[Organizational and legal aspects of implant dentistry according to the analysis of judicial practice]

The aim of the study was the analysis of complex forensic examinations and decisions of civil courts in cases related to poor-quality provision of implant care in 2013-2016. It determines specific features and algorithms for optimization of legislative protection system for dental surgeons and prosthodontist by provision of implant-related dental care.

[Legislative framework and legal regulation of dental care organization to patients with infectious diseases]

The existing normative legal framework does not fully correspond to modern requirements for the organization and delivering dental care for adult population with various infectious diseases. The authors basing on the analysis of regulatory guidelines consider that in order to provide timely, high-quality and affordable medical care to patients in the infectious diseases departments and clinical hospitals, it is necessary to update the normative legal framework and develop criteria for monitoring the quality of dental care for infectious patients at the stages of its delivering.

Opioid Use Disorder in Dental Patients: The Latest on How to Identify, Treat, Refer and Apply Laws and Regulations in Your Practice

Opioid use disorder is a persistent problem in the United States and has become an important issue to medical and dental professionals. Americans are the largest users of opioids by a large margin. The importance of knowing how to identify, handle, refer, and treat patients with opioid use disorder cannot be understated. This article attempts to educate dental professionals on the current epidemiology of opioid use, explain the physiology of addiction, teach practitioners how to identify chronic opioid users, gives options for treating dental pain, establishes criteria for referring to an addiction specialist, and describes the laws, regulations, and resources available to practitioners. With this article, practitioners should have a greater understanding of the current problem of opioid use disorder and be able to develop a protocol for treating these patients.

A Public Health Perspective on Paying for Dentistry, the Affordable Care Act, and Looking to the Future

Health care costs have traditionally been provider generated whereas payment has been split between public and private sources. There has been little pressure on health care providers to demonstrate value. The quest for value in health care financing is now widely evident as demonstrated by governmental and private sector pursuits of a 3-part aim: better health outcomes at lower cost with improved patient and population experience. Value-based approaches involve payment innovation with its attendant constraints and opportunities for innovation. This contribution posits a growing role for dental public health by exploring interfaces with these forces within the contexts of US dental care financing.

Oral Health Care in Rural America

(1) Rural Americans are twice as likely to lose their adult teeth as their urban counterparts. (2) Seventy-two percent of the country is classified as rural, but is home to only 15 percent of the population (46.2 million people). (3) According to the Pew Center on the States, rural residents are more likely to use emergency departments for their oral health needs because of a lack of dental insurance and a shortage of dental providers.

Medico-Legal Considerations in Providing Emergency Dental Care in Practice

The unpredictability of unscheduled emergency dental care carries its own clinical, communication and management challenges with associated medico-legal risks. Providing emergency dental treatment for unfamiliar patients in an unfamiliar environment amplifies the hidden pitfalls which failure to avoid can create potentially damaging critical incidents in a practitioner's professional life. These are preferably avoided through consistent attention to best practice and risk management. Day to day processes, such as excellent record-keeping, valid consent and effective communication are under the spotlight in the event that a patient complains, raises a concern with a regulator or seeks compensation following alleged negligent care. This paper aims to highlight the dento-legal pitfalls that may be pertinent in such a challenging situation.

Experiences of the Kansas Extended Care Permit Providers: A descriptive study

Purpose: A total of 40 states to date have expanded the role of dental hygienists with the goal of improving access to basic oral health services for underserved populations. In Kansas, legislative changes have resulted in the Extended Care Permit (ECP) designation. The purpose of this study is to describe the experiences of registered dental hygienists in Kansas holding ECP certificates (ECP RDH) as of July of 2014.Methods: Secondary data analysis was performed utilizing data collected from a survey conducted in 2014 by Oral Health Kansas. All registered ECP RDH's were sent the 32-item survey via Survey Monkey®. Descriptive statistical analyses consisted of frequency distributions, and measures of central tendency. Inferential analyses using t-tests and ANOVA were conducted to compare groups.Results: A total of 73 responses were received from the (n= 176) surveys that were e-mailed for a 41% response rate. Of the clinicians who responded, 80%, worked at least part-time and in school settings. The most consistent barriers to providing care were the inability to directly bill insurance (52%), financial sustainability (42%) and physical requirements (42%). Follow-up tests found significant differencs between clinician groups when examining barriers.Conclusion: Although the ECP legislation appears to be expanding access to care for citizens in Kansas, significant barriers still exist in making this a viable model for oral healthcare delivery.

Medical malpractice: An introduction for the dental practitioner

With the plethora of medical malpractice claims, health care providers are forced to deal not only with medical matters but also with legal issues. Thus, unfortunately, every time health care providers give a medical treatment, they should be aware of the legal implications of their act. Most medical malpractice cases will be resolved in civil law and will have financial implications, but in extreme cases (such as causing death by negligence) criminal procedure may also be conducted, meaning criminal sanctions (imprisonment or fine). This paper is intended to provide dental practitioners with an introduction to basic legal knowledge and concepts regarding medical malpractice law along with a short legal overview regarding the liability regime in different countries. The paper focuses on tort law and the meaning of "negligence," reviewing the main different liability regimes that exist and the legal elements that must be proven in each regime in order to receive compensation. In an era of increase in medical malpractice law suits, it is essential that physicians and dental professionals recognize the basic legal concepts of medical malpractice.

Oral Healthcare Implications of Mass Migration

Population movements, whether voluntary or forced, are an integral part of an increasingly globalized society and, while the health needs of migrant populations cannot be generalized, some migrants can have worse oral health outcomes compared with their host-country counterparts, with their first dental contact typically being for emergency care. Failure to provide immediately necessary treatment may be unlawful under the Human Rights Act 1998. CPD/Clinical Relevance: NHS dental services need to evolve and address the challenges inherent in caring for vulnerable migrants. Education and appropriate training needs to be developed for the dental profession in order to enable new ways of promoting intersectoral care and community engagement.

What's new in ... The Process of Consent

An understanding of mental capacity is fundamental to the process of obtaining valid consent. This article looks at the processes of both consent and capacity assessment, and highlights the importance of fully informed consent following recent changes in the law.

The adolescent patient: parental responsibility, the right to be informed and the right to be heard

The increasing emphasis placed on patients' rights, in dentistry as well as in other areas, is also having repercussions on the structure of the relationship between health care staff, the under-age patient and his /her parents. The authors reflect about the decision-making process when the patient is a minor in the field of dentistry and underline the role of the parties involved (dentist, parents, under-age patient) in different circumstances (e.g. ordinary care or non-routine care; urgent situations; conflict between parents; refusal of the parents; disagreement between the parents and the child, refusal of the under-age patient; etc.). The Law must first ensure that the minors' needs for protection are met by awarding their parents the power and duty to care for them and, thus, also to take health care decisions in their interest. At the same time, domestic legislation and international legislation supports the need to give greater weight to minors' opinions as they approach the age of majority and, therefore, as they acquire a certain degree of maturity. The rights of under-age patients are safeguarded by actively involving them in the decision-making process, with particular reference to their right to information and right to be heard, to the extent that their age and understanding allow, with due consideration to the specific situation.

Review of the peer review process

Discussions of dental law, ethics, and risk management often center around what a dentist should do to reduce the risk that an upset, litigious patient will seek out an attorney to address the problem. There is a very useful option for the dentist and patient to pursue that eliminates the adversarial stance associated with a lawsuit. The peer review resolution process has been shown to be a positive, professional way to end certain dentist-patient confrontations, and the results normally are upheld in most jurisdictions.

The Francis Report--dento-legal implications

This article explores the potential implications of the Francis Report for members of the dental team from a dento-legal perspective. It looks at the broad recommendations in light of the existing ethical environment in which dental registrants work and asks what is new and what the recommendations will actually mean for dental professionals in practical terms. Clinical Relevance: The fundamental recommendations of the Francis Report, namely, that those who provide care should put patients' interests first and be open about outcomes and performance, are not new concepts. A breach of these ethically based expectations may, however, create grounds for legal proceedings, which is clearly a significant point for all members of the dental team. It is therefore important to be aware of what is expected of those providing clinical care.

Analysis of Nigerian dentists' opinion and consequences on expanded function dental auxiliaries

OBJECTIVE

To examine Nigerian dentists' opinion on expanded function dental auxiliaries.

METHODS

This cross-sectional study of Nigerian dentists attending a dental conference was conducting in 2012 using self-administered questionnaire. The data were analyzed using Statistical Package for the Social Sciences version 16.0. P < 0.05 was considered statistically significant.

RESULTS

The majority of the 82 dentists that participated in this study were male, aged 31-40 years, either specialist or specializing (residents), practiced for < 10 years, teaching hospital and urban practitioners. Of the participants, 22 (26.8%) reported favorable opinion towards expanded duty dental auxiliaries. The mean scores on consequences, of expanded function dental auxiliaries ranked redundancy of dentist as highest. Males and non-specialist significantly reported expanded function dental auxiliaries would lead to redundancy of dentists. Practitioners working in other hospitals other than teaching hospital significantly reported that appropriate legislation are necessary before expansion of duties of the dental auxiliaries can be done. The dentists with favorable opinion significantly reported that expanded duty dental auxiliaries would not cause redundancy of dentist and the task are not too difficult for dental auxiliaries with necessary training but will increase service delivery and efficiency, increase job satisfaction, lead to dental auxiliary specialization with legislation.

CONCLUSION

Data from this study revealed overall unfavorable opinion of Nigerian dentists on the expanded duty dental auxiliaries. However, those with favorable opinion were significantly supportive of expanded function dental auxiliaries. This information would serve as a useful tool for Nigerian oral healthcare policy formulators.

Capacity, Consent and Dentistry - Who Decides and How Do They Do It?

Dental interventions can only occur within a legal framework. This means either the patient gives their informed consent to the procedure or, if this is not possible, an assessment is made whether they lack the ability to consent, in which case a decision on treatment is made under the Mental Capacity Act (MCA). This article takes a brief look at how the MCA sets out the test of capacity, who makes decisions when the patient is unable to do so and how 'best interest' decisions are made in a way that protects the rights of the patient and protects the dental professional from legal liability.

Considerations for use of dental photography and electronic media in dental education and clinical practice

Photography and electronic media are indispensable tools for dental education and clinical practice. Although previous research has focused on privacy issues and general strategies to protect patient privacy when sharing clinical photographs for educational purposes, there are no published recommendations for developing a functional, privacy-compliant institutional framework for the capture, storage, transfer, and use of clinical photographs and other electronic media. The aims of this study were to research patient rights relating to electronic media and propose a framework for the use of patient media in education and clinical care. After a review of the relevant literature and consultation with the University of Washington's director of privacy and compliance and assistant attorney general, the researchers developed a privacy-compliant framework to ensure appropriate capture, storage, transfer, and use of clinical photography and electronic media. A four-part framework was created to guide the use of patient media that reflects considerations of patient autonomy and privacy, informed consent, capture and storage of media, and its transfer, use, and display. The best practices proposed for capture, storage, transfer, and use of clinical photographs and electronic media adhere to the health care code of ethics (based on patient autonomy, nonmaleficence, beneficence, justice, and veracity), which is most effectively upheld by a practical framework designed to protect patients and limit institutional liability. Educators have the opportunity and duty to convey these principles to students who will become the next generation of dentists, researchers, and educators.

[THE NORMATIVE LEGAL SUPPORT OF ORTHODONTIC CARE OF POPULATION AT THE LEVEL OF SUBJECT OF THE RUSSIAN FEDERATION]

The article contends that in stomatology actual normative legal support does not handle all problems of both organization of orthodontic care of children population and control of quality of orthodontic treatment. It is assumed that in. conditions of updated federal health legislation additional efforts are to be made to enhance quality and accessibility of orthodontic care. Thereafter in the area of normative legal support procedures of organization of orthodontic care of population at the level of subject of the Russian Federation in conditions of orthodontic medical organization are to be developed additionally. The standards of curative diagnostic measures, standards of quality control, target indicators, and mechanism of audit of evaluation of effectiveness of orthodontic care at the stages of its provision.

Perceptions of Kansas Extended Care Permit dental hygienists' impact on dental care

PURPOSE

In 2003, Kansas addressed their access to oral health care needs with amended state dental practice act for registered dental hygienists. The Extended Care Permits (ECP) I, II and III have expanded the dental hygiene scope of practice, allowing dental hygienists to provide oral care to Kansans in different settings beyond the dental office. The purpoase of this study was to examine the perceptions of Kansas ECP dental hygienists on change to oral care in Kansas.

METHODS

A questionnaire was mailed to all ECP dental hygienists (n=158) registered with the Kansas Dental Board. Questions were open-ended, close-ended and Likert scale. Information was sought regarding demographics, areas of employment, work related activities and impact to oral health care. Study exclusions included ECP providers no longer practicing in Kansas, practice more than 50% in another state or no longer practice dental hygiene at all.

RESULTS

A total of 69 surveys were returned, with 9 surveys excluded for exclusion criteria. Most respondents (92%) agreed the ECP is a solution to oral health care access issues in Kansas. Barriers to utilizing their permits fully included: difficulty locating a sponsoring dentist (12%), locating start up finances (22%), limited work space (14%) and difficulty with facility administrators (39%). Many respondents (62%) agreed the proposed registered dental practitioner would improve access to oral health care to Kansans.

CONCLUSION

The Extended Care Permit providers in Kansas appear to be satisfied with their current employment situations and feel oral health care has improved for their patients served but they are unable to utilize their permits fully for various reasons.