Withdrawal, Changes, Emergencies, and Distress

Consent can change. A patient who agreed at the treatment planning appointment may hesitate on the day. A patient who consented before local anaesthetic may ask to stop during treatment. A patient may accept one procedure but refuse an additional step that becomes possible or necessary.

Dental nurses are often best placed to notice distress. A raised hand, pulling away, tears, freezing, repeated swallowing, panic, or a sudden change in breathing can signal the need to pause. If the patient has an agreed stop signal, the whole team should respect it.

When consent changes

• Pause treatment or preparation where it is safe to do so.
• Acknowledge the patient's right to stop or to ask for more information.
• Inform the dentist promptly and calmly.
• Do not pressure the patient to continue because the appointment is running late.
• Record the change, the discussion, and the agreed next step factually.

Emergencies are different but still governed by patient rights and local law. If a patient lacks capacity during a genuine emergency, treatment may be necessary to preserve life, prevent serious deterioration, or act in the patient's best interests under the relevant legal framework. Dental nurses should follow emergency protocols, ensure clear records, and avoid stretching the definition of "emergency" to suit convenience.

Sedation, general anaesthesia, and written consent

A patient can withdraw consent at any time. A calm pause is usually safer than pushing through uncertainty, distress, or a changed decision.