Dental services

National Standards for Dental Services

Standards 1 to 14 apply to all service users. Standard 15 applies to aspects of care that are specific or unique to children. These include the rights of children, the responsibilities of the people treating them, and the responsibilities of parents and guardians consenting on behalf of children.

Standard 1: Choosing your dental service

You have access to accurate, clear and easy-to-understand information that is readily available to help you choose the dental service that best meets your needs.

  1. You know if the dental service is accepting new patients.
  2. You can get information about the dental service, which may be in the form of a leaflet, including the following:
    • a guide to the services provided and whether these services are provided under the NHS or privately;
    • opening hours of the service;
    • where the dental service is and how to get there;
    • a contact number for any questions about the services or facilities;
    • details of any disabled access or facilities;
    • how the service meets any special needs, including the need for an interpreter;
    • a guide to the range of charges for the services provided – in particular, initial consultation, treatments, investigations and prescriptions;
    • a guide to the method and time of payment, and any charges for failing to attend an appointment;
    • how your continuing care is provided out-of-hours or if your dentist is not available; and
    • a contact number for any questions you may have about NHS dental provision in your area.
  3. The service gives you information in a form you can understand. If this is not available, you receive advice on how to get the information in a language or format that you can understand.
  4. If you want, you can receive from your dental service its latest inspection or review report measured against these standards.

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Standard 2: Before your appointment

You receive all the information you need in advance, to help you when you attend your appointment.

  1. Your appointment is agreed for a time that suits both you and the service and that recognises the urgency of your oral healthcare needs.
  2. Before your appointment, you receive adequate information about it, including:
    • who the appointment is with and how long it is likely to last;
    • what you need to bring with you; and
    • contact details, in case of cancellation either by you or by the dental service.
  3. If your first language is not English, or if you have any other communication needs, you will receive, on request, advice and information on how to get interpreting services, adaptations and equipment for communication.

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Standard 3: Your visits

You are treated with dignity and respect by the dental team throughout your visits.

  1. The dental team treats you with respect as an individual. Your age, gender, race, religion or belief, disability and sexual orientation will not affect the quality of service you receive.
  2. If the facilities are not accessible for you for reasons of disability, special needs or language, the dental team will refer you for care to somewhere else that is suitable.
  3. The dental team confirms your personal details in a manner which is sensitive to your privacy and dignity.
  4. Your consultation and treatment take place in an environment that allows privacy.
  5. You are made aware of the names of the dental team involved in your care. You are made familiar with the facilities.
  6. You receive an apology and an explanation if you are kept waiting beyond your appointment time and can discuss alternative arrangements.
  7. Normally, there is a third person present during your treatment. This is usually the dental nurse. In exceptional circumstances, you may be asked to bring someone with you to be there during your treatment (for example, during out-of-hours emergencies).
  8. You receive explanations about your care and treatment in a way that you can easily understand, and you have an opportunity during your appointment to ask questions.

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Standard 4: Assessing your needs

All decisions on your dental care, including preventative care, will be based on a full assessment of your needs.

  1. Before your treatment begins, a member of the dental team will take your medical history, to make sure as far as possible that the treatment is safe for you. This will include recording any current medication and asking about your current state of health. Medication may include prescribed drugs, as well as over-the-counter preparations, including aspirin and other remedies such as herbal preparations. You receive help, if needed, to provide this information.
  2. If at any time your dentist needs to contact your own doctor for information about you that is relevant to your dental care and treatment, you will be asked to give your permission for this.
  3. You are asked about your dental history. This is followed by a dental and oral examination, which includes looking for any signs of possibly serious disease in your mouth and surrounding areas that will need to be investigated further.
  4. You will be offered any investigations that your history and examination show that you need.
  5. You will be informed of the results of any assessment and investigations.
  6. If you are assessed as needing urgent referral, the dental service has a system in place for this referral to be made as a matter of priority.

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Standard 5: Deciding and agreeing your care and treatment

Your decisions on any care and treatment provided to you by the dental team are based on you being fully informed by your dentist of the risks, benefits and cost involved.

  1. Your dentist gives you clear information about the range of treatments that are available, and are relevant to your needs and preferences. This includes an explanation of the advantages, disadvantages and costs of any treatment, as well as what may happen if you choose not to proceed.
  2. You have a verbal or written estimate of treatment costs before you decide on and have treatment. You are clear which treatment is provided under the NHS and which is provided privately.
  3. You have the opportunity to ask questions or receive further advice from the dentist or from an appropriate member of the dental team (or both). You can have a member of your family or another person of your choice to ask questions on your behalf.
  4. You have the time you need to consider and agree the treatment.
  5. Your treatment plan is recorded and you can have access to it. You are informed if any changes need to be made to this plan, and the reasons and costs, when they arise.
  6. You will be told how long your appointments are likely to last and the timescale of the proposed treatment.
  7. If you need treatment after an examination, you are offered an appointment within a timescale agreed by you and the dental team.
  8. If you want to, you can discuss any aspects of your proposed care at a later date.
  9. The dental team obtains your consent to treatment in line with current best practice guidelines and legislation.
  10. If you are unable to express your own wishes or views, decisions about your care and consent to it will be in line with current best practice guidelines and legislation, e.g. Adults with Incapacity (Scotland) Act 2000; Mental Health Care and Treatment (Scotland) Act 2003.
  11. You are involved in making decisions about your care and treatment.

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Standard 6: Receiving your care and treatment

You receive safe and competent care and treatment in a manner designed to put you at ease.

  1. Any examination, investigation or treatment will only be carried out after you have been advised what will happen.
  2. Any concerns you may have about treatment, including pain control or anxieties, are discussed. You are offered a range of pain and anxiety control options to help.
  3. If medication is needed as part of your treatment, this is fully explained to you, including:
    • the reasons for taking the medication;
    • any common side-effects; and
    • how to get your medication.
  4. If you need to be referred to another dentist, dental service or hospital for your continuing care and treatment, the service makes suitable arrangements for this, and you will be told where you will be seen, and the likely waiting times.
  5. If you are assessed as needing urgent referral, the dental service has a system in place to refer you with your agreement.

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Standard 7: Ongoing care

Following your consultation, investigation or treatment, you know about, and agree, the ongoing care you need and the arrangements for providing it, including who is to provide it.

  1. The dental team explains your ongoing care to you and agrees with you the plan for how it will be provided, taking account of your oral healthcare needs and preferences.
  2. You are provided with clear information and an explanation about what your responsibilities are in the ongoing care of your mouth and teeth.
  3. As part of your ongoing care, you will be offered routine checkups at a frequency that reflects your oral health needs. The service has systems in place to remind you to attend.
  4. If any changes need to be made to your treatment plan, the dentist will discuss and agree these with you and any changes will be recorded.
  5. You receive advice, tailored to your needs, about maintaining or improving your oral health and preventing problems. You have access to oral health promotion literature.
  6. You are reminded of any potential long-term treatment needs you may have.
  7. You receive information on how to get advice and emergency care out-of-hours.
  8. You know that information about your care and treatment will be shared between your dental team and any service that you are referred to. If you do not agree to this, the team will respect this and explain any implications for your care.
  9. You are informed of arrangements for your continuing care if your dental service closes.
  10. If you are removed from the dentist’s list, you are given reasons in writing.

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Standard 8: The quality of your care and treatment

Your care and treatment are provided according to recognised current best practice guidelines.

  1. Your dental service reviews its performance of clinical treatment and care against current best practice guidelines, and all members of the dental team are involved in the review.
  2. The ongoing process of review leads to changes in practice and improvements in the standard of care and treatment you receive.
  3. You can request information about the review process and its results.
  4. Your dental service makes sure that any laboratory it uses for diagnostic tests is accredited by an appropriate body.
  5. The care and treatment you receive from the dental service takes account of all relevant NHS Quality Improvement Scotland standards.

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Standard 9: Expressing your views

The dental service will welcome and actively seek your views to help it continuously improve the quality of care it provides.

  1. You have the opportunity to make known your views on any aspect of the service and your care. You can do this confidentially.
  2. You are made aware of the service’s policy for handling any concerns or complaints you may have. The policy includes how long it will take to handle your concerns or complaints.
  3. You are made aware of how to raise any concerns or complaints about your dental service with the service itself. You are also made aware of other organisations to raise concerns or complaints with, including the NHS, the Care Commission and the General Dental Council.
  4. Your views and feedback from any praise or criticism are used by the service to continuously improve it.
  5. If you are unable or feel unable to express your views yourself, you can have a representative of your choice to help you.

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Standard 10: Confidentiality and information held about you

The service keeps an accurate, full and up-to-date record of all aspects of your care. It uses and stores it in a manner that ensures your confidentiality, and is in line with current legislation, e.g. The Data Protection Act 1988.

  1. Your patient care record:
    • is confidential;
    • is used by members of your dental team to make sure there is continuity in your care and treatment;
    • contains up-to-date information recorded by any member of the dental team about every aspect of your care on each visit; and is kept in line with best practice guidelines.
  2. All your personal information is stored securely.
  3. Only you and the people involved in your care, or other people agreed by you, have access to information held about you, unless there is a lawful basis for disclosure.
  4. If you are unclear about any part of your patient care record, you can ask for and get an explanation.
  5. There is clear and effective communication about your care within your dental team and with other healthcare professionals involved in your care.
  6. You are made aware of the arrangements for the safe storage and retrieval of your patient care record if the dental service closes.

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Standard 11: The dental team and service management

Your care and treatment will be provided by a dental team who are all suitably qualified or skilled (or both) for their job.

  1. The dental service’s recruitment and selection procedures comply with all relevant legislation.
  2. You receive care and treatment from a dental team (including temporary members) whose qualifications, skills, training and all necessary records have been checked before they start work in the service. This includes checking:
    • the registration of professional staff;
    • professional indemnity insurance; and
    • Disclosure Scotland checks (if they apply).
  3. Your dental team will have received induction training upon joining the service and continue to get support for ongoing training that meets the needs of the team and the services they provide to you.
  4. Your dental team takes part in continuing professional development and post-graduate training to update knowledge and improve skills.
  5. You receive care and treatment from members of a dental team who are able to raise concerns in confidence about any aspect of service delivery that they feel may harm patients’ care or the quality of the service. The service keeps a confidential record of all concerns raised and the action taken in response.
  6. Your dental service has effective team working, including communication between dentists, specialists, dental nurses, hygienists, therapists, and other medical and social care professionals.
  7. Your dental service recognises that the team may need personal support and help in providing patient care and treatment, and makes sure that this is provided, including access to occupational health services.
  8. Your dental service identifies any member of the dental team who is performing poorly and provides him or her with support.

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Standard 12: Medical and other emergencies

If there is an emergency while you are attending the dental service, the dental team is trained to deal with it.

  1. Your dental service has an up-to-date written protocol for dealing with emergencies.
  2. The whole team is suitably trained in dealing with emergencies and knows how to respond at any time.
  3. Your dental team has its resuscitation and emergency care skills updated annually.
  4. Your dental service has the equipment and drugs recommended by the National Dental Advisory Committee for treating medical emergencies. The equipment is kept in working order. All drugs kept by the service are within their expiry date and are stored safely.
  5. You are made aware of what will happen and what to do ifthere is a fire or if the premises need to be evacuated.

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Standard 13: Control of infection

The dental service takes every reasonable precaution to make sure you are not exposed to risk of infection.

  1. Your dental service premises are clean.
  2. Your dental service has comprehensive infection control policies and procedures readily available, in line with current best practice guidelines and legislation.
  3. Your dental service has systems in place, including induction and ongoing training, to make sure these policies and procedures are known and are being carried out in the service at all times.
  4. Where required, you are informed about the need for procedures designed to prevent and control infection.

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Standard 14: Your care environment

The design, layout and facilities of the dental service will support the safe and effective delivery of your care and treatment.

  1. You receive care and treatment in an environment that is suitable for your needs, gives you privacy and ensures your comfort.
  2. The buildings, facilities and grounds of the dental service are maintained and reviewed in line with health and safety regulations and any other relevant regulations and legislation.
  3. The dental premises are equipped with instruments and materials appropriate to the clinical treatments provided.
  4. All equipment used in support of your care and treatment is installed, checked and maintained in line with the manufacturer’s instructions, current best practice guidelines and legislation.
  5. Dental materials and drugs are stored and used safely.
  6. If there is a failure in any major service, your dental service will provide either back-up systems to allow your care to continue safely or postpone treatment until it is safe to continue.
  7. The dental service carries out any necessary x-rays safely and in line with current best practice guidelines and legislation.
  8. The dental service has an ongoing risk management programme to make sure of your safety.

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Standard 15: Children and young people

The care and treatment that children and young people receive from their dental service take account of their special physical, psychological and social needs, and are provided in partnership with parents or guardians.

  1. The dental team is aware of the law on children and young people giving informed consent. The team understands the consequences if children and young people agree or refuse to have treatment, e.g. Age of Legal Capacity (Scotland) Act 1991 Chapter 50 Section 2 (4).
  2. Dental care provided for children and young people takes account of their different stages of development.
  3. The dental team has procedures for child protection which take account of local child protection guidance and best practice (a multi-agency children’s services partnership is based around a local authority’s geographical boundary). The dental team carries these procedures out when required.
  4. All team members with access to children have an enhanced disclosure check from Disclosure Scotland before starting to work with children in the service. Team members can work supervised in the dental service pending a disclosure check.

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