How is consent proved (or the lack of it) in dental practice?

I understand that "informed consent" is required for all dental procedures. That is, the dentist shall ensure that the patient is supposed to be informed of the procedures he will perform, the risks and the cost.


But in practice, at least for minor procedures, there is rarely a consent form signed.


So, when is it considered that the patient gave consent in case a conflict arises? Who takes the risk when this is not done formally or informally with proper information?


For example, a patient goes for a regular cleaning and the dentist bills a "full mouth debridement" which has double the cost and is not covered by insurance, without that been clearly explained.


Can the patient claim he never gave consent? (and win in court with that argument if he gets to that point)


All responses welcome, but please indicate if yours is just an opinion or if you have real knowledge from the dental or legal perspective.

How is consent proved (or the lack of it) in dental practice?
I sign a consent form prior to all procedures in both my general dentist's and my periodontist's office. All prospective procedures are explained to me in advance.


Find another dentist who has decent ethics.
Reply:No. What the consent does is the patient gives their consent on letting the Dr. do an extraction or a root canal really something major. It doesn't work on preventative procedures. The insurance part is kind of crazy. Basically the person is suppose to know what kind of insurance they themselves have. The doctor doesn't really know if the insurance covers it until they send it to insurance and they deny it or if the office people call up on it before.
Reply:I'm a dentist.





Boy, you're a real troublemaker, aren't you. People like you are the ones that make us so suspicious of patients and unwilling to help them out.





You probably do not have a case.





By sitting in the chair, you are providing consent for basic treatment. While that doesn't mean we don't tell you ahead of time what we will be doing, it does mean that we do not need you to sign a consent form. Your consent is implicit.





The only times we do have you sign a consent form is when we are performing procedures that are more involved than basic dental work--i.e. procedures that carry with them additional considerations and additional risks.





The situation you are describing is not an issue of consent. It's an issue of a miscommunication, and the chances are exceedingly high that the doctor DID tell you that you would have a "full mouth debridement", but you didn't hear it, didn't understand it, or simply forgot.





Additionally, the fact that the procedure isn't covered by your insurance is not the doctor's problem. It is yours. YOU, and ONLY YOU are responsible for knowing your insurance benefits. The doctor's office checks this for you only as a courtesy. In no way is it our responsibility to provide you with an accurate description of what your insurance covers and doesn't cover. This is probably written somewhere in the office--either on a paper that you signed or posted at the front desk. Perhaps elsewhere.





Finally, a full-mouth debridement rarely costs more than $200. Are you honestly willing to make a big fuss over something that almost certainly amounts to less than $200? You are truly a cheapskate.





Oh, and just one more point: the very fact that you needed a full-mouth debridement on your "cleaning" appointment indicates to me that your mouth is a filthy, stinking sewer, and that the doctor's staff could not simply brush your teeth with the rotating brush. You should be thankful that the doctor made time to perform that additional work for you.





Or would you have preferred to schedule it for another day?
Reply:Hey, if you're even curious why he "debrided" your mouth, it's because your teeth was caked with so much crap on it, that he or she couldn't see your teeth to provide an accurate diagnosis and treatment plan. By debriding the mouth, the dentist can get a better visual on all of your teeth.





I once had a patient with big chunks of plague and calculus covering 1/4 or 1/5 or his teeth. Thinking nothing of it, I debrided the entire mouth and lo and behold cavities upon cavities were underneath the calculus.





As a dentist, the work I do, I expect to get paid for it. It doesn't matter if it was a 5 minute check up or a 20 minute debridement (actual time may vary). If I do the work, I expect compensation. My time is just as valuable as yours.

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