Exam Pass Notes

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Dental Nurse Role Boundaries

• Dental nurses are registered professionals with their own duties and accountability.
• They assist with examinations and treatment, support communication, keep records, reassure patients, and help with follow-up.
• Dental nurses do not diagnose disease or plan treatment.
• Clinical questions about diagnosis, prognosis, treatment options, risks, or responsibility should be directed to the dentist or another appropriate clinician.
• Work only within your training, competence, and the limits of your indemnity or insurance.

Bad News in Dental Practice

• Bad news can include suspicious oral lesions, urgent referrals, tooth extractions, complex or costly treatment, complications, formal complaints, or loss of patient trust.
• What the dental team considers routine may feel frightening or life-changing for a patient.
• Patients often remember the privacy, tone, and support provided as much as the words used.

Before and During the Conversation

• Prepare records, images, written information and referral documents. Arrange a private setting.
• Help the patient sit comfortably and in a position that is clinically appropriate for listening.
• Keep body language calm and avoid side comments that might alarm the patient.
• Look for signs of confusion, distress, silence, anger, or information overload.
• Create a pause if the patient needs the dentist to repeat or clarify details.

Responding and Escalating

• Use plain, supportive phrases such as "I can see this is worrying" or "Would you like the dentist to explain that again?"
• Avoid saying "I am sure it is nothing" or offering false reassurance.
• Redirect clinical questions: "I need the dentist to answer that properly."
• Escalate urgent symptoms, safeguarding concerns, patient-safety risks, unclear consent, or any situation where understanding is poor.
• Speaking up respectfully about concerns is part of professional practice, even within a hierarchy.

After the Conversation

• Confirm the patient knows the immediate next step.
• Provide written information, referral letters, appointments, and follow-up as directed.
• Record or hand over practical details according to local procedures.
• Be aware of the complaints, candour, safeguarding, and concern-raising routes.
• Use reflection and debriefing to identify system improvements rather than to self-blame.