The GDC issues clear guidance on the subject:
"There can be no justification for intimidation or, other than in the most exceptional circumstances, for the use of physical restraint in dealing with a difficult patient. When faced with a child who is uncontrollable for whatever reason, the dentist should consider ceasing treatment, making an appropriate explanation to the parent or representative and arrange necessary future treatment for the child, rather than continuing in these circumstances."
The GDC anticipates the use of physical restraint but only "in the most exceptional circumstances."
Assault charge considered
A dentist treated a six-year-old girl who was known to be difficult. Previously she had refused to come into the surgery or sit in the chair or open her mouth. These events were all clearly recorded over a three-year-period in her notes
The girl returned for fillings to D & Es which the dentist had been unable to treat earlier because she would not co-operate. The appointment proved difficult and traumatic and in trying to persuade the recalcitrant patient to accept treatment the dentist, out of sheer frustration, slapped her. He admitted what he had done and apologised to the child's family, but he was asked to attend a police interview to answer a charge of assault. The child had been left with marks on her face and evidence of this was corroborated by her GP and photographs.
The dentist readily repeated his admission to the DDU adviser, though there was a dispute about various material facts such as how many times the child had been slapped and whether she had been held back in the chair during the treatment. The dentist's notes of the incident were not lengthy, and neither his dental nurse nor the parents had been present throughout the treatment.
After the police interview, the dentist was referred to the CPS, which advised that it was not in the public interest to proceed to a court hearing. The dentist was cautioned by the police, but it was not treated as a criminal conviction.
Nevertheless the GDC considered the patient's complaint, since it may have amounted to evidence that the dentist was guilty of serious professional misconduct. Written representations were made to the GDC's preliminary proceedings committee, but the matter was not referred to a public hearing before the professional conduct committee.
Finger bite
A two-and-a-half-year-old boy bit a dentist during a review appointment. The dentist was examining him when the child bit down forcibly on his right index finger. As a reflex the dentist slapped the child on the left side of the head and his finger was released.
Again, the patient's conduct was not an isolated incident and there was a note of earlier problems in the record. On this occasion, both parents were present throughout the treatment as was the dental nurse. The dentist explained his action to the parents, then completed the treatment. He also wrote a lengthy note about the incident and the nurse prepared her own report which corroborated the dentist's version. Unfortunately his explanation was not enough for the parents, who instructed solicitors and claimed damages for assault and battery.
Briefly, an assault is an act by which a person intentionally or recklessly causes another to apprehend immediate and unlawful violence. The fundamental principle of "battery" is that every person's body is inviolate. Battery is a catch-all term and includes even touching or laying hold, in whatever manner, of another person or clothing in an angry, revengeful ,rude, insolent or hostile manner.
The dentist agreed that the claim should be settled as soon as possible and it was settled within a few weeks of the event.
This page was correct at publication on 03/07/2002. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.