Standards of Care, Recordkeeping, and Informed Consent
The standard of care
The standard is what a reasonably prudent dentist in similar circumstances would do - not the best possible care, and not the care the patient demands. Expert testimony usually establishes the standard. Traps include questions that equate a bad outcome with negligence; the law requires a breach of the standard plus causation.
Records
Patient records must be accurate, contemporaneous, and retained for the period required by board rule. Records belong to the practice, but patients have rights of access. Common traps: altering records after a complaint (which is itself a disciplinary matter), failing to document informed refusal, and charting retrospectively without notation.
Informed consent
Valid consent requires capacity, disclosure, voluntariness, and comprehension. Disclosure includes the nature of the procedure, material risks, alternatives (including no treatment), and likely consequences. Written consent documents the conversation but does not substitute for it. Watch for questions where a signed form is offered as a complete defense despite no discussion.
Worked example
A patient declines a recommended extraction and the dentist notes 'patient refused' with no further detail. A stronger record documents the risks explained, alternatives offered, and the patient's questions. Rule of thumb: if it isn't in the record, the board and a jury will assume it didn't happen.
Trap patterns
Minor consent, emergency exception, and consent by a guardian are frequent curveballs.