Dentist fails to provide appropriate information about treatment required

Deputy Health and Disability Commissioner Deborah James today released a report finding a dentist in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failures in their care of a woman undergoing treatment to align her teeth.

The woman went to the dentist for an orthodontic evaluation for treatment to correct the alignment of her teeth, which were “wonky” and off-centre because she was naturally missing her top right incisor (tooth 12).

The dentist provided treatment with braces and an upper fixed growth guiding appliance (FGA). After six months of treatment, a gap opened where tooth 12 was meant to be. Prior to the treatment the woman was not informed by her dentist that this gap would be opened, or the options to fill it (with a dental implant, bridge, or cosmetic shaping of the adjacent tooth).

The woman said she would not have proceeded with the treatment if she had known the full extent of the treatment and the cost involved in having an implant installed.

The Deputy Commissioner found that the dentist didn’t provide the woman with information about the fact that a gap would be opened by the FGA at the tooth space, and the options and costs of correcting this.

“In my view the dentist did not provide information that a person in this woman’s circumstances would expect to receive before commencing treatment. By failing to give the woman an explanation of the options available and their costs, the woman was not in a position to make informed choices about her orthodontic treatment,” said Deborah James.

“By the time the woman was aware of her options, she felt obliged to continue with the treatment because it was already well underway.”

Deborah James recommended that the dentist provide evidence of a system for documenting treatment options clearly in letters to patients, reflect on how the letters could be written using more plain English, and review the Dental Council of New Zealand’s Informed Consent Practice Standard.

She also recommended that the dental service use this case as a basis for a staff education session, and provide evidence to HDC of steps taken to ensure that treatment options and costs are laid out clearly in its letters to patients. She also asked the dentist to apologise to the woman.