Best Practices for Dentists Treating Newcomers

As a dentist you feel confident providing the best treatment when it comes to your patients. You take extra care to keep detailed patient charts and consult any past dental records for your patients. Communication with the patient and gaining consent are important parts of the process.

With the number of newcomers and visitors to Canada continuing to grow, it is increasingly likely that you will be asked to provide care for patients who are being treated for the first time in our country.

What do you need to know?

Some of the challenges include the potential for language and cultural barriers, and the reality that your new patient’s dental records may not be available, or the records may be in another language. In these situations, you need to be extra diligent if you don’t have a history or prior x-rays to rely on. You can avoid potential issues with accurate documentation of current and future conversations, charts, records of diagnostic procedures, treatment plans and cost. This is an important step in the process for dentists and their staff with newcomers and visitors to Canada seeking treatment.

Language barrier solutions for dentists

It is worth the time invested to carefully communicate and document information on procedures, cost, and options thoroughly to someone who doesn’t read or speak English or French as a first language. Documenting is important but equally as important is connecting with the patient to ensure that they understand and are consenting to the procedures as described. Dentists can manage this extra layer of complexity in the treatment of newcomers to Canada through clear communication and by limiting technical terms and jargon.

When a patient and dentist have little or no knowledge of each other’s language, the patient should be accompanied by someone who can translate. You should not provide treatment until you are completely confident that the patient fully understands and consents to the treatment you are proposing. If you need to explain a complicated procedure, the patient may need an interpreter or may need to come back after reviewing all the details you provide with other family members or friends.

It is important that the patient’s medical history be documented or in some cases, translated and this should include their general health. Are they on any medications? How might this impact medications you may use or prescribe? Make sure you get as much information as you can, and record and date it. You may consider reaching out to dentists in your network who are from a patient’s country for help interpreting language/cultural norms/dental records. Contact your dental association for information and to make connections with dentists who can help you.

According to the Canadian Dental Association, informed consent is based on two principles: personal inviolability and free will.¹ The first thing the court will look at is disclosure—or whether all risks were adequately disclosed. The second is causation—if the risks were not adequately disclosed, did that impact the patient’s decision?

Some helpful tips for your team

Dentist advising patient

A patient’s satisfaction with your work is sometimes dependent on their attitude before you even start treatment. You need to be extremely cautious in managing and communicating their expectations. Be approachable and take the time to connect with your patient. Build rapport with open communication and follow up calls which are good opportunities to ensure you are made aware of any issues. Keep your staff in the loop about what needs to be communicated and what to watch for.

It is important that the patient’s medical history be documented or in some cases, translated and this should include their general health. Are they on any medications? How might this impact medications you may use or prescribe? Make sure you get as much information as you can, and record and date it. You may consider reaching out to dentists in your network who are from a patient’s country for help interpreting language/cultural norms/dental records. Contact your dental association for information and to make connections with dentists who can help you.

A recent study analyzing complaints made by the public to the Royal College of Dental Surgeons of Ontario shows that complaints around the conduct and the communication with your patient is second only to the clinical care and treatment you provide. Relationships and conduct factors include patient interaction and interpersonal skills and the rights of patients including consent, stigma, discrimination, and confidentiality.²

 

“Show empathy. Do follow-up calls. Build rapport. Aside from careful dentistry this is the best defense against potential complaints.”
- Matthew Wilton LLB, Wilton Barristers

 

Anyone visiting the dentist may be anxious about seeing a dentist and you need to be aware if they have a history of treatment or bad experiences. A little calming communication from you and your team will go a long way to making them feel at ease.

When communications break down.

When communications break down between a dentist and any patient, that is often when legal issues arise. You are covered by your malpractice insurance for the treatment of any patient within the jurisdiction where you are licensed, provided the suit is brought in Canada and subject to the terms and conditions of the policy. The patient does not need to be a resident of your province or territory, or of Canada.

How much coverage do you need?

Malpractice Insurance offers a range of coverage limits — you can choose the one best suited for you. The amount of malpractice insurance you require may vary according to your patient demographics, your specialty, if any, and the types of procedures you typically perform.

It is important to note that extra protection does not cost a lot. As a licensed professional, you are legally responsible for the services you or your staff perform.

CDSPI Malpractice Insurance offers up to $25 million protection for a single claim. A claim could be financially crippling if you’re not adequately covered. That means you may be accused of malpractice, error or omission while you’re practising, and have to bear the significant financial consequences that can accompany those charges.

To learn more about malpractice insurance, visit the Malpractice Knowledge Library for curated resources to help you learn about your risks and how you can manage them.

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CDSPI Malpractice Insurance is underwritten by Zurich Insurance Company Ltd (Canadian Branch). CDSPI Malpractice Insurance is offered in all provinces and territories except Alberta, Ontario and Quebec. Excess Malpractice Insurance is offered to dentists licensed to practice in the province of Alberta or Ontario, who are a member of their provincial or territorial dental association and have their primary mandatory malpractice insurance directly from their provincial regulatory body.

¹ The CDA-ADC Volume 70 Issue 2/98 - The Personalized Consent Form: An Optional, but Useful Tool!

² ANALYZING COMPLAINTS MADE BY THE PUBLIC TO THE ROYAL COLLEGE OF DENTAL SURGEONS OF ONTARIO prepared by the Royal College of Dental Surgeons of Ontario and University of Toronto, Faculty of Dentistry December 2, 2019

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