Children, Young People, Parents, and Consent

Consent involving children and young people requires clear, age-appropriate communication with the child or young person, their parent or carer, and the dentist. Dental nurses should ensure young people are heard, notice signs of fear or confusion, and raise concerns when consent, refusal or parental pressure is unclear.

In most cases 16- and 17-year-olds are presumed to have capacity to consent to treatment, though complex refusals or high-risk situations should prompt senior advice. Children under 16 may consent if they have sufficient maturity and understanding for the decision - commonly referred to as Gillick competence.

What dental nurses should watch for

• The child looks frightened but nobody has explained the procedure in an age-appropriate way.
• A parent answers for a young person who clearly wants to speak for themselves.
• The child agrees to please an adult but then pulls away or becomes distressed.
• There is disagreement between parent, child and clinician.
• The proposed treatment, sedation plan, cost or urgency has changed.

Parents and carers are often necessary partners, but parental agreement does not replace listening to the child. The younger the child, the more the team relies on parental responsibility and the dentist's judgement. Nevertheless, children should receive explanations suited to their age and should not be forced through avoidable distress when the situation can be paused and reviewed.

Gillick competence and parental responsibility

Children and young people should be involved in decisions about their care at a level that matches their age, maturity, understanding and the seriousness of the decision.