Managing client expectations around dental procedures
The Vet Board regularly receives complaints from animal owners claiming that they were not aware that any of their animal’s teeth, or so many teeth, would be extracted during a dental procedure. In such cases owners often claim they only presented their animal for a scale and polish or to have one or two teeth removed. The Board has received complaints about as many as 20 to 30 teeth, or almost all an animal’s teeth, being extracted during a single procedure without informed consent.
While veterinary practitioners know that extraction of diseased teeth is standard practice in veterinary dentistry, animal owners are not always aware of this and need to be clearly informed about possible actions before their animal undergoes a dental procedure.
Owner education is crucial
Educating owners about the reasons for performing dental examinations under anaesthetic, what happens during a dental procedure, and dental disease in animals can help to reduce an animal owner’s concerns about teeth extraction and reduce disputes and complaints to the Vet Board.
It should be clearly communicated to an animal’s owner that the existence and extent of dental disease cannot be fully identified until an animal’s teeth are cleaned and examined under general anaesthesia. Diagnostic x-rays are often required.
Many owners do not understand the importance of dental extraction to relieve pain and prevent serious complications for their pet. They can become very worried when multiple teeth are extracted, believing that their animal will no longer be able to eat properly. Animal owners should be educated that tooth extraction is a common and necessary procedure to prevent ongoing pain and discomfort, local oral disease or serious systemic disease which can be life threatening in their pet.
Informed consent before procedure
Consent forms can be used to obtain consent from an animal’s owner, in advance, for an animal’s teeth to be extracted during the dental procedure if this is found to be necessary. An estimate of the range of possible costs for teeth extraction should be provided to the animal’s owner before they provide such consent.
The Board suggests that consent forms may also contain an option for an animal’s owner to be contacted during a procedure if additional treatment is identified as necessary at the time.
It should be noted in relation to obtaining consent that adequate informed consent requires the owner or their representative to understand what they are
consenting to.
What is informed consent?
Informed consent: Consent is an owner’s agreement for a veterinary practitioner to provide veterinary services, including any tests, medicines, treatments or procedures. Consent is informed consent if the owner has received clear and
sufficient information about their choices in relation to their animal’s health and treatment before they give their consent to treatment or a service. Informed consent is successful when the owner indicates they understand the information they have been given and confirm this verbally or in writing.
Informed financial consent: Financial consent is an owner’s agreement to the cost of veterinary services to be provided by a veterinary practitioner/practice. Financial consent is informed financial consent if the
owner has received clear and sufficient information about the cost of a veterinary service, preferably in writing, before the service is provided. Informed financial consent is successful when the owner indicates they understand the information they have been given and confirm this verbally or in writing.
Seeking consent during a procedure
If additional treatment is identified as necessary during a procedure but the animal’s owner may not have expected that treatment, the Board strongly recommends that the veterinary practitioner makes reasonable attempts to contact the owner to obtain their consent to that treatment and records this in patient records.
Communication gaps can occur when one veterinary practitioner recommends a dental procedure but a different veterinary practitioner performs the procedure. Where there is any doubt about what has been communicated to the animal owner previously, the Board encourages the veterinary practitioner who is performing the dental procedure to actively communicate with the owner should any teeth need to be removed (either before or during the procedure as appropriate).
Clinics may want to consider producing a client handout about what to expect when an animal is booked in for a dental procedure, explaining why teeth extraction is sometimes required in animals, that it is very common for extractions to be found to be required when an animal is under anaesthesia, and that this is often in the best interests of the animal’s wellbeing.
Relevant guidelines
Other resources