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by R. Patel (Author), V. Babu (Author), Sri H. Ravi (Author)
The Dentistry interview book is the number one selling dentistry book worldwide, providing an up-to-date review of the most common questions, with full answers and pointers on what the interviewers are looking for. Described as the 'essential guide', it is a vital resource as part of your preparation. Example question: Consider the case of nine year old Rebecca who comes in to surgery with her parents. This is her first dental visit. She has been kept awake with a painful tooth. Examination shows that she has several decayed teeth and that a lower right primary molar is causing the present pain. Rebecca is crying and climbing out of the dental chair. What is the best way to handle this situation. Clinically Rebecca's case draws on various themes. Without starting your undergraduate training you will not need to know about the clinical implications in detail. However, an understanding of the themes will make you stand out. A common answer is to indicate that some dentists may consider writing a brief referral letter to the local hospital for this tooth to be extracted with a general anaesthetic. The questions that you want to be thinking about clinically are: -Can this tooth be restored or does it need extraction? -What are the implications if I extract in the future (orthodontically can it have consequences) -Does the patient need General Anaesthetic or can this be managed within practice under Local Anaesthetic. -Rebecca has other dental needs as stated and has never attended a dentists before, how would I like to manage this to cause her the least upset? All of the above would require consideration of who would be consenting for the patient. In this case at 9 years old, the patient would require a parent or legal guardian to consent for her. 'Gillick Competence' allows for a child up to the age of eighteen to make their own decision regarding their care. However, the dentist must carefully assess that all the criteria for valid consent detailed in question four are present. There is particular emphasis placed on the patient's ability to understand and retain all the information given and communicate their reasoned decision. 'Gillick Competence' will be more relevant for scenarios where the child in question is slightly older. The ethical and legal responsibility to respect children as well as those who support them is essential in establishing strong professional relationships. In this particular situation explaining the options and offering choices will help the parents to make their decisions appropriately after understanding what's on offer, which in turn will increase the likelihood of co-operation, whichever option is finally decided upon. For Example: "The dentist should tell the family about the options and explain how the pain can be controlled with analgesics and a simple dressing. He /she should explain that it may be wise to slowly introduce Rebecca to dental care so that she becomes familiar with the dental environment before starting treatment. In this way he is enforcing the act of beneficence by acting in the patient's best interests and enabling the child's parents to make an informed decision- thereby enabling autonomy" Topics covered: GENERAL POINTS TO CONSIDER
