In continuing with the second part of this blog, we’ll discuss some of the factors and variables in regards to standard of care (SOC).

While some professionals feel that SOC defines what is minimally required, others believe that clinicians should strive for excellence in care. Treatment based on SOC depends on several factors and variables as follows:

• Location- The location of the practice dictates the SOC. In rural areas, there may be few dental practices and fewer specialists. Therefore, treatment that would normally be referred to a specialist may be performed by a general dentist. However, this is not to say that the care will be sub-standard. Rather, the general dentist will have a greater responsibility, and the SOC may be different.
• Medical Conditions- The patient’s medical condition may guide SOC. Depending on the severity of their health condition, the patient may not be able to withstand ideal treatment. Therefore, a minimal and less invasive procedure might be more appropriate.
• Economics- The patient’s inability to pay for a procedure is a very common occurrence. Even with insurance, the remaining balance can be overwhelming. In this instance, the patient and the doctor may have to take a step back and develop a plan that will allow for treatment within the patient’s budget. This doesn’t necessarily mean that the patient’s dental health is being neglected; it means that both parties are realistic in providing the best treatment with the available funds.
• Continuous Evolvement - SOC continuously evolves due to new technology, improved materials, and current court rulings. As updated information becomes available, the doctor is responsible for incorporating necessary and progressive methods into the practice as deemed safe and practical.
• SOC Dictated by the Patient- On the flip side, patients may try to convince the dentist to override their needs and address their wants. Patient-driven care can easily lead to costly aesthetic overtreatment and negligence of proper oral health.

It’s wise to have the best interest of the patient as a top priority. Base treatment on sound judgment, do no harm, use evidence-based techniques, and meticulously document each visit. Taking into account that most practitioners view ethics, morals, and values in high regard, practicing within the standard of care is second nature.

The next topic in this blog series is Informed Refusal (treatment refusal). Informed refusal pertains to a patient declining procedures even after being informed of the consequences of not receiving the proposed treatment.