A dentist called the DDU after a patient made an unusual request for his teeth to be made to look like fangs.
The patient was inspired by an influencer in the US who had his canine teeth contoured and sharpened. He asked if it was possible to achieve the same look.
When the dentist explained that he didn't think this treatment would be in his best interest, the patient then produced some teeth jewellery he'd had made to resemble fangs and asked if the dentist could apply these to his canine teeth?
Our member was concerned about carrying out either of the patient's requests and asked for advice.
DDU advice
Although this was an unusual request, DDU members regularly called our advice line saying they feel under pressure to carry out treatment a patient has seen on a social media platform or online.
The first principle of the GDC's 'Standards for the dental team' is to "put patients' interests first". This encompasses listening to patients and being sensitive to their needs, but also acting in their best interests. This doesn't mean agreeing to any patient request.
You must be convinced the proposed treatment is reasonable, in line with current accepted practice and in the patient's best interest. You should decline to provide treatment if you don't judge it to be clinically appropriate - however persuasive the patient may be.
Tooth jewellery is growing in popularity and the GDC considers its application as the practice of dentistry. However, the charity Safe Smiles warns that, "having a jewel stuck onto the surface of your tooth can cause serious damage." This is because the tooth underneath the item is impossible to clean, causing plaque and bacteria to build-up, which can lead to tooth decay.
The charity also warns against patients trying to remove the jewellery themselves if they find it uncomfortable. Doing so can cause permanent damage and side effects.
The dentist was advised to consider whether they would be able to justify providing dental jewellery in their role as a registered dentist. Both the law and the GDC expect dental professionals to provide dental treatment that is in patients' best interests, will not damage patients' oral health, and is in line with current accepted practice and teaching as would be supported by a responsible body of dental opinion.
Our adviser suggested the member discuss the risks, consequences and potential outcomes of the treatment being requested with the patient.
If the member wasn't comfortable going ahead with the patient's request, they should inform the patient that they would not be able to provide treatment that they don't consider to be in their best interests. The dentist was advised to make a clear record of these discussions on the clinical notes.
This is a fictional dilemma, based on real cases seen by the DDU.
This page was correct at publication on 31/10/2024. 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.
by Leo Briggs BDS, MSc Deputy head of the DDU
Leo Briggs qualified from University College Hospital, London, in 1989. He has worked extensively in the Community Dental Service including a brief period overseas. He has also worked in General Dental Practice.
Leo gained a masters degree in Periodontology from the Eastman in 1995 and is on the GDC specialist register for Periodontics. Since 1995 he has provided specialist periodontal treatment in both the Salaried Dental Services and Private Practice. He started working for the DDU in 2005. Between 2007 and 2009 he worked part time at the DDU and part time as a Clinical Tutor at the School for Professionals Complementary to Dentistry in Portsmouth. In 2009 Leo went full time with the DDU. In January 2016 he became deputy head of the DDU. He continues to work clinically as a specialist periodontist in a General Practice on Saturdays.