Do We Consent to Change? An Evaluation of the Oral and Maxillofacial Outpatient Department Dentoalveolar Consent Forms

Abstract

BackgroundObtaining informed consent before performing any dentoalveolar procedure is a professional, ethical, and legal obligation. Prior to this work, no standardized consent process existed for dentoalveolar procedures in this Oral and Maxillofacial Department. MethodsA targeted literature review established localized gold standards for dentoalveolar procedures. Retrospective data from 56 dentoalveolar consent forms over a 4-week period assessed baseline compliance with these standards. ResultsData analysis identified that risks of dry socket and trismus were documented in only 7% of cases respectively, and maxillary tuberosity fracture was never documented. 33% of lower third molar cases did not include consent for inferior alveolar nerve injury. Findings were discussed in a departmental audit meeting, and a root cause analysis identified memory failure, repetition fatigue, and varying clinician knowledge and experience as key drivers. ActionsThe evidence base and localized gold standards were discussed. A standardized bilingual triple-copy dentoalveolar consent form was developed, including pre-defined indications, additional procedures, and risks in a tick-box format. This form was presented to the Department of Patient Safety and Quality and gained local approval. Cases completed with the new form will now be evaluated against the localized gold standards, with a mixed-methods feedback survey investigating staff and patient opinions. ConclusionsLocal processes for obtaining and documenting valid consent for dentoalveolar treatment were found to be inconsistent and frequently inadequate. 15 localised gold standards were set, and a new standardised consent form developed which will be evaluated for effectiveness and acceptability.