Question 31

3 way consent may be given?

Answer 31

- Implied - Book and turn up for appointment and sit in the chair - Expressed - Verbally or written express that happy to go ahead with treatment prescribed. - informed - Signing a consent form with all option, risks, benefits, advantages and disadvantages given letting them know it's an inform decision.