Brad Wright - Barrister

Brad Wright  - Barrister Brad Wright is a barrister at the Queensland Bar. His practice is principally Health Law. Dental Practice has unique problems.

Employment Law, Contracts, Health Practitioner regulations, and intellectual property arise often. For 30 years of dental and legal experience for dental professionals, insight and advice that is tailored to the dental profession. Liability limited by a Scheme approved under Professional Standards Legislation.

In this recent case in Victoria, a dental practitioner qualified to practice as an oral health therapist was found to ha...
11/04/2026

In this recent case in Victoria, a dental practitioner qualified to practice as an oral health therapist was found to have practised outside her scope of practice by performing orthodontic procedures. She had inappropriately billed patients for those procedures and created false clinical records, and gave false information to the regulator.

The Tribunal found the allegations were proven, and reprimanded the practitioner and disqualified her from applying to for registration for three years although she had not been registered since 2020

Summary In this recent case in Victoria, a dental practitioner qualified to practice as an oral health therapist was found to have practised outside her scope of practice by performing orthodontic procedures. She had inappropriately billed patients for those procedures and created false clinical rec

This I think is pure quintessence....
01/02/2026

This I think is pure quintessence....

10/12/2025

๐—–๐—น๐—ฎ๐˜‚๐˜€๐—ฒ๐˜€ ๐—ถ๐—ป ๐—ฑ๐—ฒ๐—ฒ๐—ฑ๐˜€ ๐—น๐—ถ๐—บ๐—ถ๐˜๐—ถ๐—ป๐—ด ๐—ฃ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜ ๐—–๐—ผ๐—บ๐—ฝ๐—น๐—ฎ๐—ถ๐—ป๐˜๐˜€ ๐—ป๐—ผ๐˜„ ๐—œ๐—น๐—น๐—ฒ๐—ด๐—ฎ๐—น

As has been the case in NSW for some time and as been foreshadowed by the writer previously, presenting Deeds of Release and Settlement that purport to prevent a patient making a complaint to the regulator are illegal as of 1 December.

๐˜—๐˜ฆ๐˜ฐ๐˜ฑ๐˜ญ๐˜ฆ ๐˜ธ๐˜ฉ๐˜ฐ ๐˜ฎ๐˜ข๐˜ฌ๐˜ฆ ๐˜ข ๐˜ค๐˜ฐ๐˜ฎ๐˜ฑ๐˜ญ๐˜ข๐˜ช๐˜ฏ๐˜ต ๐˜ข๐˜จ๐˜ข๐˜ช๐˜ฏ๐˜ด๐˜ต ๐˜ข ๐˜ฉ๐˜ฆ๐˜ข๐˜ญ๐˜ต๐˜ฉ ๐˜ฑ๐˜ณ๐˜ข๐˜ค๐˜ต๐˜ช๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ฆ๐˜ณ ๐˜ธ๐˜ช๐˜ญ๐˜ญ ๐˜ฃ๐˜ฆ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ต๐˜ฆ๐˜ค๐˜ต๐˜ฆ๐˜ฅ ๐˜ง๐˜ณ๐˜ฐ๐˜ฎ ๐˜ณ๐˜ฆ๐˜ฑ๐˜ณ๐˜ช๐˜ด๐˜ข๐˜ญ๐˜ด ๐˜ฐ๐˜ณ ๐˜ณ๐˜ฆ๐˜ต๐˜ข๐˜ญ๐˜ช๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜ถ๐˜ฏ๐˜ฅ๐˜ฆ๐˜ณ ๐˜ช๐˜ฏ๐˜ค๐˜ณ๐˜ฆ๐˜ข๐˜ด๐˜ฆ๐˜ด ๐˜ต๐˜ฐ ๐˜ค๐˜ฐ๐˜ฏ๐˜ด๐˜ถ๐˜ฎ๐˜ฆ๐˜ณ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ต๐˜ฆ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ด ๐˜ต๐˜ฉ๐˜ข๐˜ต ๐˜ค๐˜ข๐˜ฎ๐˜ฆ ๐˜ช๐˜ฏ๐˜ต๐˜ฐ ๐˜ฆ๐˜ง๐˜ง๐˜ฆ๐˜ค๐˜ต ๐˜ฐ๐˜ฏ 1 ๐˜‹๐˜ฆ๐˜ค๐˜ฆ๐˜ฎ๐˜ฃ๐˜ฆ๐˜ณ 2025.

๐˜—๐˜ฆ๐˜ฐ๐˜ฑ๐˜ญ๐˜ฆ ๐˜ธ๐˜ฉ๐˜ฐ ๐˜ฎ๐˜ข๐˜ฌ๐˜ฆ ๐˜ข ๐˜ค๐˜ฐ๐˜ฎ๐˜ฑ๐˜ญ๐˜ข๐˜ช๐˜ฏ๐˜ต ๐˜ช๐˜ฏ ๐˜จ๐˜ฐ๐˜ฐ๐˜ฅ ๐˜ง๐˜ข๐˜ช๐˜ต๐˜ฉ ๐˜ข๐˜ณ๐˜ฆ ๐˜ข๐˜ญ๐˜ณ๐˜ฆ๐˜ข๐˜ฅ๐˜บ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ต๐˜ฆ๐˜ค๐˜ต๐˜ฆ๐˜ฅ ๐˜ง๐˜ณ๐˜ฐ๐˜ฎ ๐˜ญ๐˜ช๐˜ข๐˜ฃ๐˜ช๐˜ญ๐˜ช๐˜ต๐˜บ ๐˜ง๐˜ฐ๐˜ณ ๐˜ช๐˜ฏ๐˜ง๐˜ฐ๐˜ณ๐˜ฎ๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜ต๐˜ฉ๐˜ฆ๐˜บ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ท๐˜ช๐˜ฅ๐˜ฆ ๐˜ต๐˜ฐ ๐˜ˆ๐˜ฉ๐˜ฑ๐˜ณ๐˜ข ๐˜ข๐˜ฏ๐˜ฅ ๐˜ต๐˜ฉ๐˜ฆ ๐˜•๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ข๐˜ญ ๐˜‰๐˜ฐ๐˜ข๐˜ณ๐˜ฅ๐˜ด. ๐˜›๐˜ฉ๐˜ฆ ๐˜ค๐˜ฉ๐˜ข๐˜ฏ๐˜จ๐˜ฆ๐˜ด ๐˜ธ๐˜ช๐˜ญ๐˜ญ ๐˜ฆ๐˜น๐˜ต๐˜ฆ๐˜ฏ๐˜ฅ ๐˜ต๐˜ฉ๐˜ช๐˜ด ๐˜ฑ๐˜ณ๐˜ฐ๐˜ต๐˜ฆ๐˜ค๐˜ต๐˜ช๐˜ฐ๐˜ฏ, ๐˜ฎ๐˜ข๐˜ฌ๐˜ช๐˜ฏ๐˜จ ๐˜ช๐˜ต ๐˜ข๐˜ฏ ๐˜ฐ๐˜ง๐˜ง๐˜ฆ๐˜ฏ๐˜ค๐˜ฆ ๐˜ง๐˜ฐ๐˜ณ ๐˜ด๐˜ฐ๐˜ฎ๐˜ฆ๐˜ฐ๐˜ฏ๐˜ฆ ๐˜ต๐˜ฐ ๐˜ต๐˜ฉ๐˜ณ๐˜ฆ๐˜ข๐˜ต๐˜ฆ๐˜ฏ, ๐˜ช๐˜ฏ๐˜ต๐˜ช๐˜ฎ๐˜ช๐˜ฅ๐˜ข๐˜ต๐˜ฆ ๐˜ฐ๐˜ณ ๐˜ฐ๐˜ต๐˜ฉ๐˜ฆ๐˜ณ๐˜ธ๐˜ช๐˜ด๐˜ฆ ๐˜ณ๐˜ฆ๐˜ต๐˜ข๐˜ญ๐˜ช๐˜ข๐˜ต๐˜ฆ ๐˜ข๐˜จ๐˜ข๐˜ช๐˜ฏ๐˜ด๐˜ต ๐˜ข ๐˜ฏ๐˜ฐ๐˜ต๐˜ช๐˜ง๐˜ช๐˜ฆ๐˜ณ ๐˜ง๐˜ฐ๐˜ณ ๐˜ฎ๐˜ข๐˜ฌ๐˜ช๐˜ฏ๐˜จ ๐˜ข ๐˜ค๐˜ฐ๐˜ฎ๐˜ฑ๐˜ญ๐˜ข๐˜ช๐˜ฏ๐˜ต.

๐˜›๐˜ฉ๐˜ฆ ๐˜ฎ๐˜ข๐˜น๐˜ช๐˜ฎ๐˜ถ๐˜ฎ ๐˜ฑ๐˜ฆ๐˜ฏ๐˜ข๐˜ญ๐˜ต๐˜บ ๐˜ธ๐˜ช๐˜ญ๐˜ญ ๐˜ฃ๐˜ฆ $60,000 ๐˜ง๐˜ฐ๐˜ณ ๐˜ข๐˜ฏ ๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ท๐˜ช๐˜ฅ๐˜ถ๐˜ข๐˜ญ ๐˜ฐ๐˜ณ $120,000 ๐˜ง๐˜ฐ๐˜ณ ๐˜ข ๐˜ฃ๐˜ฐ๐˜ฅ๐˜บ ๐˜ค๐˜ฐ๐˜ณ๐˜ฑ๐˜ฐ๐˜ณ๐˜ข๐˜ต๐˜ฆ.
๐˜๐˜ต ๐˜ธ๐˜ช๐˜ญ๐˜ญ ๐˜ข๐˜ญ๐˜ด๐˜ฐ ๐˜ฃ๐˜ฆ ๐˜ช๐˜ญ๐˜ญ๐˜ฆ๐˜จ๐˜ข๐˜ญ ๐˜ต๐˜ฐ ๐˜ฆ๐˜ฏ๐˜ต๐˜ฆ๐˜ณ ๐˜ช๐˜ฏ๐˜ต๐˜ฐ ๐˜ข ๐˜ฏ๐˜ฐ๐˜ฏ-๐˜ฅ๐˜ช๐˜ด๐˜ค๐˜ญ๐˜ฐ๐˜ด๐˜ถ๐˜ณ๐˜ฆ ๐˜ข๐˜จ๐˜ณ๐˜ฆ๐˜ฆ๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต (๐˜•๐˜‹๐˜ˆ) ๐˜ธ๐˜ช๐˜ต๐˜ฉ ๐˜ข ๐˜ฑ๐˜ข๐˜ต๐˜ช๐˜ฆ๐˜ฏ๐˜ต, ๐˜ถ๐˜ฏ๐˜ญ๐˜ฆ๐˜ด๐˜ด ๐˜ช๐˜ต ๐˜ค๐˜ญ๐˜ฆ๐˜ข๐˜ณ๐˜ญ๐˜บ ๐˜ด๐˜ต๐˜ข๐˜ต๐˜ฆ๐˜ด ๐˜ช๐˜ฏ ๐˜ธ๐˜ณ๐˜ช๐˜ต๐˜ช๐˜ฏ๐˜จ ๐˜ต๐˜ฉ๐˜ข๐˜ต ๐˜ช๐˜ต ๐˜ฅ๐˜ฐ๐˜ฆ๐˜ด ๐˜ฏ๐˜ฐ๐˜ต ๐˜ญ๐˜ช๐˜ฎ๐˜ช๐˜ต ๐˜ข ๐˜ฑ๐˜ฆ๐˜ณ๐˜ด๐˜ฐ๐˜ฏ ๐˜ง๐˜ณ๐˜ฐ๐˜ฎ ๐˜ฎ๐˜ข๐˜ฌ๐˜ช๐˜ฏ๐˜จ ๐˜ข ๐˜ฏ๐˜ฐ๐˜ต๐˜ช๐˜ง๐˜ช๐˜ค๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ ๐˜ฐ๐˜ณ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ท๐˜ช๐˜ฅ๐˜ช๐˜ฏ๐˜จ ๐˜ข๐˜ด๐˜ด๐˜ช๐˜ด๐˜ต๐˜ข๐˜ฏ๐˜ค๐˜ฆ ๐˜ต๐˜ฐ ๐˜ณ๐˜ฆ๐˜จ๐˜ถ๐˜ญ๐˜ข๐˜ต๐˜ฐ๐˜ณ๐˜ด. ๐˜ˆ๐˜ฏ๐˜บ ๐˜•๐˜‹๐˜ˆ๐˜ด ๐˜ต๐˜ฉ๐˜ข๐˜ต ๐˜ฅ๐˜ฐ ๐˜ด๐˜ฆ๐˜ฆ๐˜ฌ ๐˜ต๐˜ฐ ๐˜ญ๐˜ช๐˜ฎ๐˜ช๐˜ต ๐˜ข ๐˜ฑ๐˜ฆ๐˜ณ๐˜ด๐˜ฐ๐˜ฏโ€™๐˜ด ๐˜ข๐˜ฃ๐˜ช๐˜ญ๐˜ช๐˜ต๐˜บ ๐˜ต๐˜ฐ ๐˜ฎ๐˜ข๐˜ฌ๐˜ฆ ๐˜ข ๐˜ค๐˜ฐ๐˜ฎ๐˜ฑ๐˜ญ๐˜ข๐˜ช๐˜ฏ๐˜ต ๐˜ธ๐˜ช๐˜ญ๐˜ญ ๐˜ฃ๐˜ฆ ๐˜ช๐˜ฏ๐˜ท๐˜ข๐˜ญ๐˜ช๐˜ฅ.

In plain language, although a deed of release may be presented to set out the terms of the settlement and even limiting civil liability, to the extent that there was any doubt, any attempt to prevent a patient complaint is not only arguably unenforceable (as against public policy) as has been the case for many years - it is now illegal.

Further although it has not been stated, this will clearly also lead to allegations of unprofessional conduct.

If a practitioner wants to settle a matter with a patient use an indemnifier approved deed of release (not something you get from ChatGPT for example)

๐™๐™๐™ž๐™จ ๐™–๐™ง๐™ฉ๐™ž๐™˜๐™ก๐™š ๐™™๐™ค๐™š๐™จ ๐™ฃ๐™ค๐™ฉ ๐™˜๐™ค๐™ข๐™ฅ๐™ง๐™ž๐™จ๐™š ๐™ก๐™š๐™œ๐™–๐™ก ๐™–๐™™๐™ซ๐™ž๐™˜๐™š. ๐™€๐™–๐™˜๐™ ๐™ฅ๐™ง๐™–๐™˜๐™ฉ๐™ž๐™ฉ๐™ž๐™ค๐™ฃ๐™š๐™ง ๐™จ๐™๐™ค๐™ช๐™ก๐™™ ๐™จ๐™š๐™š๐™  ๐™ž๐™ฃ๐™™๐™ž๐™ซ๐™ž๐™™๐™ช๐™–๐™ก๐™ž๐™จ๐™š๐™™ ๐™–๐™™๐™ซ๐™ž๐™˜๐™š ๐™—๐™–๐™จ๐™š๐™™ ๐™ค๐™ฃ ๐™ฉ๐™๐™š๐™ž๐™ง ๐™˜๐™ž๐™ง๐™˜๐™ช๐™ข๐™จ๐™ฉ๐™–๐™ฃ๐™˜๐™š๐™จ.

Liability limited by a Scheme approved under Professional Standards Legislation.

๐—” ๐—ช๐—ผ๐—ฟ๐—ธ๐—ฎ๐—ฏ๐—น๐—ฒ ๐—ฆ๐—ผ๐—น๐˜‚๐˜๐—ถ๐—ผ๐—ป ๐—ณ๐—ผ๐—ฟ ๐—ฝ๐—ผ๐—ผ๐—ฟ ๐—ฑ๐—ฒ๐—ป๐˜๐—ฎ๐—น ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐—ฟ๐—ฑ๐˜€?In a recent article, the issue of Ai and dental notes transcription was addr...
01/12/2025

๐—” ๐—ช๐—ผ๐—ฟ๐—ธ๐—ฎ๐—ฏ๐—น๐—ฒ ๐—ฆ๐—ผ๐—น๐˜‚๐˜๐—ถ๐—ผ๐—ป ๐—ณ๐—ผ๐—ฟ ๐—ฝ๐—ผ๐—ผ๐—ฟ ๐—ฑ๐—ฒ๐—ป๐˜๐—ฎ๐—น ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐—ฟ๐—ฑ๐˜€?

In a recent article, the issue of Ai and dental notes transcription was addressed.

(Oโ€™Kane R, Stonehouse-Smith D, Ota LCU, et al. Transcription Accuracy of Automatic Speech Recognition for Orthodontic Clinical Records. Journal of Dental Research. 2025;0(0). doi:10.1177/00220345251382452)

In essence the article states perhaps unsurprisinglyโ€ฆ

โ€œThis investigation revealed significant performance variability among tested ASR systems, with all capable of introducing clinically significant mistranscriptions. Clinicians using these systems should be cautious about plausible subtle substitutions or omissions of domain-specific terminology. The current status of ASR necessitates vigilance to guard against automation bias in the clinical environment, improvement in domain-specific accuracy, and potential uncertainty-aware features to ensure safe and reliable integration into clinical practice.โ€

Clearly time at the end of the clinical day or session day could be set aside for a practitioner review of each patientโ€™s AI records and then they should be finalised on that day.

In Australia, it accepted that one of the best indicators for clinical record standards is whether a patient could use those records for treatment by another practitioner.

No matter how good the transcription, unless the records contain relevant information then the records may still be inadequate.

Practitioners might reference a check list and headings for all patent records while they are treating the patient to ensure all aspects of this requirement are captured whilst using AI transcription.

๐™๐™๐™ž๐™จ ๐™–๐™ง๐™ฉ๐™ž๐™˜๐™ก๐™š ๐™™๐™ค๐™š๐™จ ๐™ฃ๐™ค๐™ฉ ๐™˜๐™ค๐™ข๐™ฅ๐™ง๐™ž๐™จ๐™š ๐™ก๐™š๐™œ๐™–๐™ก ๐™–๐™™๐™ซ๐™ž๐™˜๐™š. ๐™€๐™–๐™˜๐™ ๐™ฅ๐™ง๐™–๐™˜๐™ฉ๐™ž๐™ฉ๐™ž๐™ค๐™ฃ๐™š๐™ง ๐™จ๐™๐™ค๐™ช๐™ก๐™™ ๐™จ๐™š๐™š๐™  ๐™ž๐™ฃ๐™™๐™ž๐™ซ๐™ž๐™™๐™ช๐™–๐™ก๐™ž๐™จ๐™š๐™™ ๐™–๐™™๐™ซ๐™ž๐™˜๐™š ๐™—๐™–๐™จ๐™š๐™™ ๐™ค๐™ฃ ๐™ฉ๐™๐™š๐™ž๐™ง ๐™˜๐™ž๐™ง๐™˜๐™ช๐™ข๐™จ๐™ฉ๐™–๐™ฃ๐™˜๐™š๐™จ.

Liability limited by a Scheme approved under Professional Standards Legislation.

Current considerations around health practitioner liability continue to develop.Dental practitioners can be liable for t...
14/05/2025

Current considerations around health practitioner liability continue to develop.

Dental practitioners can be liable for the personal injuries that patients might allege against them for dental treatment. In simple terms patients can sue their treating practitioner for failed dental treatment and has been the case in common law since time immemorial. Practitioners are required to have Indemnity insurance in place personally for these purposes as one of the AHPRA registration standards.

However, in recent times because of the development of more and more group practices, patients may seek to sue the practice in addition to the dentist to provided them the treatment. This arises because patients usually receive an invoice with the practice facility name on it as well as the name of the practitioner who provided the actual dental treatment. This risk can be insure with most of the indemnifiers.

It is understandable therefore that patients might view their contract as having been with the practice rather than the dental practitioner who provided the treatment. Depending on how the case is pleaded, this may mean that the practice is alleged to have a liability because of some of the processes that the practice is responsible for in addition to assertions of oversight and vicarious liability which may or may not be evidence. In plain language this means that owners of dental practices are at risk of suit from patients for the personal injuries for negligent dental treatment as alleged by dentists who work at the practice and invoice through the practice.

In addition where multiple practitioners treat a patient over a period of time within a practice, a patient might quite reasonably commence action against all of the practitioners who have provided treatment to the patient as well as the practice itself and the directors of the practice entity.

In such cases the issue of proportionate liability arises.

The Victorian Civil Juries Charge Book states at 2.1.9 in relation to apportionment that

โ€œYou would need to consider, in deciding to what extent it was just and equitable that one defendant should recover contribution from the other, the extent to which each defendant, in your judgment, fell short of taking that care for the plaintiff which it should have taken in all the circumstances. In considering that matter, it would be appropriate to take into account whether, in your view, one defendant had greater control over the situation than the other. You would also need to consider, in deciding that matter, the importance of the conduct of each defendant in causing the accident and the plaintiffโ€™s injuriesโ€ฆโ€

In the circumstances there are a number of mechanisms which are appropriate for practice owners to reduce their risk in the circumstances and this can be done by way of the agreements that the practice has with the patients and with the dentist who they engaged. If this is a concern then these practice practices should seek appropriate legal advice about these protections.

Somewhat more problematic and difficult to prevent is the issue of regulator action against practitioners who were only minimally involved in the treatment of a practitioner and this can be because of the practice ownership being perceived to be part of the treatment.

As is well known anyone can complain about the treatment provided and the conduct by any practitioner at any time. Often, dissatisfied patients will complain about the practice and the communications of the staff as well as about the dentist who provided the actual treatment.

Then issues of shared care responsibility arise. The Dental Board Code of Conduct has a shared care provision including the following

Good practice includes that you:

a. take reasonable steps to ensure that any person to whom you delegate, refer or hand over to has the qualifications and/or experience and/or knowledge and/or skills to provide the care needed

b. understand that, although as delegating practitioner you will not be accountable for the decisions and actions of those to whom you delegate, you remain responsible for the overall management of the patient and for the decision to delegate, and

c. always communicate sufficient, timely information about the patient and the treatment needed to enable the continuing safe care of the patient.

However practice owners are at some risk of being involved in patient complaints in matters connected to treatment such as patient recalls communications with patients and even infection control.

It is prudent for practice owners particularly to review these processes and minimise their risk by way of clear communications and policies.

Consider:

Indemnities in service agreements or independent contracts.
Insurance cover for engaged dentists and the corporate who owns the practice
Patient Consent forms including an explanation of practice arrangements.
Consistent policies and reviews of communications with patients about these issues.

Brad Wright

May 2025

This short article is not intended as legal advice and is for general information only. Any practitioners who consider the issues arise in this article that give them any concern should seek independent legal advice from an appropriately qualified legal practitioner.

Liability limited by a Scheme approved under Professional Standards Legislation.

15/02/2025

๐——๐—ฒ๐—ป๐˜๐—ฎ๐—น ๐—ฃ๐—ฟ๐—ฎ๐—ฐ๐˜๐—ถ๐—ฐ๐—ฒ ๐—–๐—•๐—ฉ๐—ง/๐—–๐—•๐—–๐—ง ๐—ฅ๐—ถ๐˜€๐—ธ ๐— ๐—ฎ๐—ป๐—ฎ๐—ด๐—ฒ๐—บ๐—ฒ๐—ป๐˜

It is generally accepted that dentists recording CBVT- particularly large volume CBVT datasets- have responsibility for the interpretation of all data, not just the area of interest. (Dentists who record OPG radiographs must take responsibility for all non-dental diagnosis from such images or alternatively have them assessed on referral by an oral radiologist or medical radiologist and include this cost in their estimate of fees to the patient (see Aust Dent J
2012 Mar:57 Suppl 1:9-15. doi: 10.1111j.1834-7819.2011.01653.x.)

Practitioners frequently use a CBVT dataset to โ€™constructโ€™ an OPG.

If this construction is based on a full volume dataset, it is arguable that there may be pathology not detected by a general dentist who has training for the use of machine that they use.

In Western Australia, Section 36 of the Radiation Safety Act 1975 provides for the Radiological Council to impose conditions, restrictions or limitations on a licence, exemption, or registration.

In Western Australia, the standard condition of registration for the purpose of Radiology โ€“ Dental, requires that: โ€œas soon as practicable, all CBCT images are reported on by an Australian Health Practitioner Regulation Agency registered medical radiologist or dento-maxillofacial radiologistโ€.

It is probably therefore prudent, if not a legal requirement, in other states that practitioners recording CBVT data sets give consideration to having all of the datasets reviewed by an appropriate radiologist to reduce a failure to diagnose risk. Such reports would then need to be communicated to the patients as a matter of course.

08/01/2025

In some recent work I had cause to consider radiology in dental practice. I had an interest in this through practice and an article I wrote when I first went to the bar in 2011. https://pubmed.ncbi.nlm.nih.gov/22376092/

I still see references to the ALARA principle - meaning as low as reasonably achievable.

That is no longer relevant in Australian health practice at least in relation to diagnostic radiology.

That phrase is no longer used in the code for diagnostic medical / dental radiology under Justification or Optimisation. The phrase ALARA references the superseded 2008 Code.

See here for the 2019 code.https://www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf

The new code specifies as to optimisation:

2.2.2 Optimisation

Optimisation of protection is maximising the benefit-risk ratio of a medical exposure for that patient.

Radiation exposure must be minimised yet still sufficient to fulfil the clinical objective of the procedure, with account taken of relevant norms of acceptable image quality or therapeutic efficacy. Special attention is required for exposures of paediatric patients, for individuals undergoing health screening, for volunteersin medical research and where a fetus or breastfed infant may receive an incidental exposure.

Diagnostic reference levels (DRLs), which give an indication of levels of doses to patients for common procedures, are one method that can be used as an optimisation tool in medical imaging. Their purpose is to raise awareness of patient doses and prompt medical radiation facilities administering doses greater than the reference levels to review procedures and revise or justify as appropriate.

This justification is now a three tier process.

See here for the 2019 code.https://www.arpansa.gov.au/sites/default/files/medical-exposure-code-rps-c-5.pdf

When Giles Coren is good, he is absolutely fantastic. This is an example.
02/11/2024

When Giles Coren is good, he is absolutely fantastic. This is an example.

In the 1970s youโ€™d find all-American razzle-dazzle and tasty food in the golden arches. Now the chain symbolises US decline

Had to go to the NY Times to get this news of Dr Warrenโ€™s passing. How many people had a better life because of these tw...
14/08/2024

Had to go to the NY Times to get this news of Dr Warrenโ€™s passing. How many people had a better life because of these two.

He endured skepticism but won a Nobel Prize for his work upending the conventional wisdom that stress, diet or alcohol caused the painful condition.

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