Recognising When Something Has Gone Wrong

Dental nurses are often the first to notice when care has not gone as intended. This can include a clinical complication, missing or incorrect information, incorrect aftercare, a privacy breach, a wrong appointment, unexpected pain, a delayed referral, equipment failure, a misunderstanding about cost, or a patient complaint about how they were treated.

Not every patient dissatisfaction requires a formal candour response, and not every candour incident starts as a complaint. Patients may be embarrassed, grateful, worried about future care, or reluctant to challenge the clinician. Dental nurses can use observation and empathy to detect when a patient says "I'm fine" but looks unsettled.

Signals to take seriously

• The patient says they did not know something had happened.
• They repeat the same question after a rushed explanation.
• They appear distressed after a procedure, cost discussion or complication.
• They say they do not want to make a fuss but still look worried.
• They raise a concern at reception instead of with the dentist.
• A colleague mentions an error but suggests not telling the patient.

Do not assume "it's probably nothing." Ensure the right person reviews the concern. Early escalation is safer than silence, particularly where there may be harm, distress, consent issues, a complaint, safeguarding concerns, privacy breaches or decisions affecting future treatment.

Power imbalance and unvoiced concerns

Noticing and escalating concerns early helps protect the patient, preserve trust and reduces the chance of a complaint becoming harder to resolve.