Fight the fear; arm yourself well – Mark Allen, General Manager at COLTENE

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  Posted by: Dental Design      22nd November 2019

At a recent dental conference, when an audience of practitioners was asked
if the fear of litigation was likely to be higher in the future, there was an almost unanimous show of hands. The statistics on this topic point in the same direction; a survey from the end of last year found that 89 per cent of dentists are worried about litigation and 64 per cent are making more referrals due to the fear of being sued.[i]

There are many threads to this topic, including consent and compliance, communication, tools and material selection and the importance of doing the bits of dentistry that are right for you. Rather than feeling intimidated by what might happen, practitioners must strive to not let their work be inhibited by the perceived threat of increased litigation.

The issue of referrals

Knowing when to refer is a key part of being a great dentist. A pragmatic, common sense approach, considering each case in isolation, and deciding whether you have the skills to deliver a stable result has obvious benefits for both you and your patients. Even if an individual has been attending your practice for years, if you can outline the reasons why they should be treated elsewhere, this will deepen your practitioner-patient relationship. By referring them out, you are showing them that you have their long-term dental health as a priority and that they should trust you. Referrals will return for their preventive-maintenance appointments, happy in the knowledge that you looked at the bigger picture and helped them to receive the gold-standard of care. 

Good chairside conversations are fundamental to compliance and informed consent. Impediments to consent include anything from dental anxiety or phobia, to worries about cost and how many appointments it will take to complete treatment. When faced with a dentist’s recommendation, Google-happy and internet savvy patients will often get to work with independent online research and may find information that makes them question a) if treatment is necessary and b) if they should go ahead with that particular practice. If you are not a natural communicator, there are things that you can do to enrich patient discussions. Digital technology really comes into its own here as it enables patients to see what you see, levelling the playing field and deepening their understanding of your diagnosis.

Great dentistry is appropriate dentistry

Even if you haven’t made the move to digital yet, it’s about using every method available to ensure your patient knows that what you are suggesting is appropriate. This means, right for them. So, any recommendation of implant therapy will require the patient to understand that it’s not simply ‘place and go’ and that an ongoing investment of their time and money (to cover the cost of maintenance appointments) will be required to protect the implant’s stability. In a restorative scenario, where there may be several treatment options – a direct overlay versus a ceramic restoration for example – if you are confident that they have fully understood the benefits and limitations of each, then it will be appropriate for you to go ahead as they wish.

During the pre-treatment period, quality note-taking comes under ‘communication’, while also helping you protect yourself against future complaints and, in the worse-case scenario, legal reprisals. Good notes show that you followed protocols, outlined all the options and that the patient knew what they were giving permission for. Good notes will also show that they understood the immediate and future consequences of delaying treatment, or not going ahead at all.


If you are able to tell patients that you only use the very best tools and materials, this will support consent and compliance. Careful tool and material selection is how you can upgrade your dentistry and ensure an efficient, comfortable and cost-effective procedure. When facing a recommendation of root canal therapy, patients may be surprised to learn that, due to some of the fantastic tools and materials on the market, this is a treatment that can be delivered speedily, comfortably and with stable results. COLTENE’s HyFlex™ EDM endodontic file system is as comprehensive as it is flexible and high-quality; it was also recently expanded to include the Glidepath file 15/.03, designed for the preparation of severely curved canals. Many practitioners find they can complete even complex cases using just one or two HyFlex™ files; this is a fantastic selling point for consent and patients can be assured of minimal chair time as well as a successful result.

The fear of litigation is very present in modern dentistry. So, fight the fear. Refer when necessary and look for ways to support consent, deepen trust and improve communication. Your weapons include great notes, great tools and all the methods you have available to enrich patient conversations. When you arm yourself well, you will also deliver the best dentistry for every unique patient. 




To find out more visit, email or call 01444 235486




[i] Nine of out 10 dentists fear being sued by their patients. Link: (accessed July 2019).


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