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The Case Examiners considered an allegation that the Registrant’s fitness to practise is impaired by reason of misconduct. The allegations related to the Registrant, allegedly, having provided an inadequate standard of care, radiographic practice, record keeping and informed consent. It was determined, by the Case Examiners, that there was a real prospect of most of the factual allegations being found proved and the statutory ground of misconduct having a real prospect of being established by a Practice Committee. They also determined that due to the nature of the alleged misconduct, and the low likelihood of repetition of the Registrant’s actions which caused the Registrar to raise the allegations, there was no real prospect of the Registrant’s current fitness to practise being found to be impaired. However, to close the case without action would fail to take into account the need to declare and uphold proper standards of performance, and the need to maintain public confidence in the dental professions. The GDC Standards considered that may have been contravened, in particular, by the allegations in respect of ‘Standards for the Dental Team’ (30th September 2013) include: Standard 1.1 ‘You must listen to your patients.’ Standard 2.1 ‘You must communicate effectively with patients – listen to them, give them time to consider information and take their individual views and communication needs into account.’ Standard 3.1 ‘You must obtain valid consent before starting treatment, explaining all the relevant options and the possible costs.’ Standard 3.3: ‘You must make sure that the patient’s consent remains valid at each stage of investigation or treatment.’ Standard 4.1 ‘You must make and keep contemporaneous, complete and accurate patient records.’ Standard 7.1 ‘You must provide good quality care based on current evidence and authoritative guidance.’ Standard 7.2: ‘You must work within your knowledge, skills, professional competence and abilities.’ Standard 9.1 ‘You must ensure that your conduct, both at work and in your personal life, justifies patients’ trust in you and the public’s trust in the dental profession.’ In making their determination in this case, the Case Examiners have taken into account the GDC’s ‘Case Examiner Indicative Outcomes Guidance’ (February 2018). They particularly note the entry at paragraph 70 in relation to clinical care; “…If the Case Examiners consider that there is a real prospect of a Practice Committee finding that the concerns do amount to misconduct, but that there is no real prospect of a finding of current impairment being made, they may consider issuing a warning. If, on the other hand, there is a real prospect of the facts, misconduct and current impairment being established, then the Case Examiners will likely consider that the allegation ought to be considered by a Practice Committee”. In light of the above, the Case Examiners consider that publication of the warning for a period of 12 months is appropriate and proportionate in the circumstances and will ensure that a message is sent to the Registrant and to the wider profession regarding the importance of maintaining appropriate standards relevant to the level of dental care, record keeping and informed consent that is expected by the GDC. The warning will address the level of public interest in this matter and also make a declaration to the profession about unacceptable practices. The Registrant is reminded that this warning will form part of their fitness to practise history, even after it is no longer published and may need to be disclosed as required.

The Case Examiners formally warn the Registrant that: • failure to undertake full diagnostic assessments, to include hard and soft tissue assessments and adequate BPE, can have significant impact upon patients. The Registrant must undertake a full assessment at the beginning of any treatment. • failure to undertake sufficient pre-treatment investigations, to include an appropriate occlusal assessment of a worn dentition, can have a significant impact upon the patient’s oral health and can lead to inappropriate treatment being provided. The Registrant must undertake full pre-treatment investigations at the beginning of any treatment. • failure to ensure that sufficient treatment planning is carried out, particularly when embarking on extensive composite bonding, can have adverse effects on the outcome. Sufficient planning must always be carried out when commencing treatment. • failure to adequately communicate a treatment plan to a patient can undermine their choice of treatment. The Registrant must ensure they fully communicate the risks, benefits and options of treatment in a professional manner. • failure to provide a good standard of restorative work can result in premature failure. The Registrant must ensure he maintains and keeps up to date skills and knowledge of current restorative dentistry to ensure he provides an appropriate standard of restorative dentistry for all patients. • failure to take radiographs can compromise patient care. The Registrant must ensure that he follows the relevant guidelines and standards to ensure appropriate radiographs are taken when directed. • failure to obtain and record informed consent can have serious effects on the individual patient, and on the wider trust and public confidence in the profession. The Registrant must always obtain full, informed consent prior to carrying out any procedures. • failure to maintain an adequate standard of record keeping can impact upon ongoing patient care. Clinical records must be sufficiently detailed so as to allow future audit or review, to understand any and all clinical considerations, justifications and potential diagnostic conclusions.