MDU gives GPs advice on dealing with toothache

MDU gives GPs advice on dealing with toothache

Dr Sissy Frank, a medico-legal adviser at the MDU, has been advising GPs what they should do if a patient presents with dental problems. Research suggests that 600,000 patients a year see their GPs with dental problems instead of a dental professional. She writes: “If a patient asks you for help with a dental problem, there are some medico-legal issues to bear in mind.”

Figures from the Health and Social Care Information Centre show that half of adults and 40% of children have not visited the dentist in the past two years.  Given this statistic, it is perhaps not surprising that GPs are seeing more patients presenting with dental problems. The British Dental Association says this trend is caused by dental charges, which mean patients often get advice on emergency dental problems, such as toothache or abscesses from a GP, even though the BDA says doctors are ‘unequipped to provide dental treatment’.

GPs have an ethical responsibility to offer help in an emergency, which could include providing medical treatment, for example where the patient requires urgent treatment for pain or sepsis, even where the underlying cause might be a dental problem.

From a legal perspective, the Dentists Act 1984 restricts the practice of dentistry to registered dental professionals and those in training. This means that, unless dually qualified and appropriately registered with the General Dental Council, GPs are not able to treat dental conditions, but they can provide urgent and necessary medical treatment if the patient is not able to contact a dentist.

It would be inappropriate for a doctor to attempt to manage a condition requiring dental skills. But as with any consultation, it is important to keep a record of any treatment provided to the patient and the advice offered. GPs should also be aware of relevant guidance such as the NICE clinical knowledge summary on managing dental abscesses in primary care.

The BMA’s recently updated guidance on patients presenting with possible dental problems advises GP and practice teams to be ‘aware of in hours and out-of-hours dental services available locally to manage urgent and emergency dental conditions.’ This can include NHS Choices, NHS 111, local dental access centres and local NHS dentists, but arrangements vary locally, the BMA explains.

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