MJDF Part 1 - Membership of Joint Dental Faculties Law, Ethics, and Professionalism 2 — Questions and Answers
Question 1: During a routine extraction under local anaesthesia, you realise you have removed the wrong tooth. The patient has not yet noticed. According to the GDC's professional duty of candour, what must you do?
- Complete the correct extraction first, then document the error in the notes without informing the patient to avoid unnecessary distress
- Immediately inform the patient of the error, offer a sincere apology, explain what happened, and outline what will be done to address the situation (Correct answer)
- Inform the practice manager first and await their guidance before speaking to the patient
- Wait until the anaesthesia has fully worn off before deciding whether disclosure is warranted
Correct answer: Immediately inform the patient of the error, offer a sincere apology, explain what happened, and outline what will be done to address the situation
The GDC's duty of candour requires registrants to be open and honest when something goes wrong that affects a patient. This includes offering an apology, a clear explanation of what happened, and information about any remedial steps. Delayed or selective disclosure to protect the clinician's position is a breach of this duty.
Question 2: A patient discloses that they are a heavy goods vehicle driver who has been experiencing unprovoked blackouts for several months, but pleads with you to keep this confidential to protect their livelihood. What is the most appropriate course of action?
- Maintain strict confidentiality, as the patient has expressly requested non-disclosure and there is no confirmed injury yet
- Disclose the information to the DVLA immediately without informing the patient
- Strongly advise the patient to inform the DVLA themselves, explaining clearly that if they decline you may need to consider disclosure in the public interest (Correct answer)
- Refer the matter to the patient's GP, as ongoing medical conditions fall outside dental professional responsibility
Correct answer: Strongly advise the patient to inform the DVLA themselves, explaining clearly that if they decline you may need to consider disclosure in the public interest
Patient confidentiality is not absolute. Where a patient poses a serious identifiable risk to third parties — such as a driver with blackouts — ethical guidance supports disclosure in the public interest as a last resort. The correct first step is to counsel the patient to self-report to the DVLA, making clear the consequences of refusal, before any unilateral breach of confidentiality.
Question 3: During the examination of a 7-year-old child you observe multiple bruises in different stages of healing on the arms and neck. The accompanying adult becomes agitated when questioned and offers an inconsistent explanation. What is the most appropriate immediate action?
- Accept the adult's explanation and record it in the notes without further action
- Confront the adult directly and refuse to complete treatment until a satisfactory explanation is provided
- Document your concerns carefully and follow your practice's safeguarding policy, including referral to local authority children's services or advice from the named safeguarding lead (Correct answer)
- Telephone the police immediately and arrange urgent transfer to hospital
Correct answer: Document your concerns carefully and follow your practice's safeguarding policy, including referral to local authority children's services or advice from the named safeguarding lead
All dental professionals have a statutory and professional duty to safeguard children. When abuse is suspected, the correct response is to follow established local safeguarding procedures — including careful contemporaneous documentation and referral through the appropriate statutory pathway. Direct confrontation risks endangering the child, and bypassing the structured referral pathway undermines multi-agency safeguarding.
Question 4: A dental nurse notices that a colleague repeatedly arrives at work smelling of alcohol and appears clinically impaired on several occasions. According to GDC Standards for the Dental Team, what is the dental nurse's most appropriate course of action?
- Take no action, as monitoring a colleague's personal conduct falls outside professional responsibility
- Raise the concern formally with the practice manager or employer, and if it is not adequately addressed, escalate through appropriate channels including the GDC (Correct answer)
- Confront the colleague privately and warn them that repetition will result in a report
- Discuss the situation informally with other team members to gather a consensus before deciding whether to act
Correct answer: Raise the concern formally with the practice manager or employer, and if it is not adequately addressed, escalate through appropriate channels including the GDC
GDC Standards place a clear obligation on all registrants to raise concerns when a colleague's health, behaviour, or performance may put patients at risk. The correct route is through the practice's management structure in the first instance, with escalation to the GDC if the concern is dismissed or inadequately managed. Informal handling or inaction is a breach of professional standards.
Question 5: A dental nurse without additional qualifications is asked by a dentist to take alginate impressions for a study model while the dentist steps away briefly. According to GDC scope of practice guidance, is this permissible?
- Yes, impression taking is sufficiently simple to fall within the natural remit of a dental nurse
- No, impression taking falls outside the registered scope of a dental nurse unless they hold a specific additional regulated qualification (Correct answer)
- Yes, provided the dentist remains accessible within the practice and gives verbal authorisation
- No, because any clinical procedure must be performed solely by the prescribing dentist
Correct answer: No, impression taking falls outside the registered scope of a dental nurse unless they hold a specific additional regulated qualification
Impression taking is a clinical skill that requires specific additional training and, in many contexts, registration in an expanded duty category. A dental nurse without such a qualification must not perform the procedure regardless of the dentist's instruction or operational pressures. Acting outside one's registered scope of practice puts both the patient and the registrant at risk.
Question 6: A newly qualified dentist begins seeing patients at a practice before their GDC registration certificate has been received, relying on the fact that their application is confirmed as being processed. Under the Dentists Act 1984, what is the correct legal position?
- This is acceptable provided the practice principal accepts professional responsibility for all the dentist's clinical work
- The dentist may treat patients lawfully under the direct supervision of a fully registered GDC dentist
- Practising dentistry without confirmed GDC registration is unlawful, regardless of supervision arrangements or employer permission (Correct answer)
- The dentist may lawfully perform limited procedures such as examinations and study models until registration is confirmed
Correct answer: Practising dentistry without confirmed GDC registration is unlawful, regardless of supervision arrangements or employer permission
Under the Dentists Act 1984, practising dentistry in the United Kingdom without current GDC registration is a criminal offence. Pending or provisional registration status does not confer lawful authority to treat patients. The supervision of a registered colleague does not legitimise unlawful practice — registration must be formally confirmed before any patient contact.
MJDF Part 1 - Membership of Joint Dental Faculties Law, Ethics, and Professionalism 2
During a routine extraction under local anaesthesia, you realise you have removed the wrong tooth.
The patient has not yet noticed.
According to the GDC's professional duty of candour, what must you do?