Role Play Flashcards
How to deal with a patient who is worried about the pain and risks of tooth extraction?
1) I understand that you’re feeling anxious about the extraction and it’s completely normal to feel this way. Is there anything specific that you are worried about when getting your tooth removed or just the procedure as a whole.
2) First we’ll use an anaesthetic to make sure you won’t feel any pain. Then we are going to use some special tools to gently remove the tooth. This procedure will eliminate bacteria and improve oral health.
3) we perform these procedures all the time and with high precision and care to ensure the treatment goes safely and comfortably.
4) after the extraction, you may feel a little sore and for this you can take some over the counter pain medication like ibuprofen and place a cold compress on the jaw or cheek outside where the tooth was removed to reduce swelling. It may help to even treat yourself to some icecream afterwards. Are there any questions or concerns you have about the procedure or aftercare or are you happy for me to continue?
A young child is terrified of getting a dental checkup?
1) Hello! My name is Dr Sawhney and I’m here to make sure your teeth are strong and healthy!
2)let me show you on mr Bear here what I’ll be doing. It’s just like counting teeth. I’ll use this little mirror just to have a peek at your teeth, to make sure everything is as it should be.
3) if you would like, you can hold your mums hand while I’m taking a quick look.
4) offer praise, “you’re doing great!”, “after this I’ll get you a sticker for being such a brave star”
A patient insists on an unnecessary cosmetic procedure
1) I see you’re interested in this procedure. Can you tell me more about why you feel it’s necessary?”
2) while this procedure can enhance appearance, there are also risks such as unnecessary damage to the teeth just to have the procedure in the first place. This can cause long term damage and since you have relatively healthy teet, this would be worsening oral health, and it’s my duty to do the opposite.
3) have you considered these other options that might be safer and more beneficial in the long term?
4) as a dentist, my number one priority is your health and well-being. While k want to respect your wishes, I also have to ensure that any treatment is truly in your best interest, and in this circumstances, there are other routes that I think would be a better fit.
You need to explain to a mother that her child has tooth decay and tell her what needs to be done, then explain it to the child
Your child here needs fillings, I know it’s not what you want to hear, but the good news is that they’re in the right place and we can get this sorted out today, Before we get started, I have to ask are you brushing your teeth twice a day. And how often do you eat any sweeties. Talk about correct brushing techniques and importance of cutting down on sweets so that we don’t get any more of your pearly teeth ending up like this one.
Explain the procedure in simple terms, so we are going to put the tooth to sleep and then put a little cap on the tooth so that it looks as good as new. Does that sound okay? If at any point you would like me to stop, just put your hand up and I’ll stop straight away for you. Ready to begin. Okay brillant. Wow you did great today I’m super impressed. Let me get you a sticker for being such a great superstar.
A teenager comes in to see you (the dentist). She isn’t bothered about oral health and you need to explain why it is important to look after one’s teeth.
1) by not brushing your teeth well enough, the debris from the food you eat will build up on your teeth. The bacteria on the teeth will feed on this and it ends up leading to tooth decay, so it’s upper important to brush your teeth twice a day minimum ti prevent plaque build up. Make sure when you brush your teeth that you don’t rinse your mouth with water afterwards because the fluoride in your toothpaste makes your teeth stronger, ans rinsing washed all the fluoride away.
2) I’m going to talk you through some tips and tricks when brushing your teeth as I can see some decay, so something is not right, but this is something easily fixed so do not worry.
2) even though we all love sweets, it is important to cut down on the sugar that you’re eating because it also interacts with the bacteria on your teeth leading to tooth decay. You got to remember that these are your adult teeth, so you have to look after them as we don’t get another set after them.
A child , sohaib needs one of his teeth removed. His mother, Aisha is extremely anxious about the procedure and has a few questions for you:
1) what is a tooth extraction?
2) how does it work?
3) will my child be under sedation?.
Then explain to sohaib.
1) a tooth extraction is the removal of a tooth from its socket in situations when the tooth is beyond repair. We’ll never put your child through this procedure unless it’s absolutely necessary. We will inform you if we think that there is no other treatment that can save the tooth.
2) during an extraction, we will numb the treatment area to prevent your child from feelin pain. Then we will loose the tooth with a specialised tool and use forceps to remove the tooth from its socket.
3) Our top priority is to ensure that your child is safe and comfortable during the treatment, so we have sedation and anaesthesia options to help your child relax. We use nitrous oxide, or laughing gas to make your child feel less nervous and nasty and it wears off quickly after the procedure so your child can feel normal sooner.
Sohaib:
Your patient has attended for an emergency appointment, you last saw the patient a month ago where you provided a filling. The patient presents with pain and now requires the filling to be replaced and extraction of the tooth adjacent. 1) explain to the patient the treatment plan +costs
2) discuss the reasons for the treatment and the risks
1) Today we are going to replace the filling I gave to you last month and we are also going to have to extract the tooth adjacent to it. as this treatment fits into band 2, and you came to me a month ago to get a filling, these treatments today will have no added cost. You will be given local anaesthetic to numb the area so it will be less painful and less uncomfortable. Treatment is quite urgent and has to be carried out as soon as possible.
2) I can see that you are in pain, and though this procedure may seem slightly daunting, getting the filling replaced is a priority and will ensure that the pain stops. If the filling isn’t replaced, there is a risk of infection in the mouth which can enter the blood stream ans cause sepsis which is life threatening so we definitely do not want it to progress that far. There are a few risks of the treatment. It’s likely that the pain is caused by the filling but even after replacing the filling, there could be pain caused by the procedure or the underlying cause may not be found. The procedure could also cause bleeding if a blood vessel is hit as well as swelling. There is also a risk of damage to adjacent teeth but this is also quite rare. We have done this procedure many times so there is nothing to worry about. Do you have any questions?
How to treat patients with HIV?
Good dental health is an important part of good overall health for everyone, especially for people with HIV. Under the equality act 2010, it’s illegal for a dentist to refuse to treat a patient because they have HIV and this applies to both NHS analysis private dentists. The same procedure is used for all patients. It’s unethical and unlawful to refuse dental care for those with HIV. It’s also illogical because many people have HIV without knowing it, so dentists treat people who have HIV anyway and need to take the right precautions at all times. Some dentists may feel they need to take extra care when treating someone with HIV so they may be more careful when cleaning and sterilising equipment to prevent HIV being passed on. Standard infection control procedures are designed to prevent transmission of HIV and other infectious diseases for example wearing PPE and washing hands and skin surfaces thoroughly before ans after. All equipment including glasses the patient wore should be wiped down.
Imagine you are in a clinic and a patient comes in and can’t speak English.
1) speak to interviewer about the important ethical dilemmas involved in this situation
2) how would you approach the situation.
One important ethical dilemma if the patient cannot speak English is getting informed consent. The patient must know the benefits and risks of the treatment and be given full discretion about it. They need to know if there are suitable alternative and implications for not carrying out treatment. Also, information can’t be withheld by healthcare professionals solely because they think it would cause the patient distress. The patient must have the capacity to understand, retain the information and make and communicate an informed decision. If they don’t fit any of these aspects for a particular decision, it is thought they lack capacity and so cannot give consent to a procedure.
The decision can’t be made through coercion. It must be done willingly without pressure from friends, family or medical staff. With a language barrier, it’s difficult for patients to fully understand treatment options and could end up having a treatment they are not full aware of so consent is not valid.
To tackle this, you could hire a translator for the appointment ti make sure the patient understands the treatment, implications and benefits of the procedure. If possible, I would be better if dentists rely on a formal translator instead of a family member, because family members translating delicate questions can lead to embarrassment for the patient and the family member. You could also try combine the use of verbal and non-verbal language to guide their understanding to what you are saying such as hand gestures or images. You should also speak slower and use simple vocabulary.
A 7 year old child has entered the practice with multiple dental caries. They need 5 fillings but the mother refuses and says you are scamming her.
1) assess mothers concerns. Rectify misconceptions she may have about the procedure.
2) explain the treatment + why you have chosen that specific treatment.
3) mention alternative treatments like tooth extractions or doing nothing. However, explain long term effects of doing nothing so that mother can make informed decision.
4) appreciate autonomy. It is the mother’s choice whether or not her child gets the treatment since the child is so young.
You just received results that a patient has oral cancer. You as a dentist must break the news to a patient.
Hello my name is dr Sawhney and I’ll be taking care of you today. How are you feeling today? So last week they took a sample to get tested to see if there’s any underlying conditions that need to be made aware of. I’ve got the results here. Would you like to go through them now or wait for a family member to be in the room first? Okay so in regards to the results I do have some bad news unfortunately, we have indications of oral cancer in your system. I completely understand that you must be upset at the moment. Would you like some water or some tissues? I know this must be devastating news, but at this practice we are going to be providing the best possible supportive care that we can to ensure you get through this as best as possible. Unfortunately nothing is 100% however thankfully we have detected this oral cancer quite early so hopefully with the treatment plan we employ, it will provide the best solution possible. So with regards to treatment, this will be discussed at your next appointment. We will be constructing a treatment plan toilered to you and your needs. I cannot tell you in this current moment what the treatment plan will involve but rest assured that we will provide the best possible care that we can. Again I understand this is devastating news but I want to remind you that we have caught this early so we have the best chances of finding a solution. If you would like to read up or find out a little bit more about the condition we do have leaflets available and there is information on the practice’s website. Do you have any questions that you would like to ask or any concerns you want me to touch upon?
A women wants braces, however she does not fit the criteria for braces under the NHS what do you do?
1) firstly, I would acknowledge the emotional aspect of the situation. It’s clear that the dissatisfaction in her teeth is affecting her mental health. As a healthcare professional, you have to acknowledge that mental well-being is just as important as physical health.
2) In terms of the GDC principles, you should put patient’s interests first, and so I would take time to fully understand her concerns and explore all possible solutions, while being clear about the nhs criteria. I would also approach this situation with empathy as it is clearly something that is bothering her.
3) however from a clinical standpoint, I understand that NHS treatment for orthodontics is based on functional need rather than cosmetic preference. As the patient doesn’t meet the criteria, the nhs is unlikely to cover the cost.
4) it is a challenging scenario, and after fully listening to her concerns, and explaining that the nhs will not cover her treatment, I would discuss private treatment options like private orthodontist to improve aesthetics. I would also be mindful of her mental health, and would possible suggest counselling if she has extreme emotional distress over the situation. If feel like this would allow her to make a fully informed decision on what she wants to do, while being empathetic and respecting patient autonomy.
A patient comes in with severe dental anxiety and refuses to get treatment done with sedation?
1) firstly I would acknowledge the patient’s anxiety, ensuring I’m empathetic and that they feel understood. I would tell them that it’s completely normal to be nervous for dental procedures, and that I’m here to help them feel as comfortable as possible. I would reassure them that their safety is the priority.
2) then I’d try to find out what specially is causing them anxiety, is it the needles, is it previous experiences, and try to find a way around it.
3) i would explain some non-sedation techniques we can use, such as deep breathing exercises, or allowing them to take breaks during the appointment. Clear communication about each step of the procedure can also help reduce fear as the patient knows what to expect, and is also one of the GDC principles.
4) if the patient insists not on sedation, I would discuss the options available like laughing gas. I would go over the pros and cons of each method, taking into account medical history.
5) if sedation is chosen, I would discuss a long term strategy to help the patient feel more comfortable with regular dental visits, so we can work toward reducing the need for sedation.
Should all dentists have good teeth?
As a dentist, I feel that they should set a good example of oral hygiene because at the end of the day, dentists are a role model to their patients. It’s important for dentists to take care of their own oral health as it shows commitment to the practices they tell their patients.
However, things like having crooked teeth or fillings can be due to things like genetics and upbringing , which isn’t in their control. Therefore I feel that having good teeth is not a requirement as a dentist, and it’s more important that they have the skills and communication to be a dentist.
What would you do if a colleague turned up drunk?
1) firstly, patient safety is the priority so if I noticed that a colleague came to work drunk, I would take immediate action to ensure no patients are affected by their impaired state.
2) I would approach the situation sensitively because I understand that they could be dealing with personal issues, however I would also keep in the mind that this behaviour is not acceptable.
I would express concerns privately asking them if everything is okay, and if not refer to counselling.
3) you have a duty to your patients ti treat them with care and safety, so ensure that any patients that were going to be dealt with the colleague are accommodated for, review notes for any patients that the colleague may have already seen, and ensure the consultant stops working and goes home by taxi. You should also consult a senior dentist or even the practice manager on how to deal with the colleague.
