1. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Chapter 14 Legal Issues and the Dental Radiographer

2. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 2 Dental Radiography  Questions  What federal and state regulations affect the use of dental x-ray equipment?  What is the legal concept of “informed consent”?  What are the legal implications of patient refusal to have dental radiographs exposed?

3. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 3 Dental Radiography  Chapter 14 Reading:  Iannucci & Howerton (pp. 135-139)

4. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 4 Dental Radiography  Chapter 14 Outline  Legal Issues and the Dental Radiographer  Legal issues and dental radiography  Legal issues and the dental patient

5. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 5 Introduction  Purpose  To discuss general legal concepts, including various regulations as they apply to the dental radiographer who exposes dental radiographs for patient care  To address the issues of confidentiality and documentation

6. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 6 Legal Issues and the Dental Radiographer  Laws exist that govern the use of ionizing radiation in dentistry.  The dental auxiliary must be informed of and comply with these regulations.  The possibility of negligent care exists when dental radiographs are not properly exposed or used.

7. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 7 Legal Issues and Dental Radiography  Federal and State Regulations  Licensure Requirements

8. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 8 Federal and State Regulations  Iannucci & Howerton (pp.135-136)  Federal government  Requirements include safety precautions affecting the use of dental x-ray machines made and sold in the United States.  State, county, and city laws

9. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 9 Licensure Requirements  Iannucci & Howerton (p. 136)  May include:  Obtaining additional certification in dental radiography  Exposing dental radiographs only under the direct supervision of the dentist  Following restrictions concerning the types of dental radiographs that may be legally exposed

10. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 10 Legal Issues and the Dental Patient  Risk Management  Malpractice Issues  Patient Records  Patients Who Refuse Radiographs

11. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 11 Risk Management  Iannucci & Howerton (pp. 136-137)  The policies and procedures that should be followed by the dental radiographer to reduce the chances that a patient will file legal action against the dental radiographer or the supervising dentist

12. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 12 Risk Management  Informed consent  Self-determination Persons seeking health care services have the legal right to make choices about the care they receive, including the opportunity to consent to or to refuse treatment. Persons seeking health care services have the legal right to make choices about the care they receive, including the opportunity to consent to or to refuse treatment.

13. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 13 Informed Consent  Information presented to the patient should include:  The purpose and potential benefits of the radiographs  The person responsible for exposing the radiographs  The number and type of radiographs  The possible harm that may result if the radiographs are not exposed  The risks associated with x-ray exposure  The alternative diagnostic aids that may serve the same purpose as the radiographs

14. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 14 Informed Consent  Disclosure  The process of informing the patient about the particulars of exposing dental radiographs  Informed consent  Defined as consent given by the patient following complete disclosure

15. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 15 Liability  Dentists are legally accountable or liable to supervise the performance of dental auxiliaries.

16. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 16 Malpractice Issues  Iannucci & Howerton (p. 137)  Malpractice  Results when the dental practitioner is negligent in the delivery of dental care  Negligence  When the diagnosis made or the dental treatment delivered falls below the standard of care

17. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 17 Malpractice Issues  Standard of care  The quality of care that is provided by dental practitioners in a similar locality under the same or similar conditions  Statute of limitations  The time period during which a patient may bring a malpractice action against the dentist or auxiliary

18. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 18 Patient Records  Iannucci & Howerton (p. 137)  Documentation  Informed consent  Number and type of radiographs exposed  Rationale for exposing such radiographs  Diagnostic information obtained from the interpretation of the radiographs  Confidentiality

19. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 19 Ownership and Retention of Dental Radiographs  Iannucci & Howerton (pp. 137-138)  Legally, dental radiographs are the property of the dentist.  Patients do have the right of reasonable access to their records.  Dental records and dental radiographs should be retained indefinitely.

20. Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 20 Patients Who Refuse Dental Radiographs  Iannucci & Howerton (p. 138)  The situation must be carefully considered by the dentist.  The dentist must decide whether an accurate diagnosis can be made and whether treatment can be provided.