Handling dental patients’ rights to refuse treatment

Dear Dianne,

I’ve written to you in the past and I always look forward to your advice in RDH magazine because the issues are so relevant in our day-to-day practice life.

My question to you is twofold. We have a conundrum in our office regarding scaling and root planing (SRP). My coworker has taken over for a hygienist who recently retired, and she has found that many of our patients need SRP. The difficult part is getting some patients to agree to treatment. These are longtime patients of the practice who have been informed repeatedly of the need for SRP and have declined time and again.

Here’s the rub. My coworker has told me that she once worked in a practice where they allowed a patient to forego scaling and root planing, and he actually signed a “refusal of treatment” form stating that he was aware of the risks involved in not receiving treatment. It further stated that he would not hold the hygienist or doctor responsible for any negative consequences. Then, when he lost teeth, he sued the practice and won!

My coworker contacted our state board of dentistry, and someone there informed her that failure to provide scaling and root planing to periodontal patients who require this service could result in legal action and loss of our hygiene licenses.

I am very concerned. Now my coworker refuses to treat any patients who have been diagnosed with periodontal disease and refuse scaling and root planing when it has been treatment planned.