In short
Dental practitioners owe patients two kinds of consent: informed consent to the treatment itself, and informed financial consent to its cost. Many notifications about dentists arise where a patient did not understand their options, was not given a clear cost estimate, or felt pressured into treatment they did not need. Treatment must be clinically necessary and in the patient's interest, options and costs must be explained before you start, and it must all be documented. Getting consent and cost right prevents most of these complaints before they arise.
What are the two consents a dentist owes a patient?
Informed consent to the treatment, and informed financial consent to what it will cost.
Dentistry is unusual among health services in that the patient is very often paying directly, and often for elective or discretionary treatment. That means a dentist has to satisfy two related duties before starting: the patient must understand and agree to the treatment itself, and they must understand and agree to the cost. A breakdown in either is a common source of complaints, and the two are closely linked.
Informed consent
The patient understands their condition, the treatment options, the risks and the alternatives, and freely agrees.
Informed financial consent
The patient understands what the treatment will cost, in a clear written estimate, before it begins.
For the overall process, see our guide to what happens after a notification to the Dental Board.
What does informed consent to treatment involve?
A genuine discussion of the diagnosis, the options, the material risks and the alternatives, in terms the patient understands.
The Dental Board's Code of conduct requires you to support patients to make informed decisions. Valid consent means the patient understands their oral health problem, the proposed treatment and why it is recommended, the material risks including the chance it may not succeed, the alternatives including doing nothing or a simpler option, and that they are free to decide without pressure. Consent is a conversation, not a signature on a form. It should be tailored to the individual, and recorded in the notes.
Why is informed financial consent so important in dentistry?
Because unexpected or unexplained costs are one of the most common triggers for a complaint against a dentist.
Informed financial consent means giving the patient a clear, itemised estimate of the cost of their treatment before it starts, including likely item numbers, so they can make a real choice. Patients who receive a bill they did not expect, or who feel the cost changed without explanation, frequently complain, and cost concerns often bring the underlying treatment under scrutiny too. Providing a written estimate, explaining what is and is not included, flagging that costs may change if the treatment changes, and giving the patient time to consider, protects both the patient and you.
A sound financial consent process
- A written, itemised estimate before treatment begins
- The relevant item numbers, and what each covers
- Clear information on what is not included
- An explanation that costs may change if the plan changes
- Time for the patient to consider, without pressure
- A note in the record that the estimate was provided and discussed
What about necessary treatment and over-servicing?
Treatment must be clinically necessary and in the patient's genuine interest, not driven by what can be billed.
Over-servicing, recommending or providing treatment that is not clinically necessary, is a serious concern that goes to both good care and integrity. The Code asks you to provide only the treatment a patient needs, in their best interests. Complaints often allege that unnecessary or excessive treatment was recommended, that a simpler and cheaper option was not offered, or that treatment was staged to increase cost. The safeguard is straightforward: base every recommendation on the patient's genuine clinical need, offer the reasonable options including the conservative one, document your reasoning, and never let the availability of funds, insurance or superannuation drive the plan.
What if the treatment plan changes partway through?
Stop, re-consent, and re-estimate; a plan that changes without the patient's agreement is a common complaint.
Dentistry often reveals more once treatment is under way, a tooth that cannot be saved, decay deeper than expected, a crown that becomes a root canal. When the clinical picture or the cost changes materially, you should pause, explain the change to the patient, obtain fresh consent, and provide a revised estimate before continuing, unless it is a genuine emergency. Pressing on with more extensive or more expensive treatment than the patient agreed to, without a fresh conversation, is exactly the kind of situation that leads to a notification.
What if a consent or cost complaint is made?
Explain your consent and estimate process, share the records, reflect on the patient's experience, and evidence a change.
Set out what you explained and estimated, and share any written estimate and consent notes. Where the record was thin, or the patient felt rushed or under-informed, acknowledge that honestly in a reflective statement rather than becoming defensive, and evidence remediation such as a strengthened consent and financial-consent routine. Take advice from your indemnity insurer for significant matters.
Illustrative example
The concern: A patient agreed to a filling but was charged for a crown after the dentist decided mid-appointment that a crown was needed.
Acknowledge: The dentist accepts they should have stopped, explained the change, and obtained fresh consent and a new estimate before proceeding.
Reflection: They reflect on how the patient was left feeling they had not agreed to the treatment or the cost.
Remediation: They complete CPD on consent and communication, and adopt a firm rule to re-consent and re-estimate before any material change to a plan.
How can CPD help with a consent or cost concern?
Targeted CPD on consent, communication and ethics gives dated evidence that you understand the standard and have changed your process.
Consent and financial-consent concerns turn on communication and honesty, so structured learning is directly relevant. CPD on effective communication and dental ethics, aligned with your CPD registration standard, helps you show you understand what valid consent and informed financial consent require, and pairs well with a documented change to your consent process. It never guarantees an outcome, but it directly addresses the concern. Browse the range of CPD for dentists.
Matched to consent and cost concerns
Courses for a consent or cost notification
Structured CPD chosen for consent, communication and ethics concerns, to help you evidence remediation. Independent CPD you can use as evidence of remediation.
Ethics and Ethical Standards for Dentists and Dental Professionals
- Ground consent and necessity in dental ethics
- Keep treatment need-based, not billing-led
- Show the reasoning a Board looks for
Ensuring Effective Communication as Healthcare Professionals
- Improve consent and cost conversations
- Check understanding and manage expectations
- Evidence safer communication practice
Professionalism and Professional Standards for Dentists and Dental Professionals
- Written to the Dental Board's code
- Covers consent and professional conduct
- Evidence your understanding for the Board
How to Deal With a Notification or Investigation
- Understand each stage of the Board's process
- Know what to do, and what to avoid, early
- Respond calmly and well prepared
Frequently asked questions
What is informed financial consent in dentistry?
It is giving the patient a clear, itemised estimate of the cost of their treatment before it begins, including the likely item numbers, so they can make a real decision. It sits alongside clinical consent to the treatment itself.
Do I have to give a written cost estimate?
A clear written estimate before treatment is strongly expected and is the best protection against a cost complaint. It should show what is included, flag that costs may change if the plan changes, and be discussed with the patient.
Can I be reported for over-servicing?
Yes. Recommending or providing treatment that is not clinically necessary is a serious concern that goes to good care and integrity. Base recommendations on genuine clinical need, offer conservative options, and document your reasoning.
What if I find more work is needed mid-treatment?
Stop, explain the change to the patient, obtain fresh consent, and provide a revised estimate before continuing, unless it is a genuine emergency. Proceeding with more extensive treatment without a fresh conversation is a common complaint.
Is a signed consent form enough?
No. A signature is not consent. What matters is whether the patient understood their options, risks and costs through a genuine discussion. A short note that you explained and the patient agreed is worth more than a form alone.
The patient agreed at the time but complained later. What now?
Explain your consent and estimate process and share the records. Where the record was thin or the patient felt rushed, acknowledge it honestly and evidence a change, such as a strengthened consent and financial-consent routine, rather than defending your intent.
Can I keep working during a consent or cost complaint?
Usually yes. Most dental practitioners keep working while such a matter is assessed. Your registration is only restricted if the Board takes immediate action, used in a small number of higher risk matters after a show cause process.
Does CPD help with a consent or cost notification?
Yes. CPD on consent, communication and dental ethics, aligned with your CPD registration standard, gives dated evidence that you understand the standard and have changed your process. It never guarantees an outcome, but it directly addresses the concern.
Dr Richard
Course Facilitator
A practising clinician with over 21 years of experience and postgraduate training in healthcare law and ethics, so every course reflects both clinical reality and Australian regulatory standards.
Written and reviewed by Dr Richard. Last reviewed . Read full profile
AHPRA Courses is an independent training provider. Our courses are structured CPD that practitioners can use as evidence of remediation. We are not affiliated with, endorsed by, or acting on behalf of Ahpra, the Dental Board of Australia, or any other regulator. Courses provide evidence of remediation and do not determine the outcome of any matter. This article is general information, not legal advice. If you have received a notification, seek advice from your professional indemnity insurer or a health law solicitor.