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Document Dental Contract Reform - Is an OHA / OHR required if a patient presents for urgent care and upon examination it’s determined they require a band 2 or 3 Course of Treatment?

To comply with the GDS Regulations an examination must be carried out to identify all necessary treatment. If the patient has had an OHA / OHR recently but attends the practice for urgent care shortly thereafter when the dentist determines they require a Band 2 or Band 3 treatment, it would be appropriate to open a treatment without doing an OHR. However, it's important to record details of the examination in the clinical notes. The recall interval would need to be re-set as appropriate following the treatment provided. However, the dentist may also consider, following discussion with the patient, if an assessment of the presenting complaint and that Urgent Treatment would be more appropriate (The provision of a permanent filling is also available as an urgent course of treatment depending on the presenting complaint (not more than one permanent filling, extraction of not more than two teeth and a number of other discrete treatment items).

Due to the plethora of presenting symptoms and conditions, it's not possible to stipulate which clinical scenarios should be classified as ‘urgent’ and which should not. It's, therefore, the judgment of the dentist as to whether prompt treatment is necessary because the patient’s oral health is likely to deteriorate significantly, or because the patient is in severe pain. However, the classification of treatment provided and the resulting claiming approach should be based on patient needs and expectations, and a clinical decision made by the practitioner informed by these.                                                                                                  

It's essential that any patient attending for any course of treatment understands the basis of that course of treatment (including associated costs and recall intervals) and gives appropriate consent, which should be recorded accordingly in the clinical records.


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