Treating patients with dental problems: advice for GPs

Research by the British Dental Association published in 2016 found that 600,000 patients go to their GPs with dental problems, rather than see a dental professional.

According to NHS statistics published in 2018, half of adults have not visited the dentist in the last two years and 40% of children have not visited a dentist in the last year.

If a patient asks you for help with a dental problem, consider the following medico-legal issues.

Your ethical responsibility

GPs have an ethical responsibility to offer help in an emergency. This can include providing medical treatment for patients requiring urgent treatment, such as for pain or sepsis, even if the underlying cause might be a dental problem.

The GMC advises that when providing emergency assistance, you must 'take into account your own safety, your competence and the availability of other options for care'.

Under the Dentists Act 1984, dentistry practice is restricted to registered dental professionals and those in training. However, although GPs are not able to treat dental conditions, they can provide urgent and necessary medical treatment if the patient is not able to contact a dentist.

As with any consultation, it's important to keep a record of any treatment and advice you provide to the patient.

You should also be aware of relevant guidance, such as the NICE clinical knowledge summary on managing dental abscesses in primary care.

BMA guidance

The BMA advises GPs and practice staff to be 'aware of in-hours and out-of-hours dental services available locally to manage urgent and emergency dental conditions'. This includes NHS Choices, NHS 111, local dental access centres and local NHS dentists (arrangements vary locally).

Case scenario

A woman in her 40s attended her GP complaining of a severe pain in her mouth, a fever and facial swelling. The GP examined the patient's mouth and found what appeared to be a severe dental abscess.

The GP asked the patient if she had a dentist that she could make an urgent appointment with, but the patient explained that she hadn't been to the dentist for a number of years as she had a dental phobia. The patient said that she also struggled to afford the cost of dental treatment and asked the GP if he couldn't prescribe some antibiotics and painkillers, which she felt would clear the problem up.

The GP rang the MDU for advice. The MDU medico-legal adviser explained that, while the GP could provide any emergency treatment he thought was immediately necessary, he should also explain to the patient that he was not a qualified dentist and was unable to provide dental treatment.

The GP explained to the patient that it would be in her best interests to be seen by a dental professional and that legally and ethically, he couldn't provide dental treatment as he wasn't qualified to do so. He offered to arrange to contact the local dental access centre on the patient's behalf, which she accepted and arrangements were made for her to be seen urgently by an NHS dentist.

This guidance was correct at publication 13/04/2018. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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