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How would you handle this? When consent changes

A client arrives for their appointment. This is the client’s second appointment and the RDH reviews the chart and sees that the client consented to a four-appointment treatment plan that includes quadrant scaling with local anesthesia. The RDH considers that local anesthesia was recommended due to the client’s current periodontal status; the amount, depth, and tenacity of their deposits; and their previous reports of sensitivity during scaling. After updating the medical history, the RDH asks the client whether it’s okay to notify the dentist to administer local anesthesia. However, the client expresses that they didn’t like how they felt after the local anesthesia during their last scaling appointment and asks if they can skip it this time.

What should the RDH do?

RDHs are responsible for ensuring that clients have all the information they need to make informed choices. In this situation, the RDH should:

  • Ask the client first about their experience with anesthesia after the last appointment.
  • Discuss why the anesthesia was initially recommended and what benefits it provides.
  • Discuss the potential outcomes of proceeding with or without anesthesia.
  • Explore alternatives to local anesthesia for pain management, if any, and review the risks, advantages and disadvantages of each option.
  • Answer any questions the client may have.

Following the discussion, the RDH can modify the treatment plan based on the client’s informed decision. During the appointment, the RDH should continue to communicate with the client to assess their level of comfort and adapt pain management as per the client’s preference.

To learn more about the elements of informed consent, explore our online module “Consent and the Dental Hygienist”. 

Course length: Approximately 1-1.5 hours

Proof of completion available? Yes, and completion can count towards Quality Assurance learning hours.