Dental Services

Consent and other requirements

Purpose

The purpose of this guidance is to provide detail regarding consent requirements (including mature minor consent) for students to access the Smile Squad school dental program and what the school’s duty of care responsibilities are to support them to access the program.

This guidance is only applicable to Smile Squad. Schools engaging private providers must follow the Dental Services policy on the Policy tab of this topic and ensure private dental providers comply with the requirements set out in the School council health services licence agreement – dentist between the school and the provider, including consent requirements.

Consent

The law recognises that as children become older and more mature, they are more capable of making their own decisions, including about seeking and obtaining their own health care. Young people may reach this stage before they turn 18 years of age. These young people are referred to as 'mature minors'.

For Smile Squad, it will be the Smile Squad clinician (oral health therapist, dental therapist, dentist) who will assess if the young person is a mature minor with respect to the issue for which they are seeking dental treatment. The Smile Squad clinician must be satisfied that the student has sufficient understanding of the risks, benefits, and possible complications of their condition and proposed treatment to give informed consent. This is in line with ordinary practice for young people accessing dental services in the community. The Dental Board of Australia’s code of conduct states that good practice involves considering the young person’s capacity for decision making or consent.

In seeking consent, dentists and dental clinicians must comply with the Dental Board of Australia’s code of conduct as part of their registration requirements, and be guided by the Australian Dental Association’s Guidelines for Consent for Care in Dentistry (PDF).

Consent will be required for all students to access dental services through Smile Squad.

Parent/carer consent must be received for primary school aged students. Consent for secondary school students may be provided by a parent/carer or the student if they are considered to be a ‘mature minor’ by the treating clinician.

Consent processes

There are 2 consent processes included in the program:

• written consent collected via the Smile Squad consent form prior to a dental examination. A link to an electronic consent form will be provided to all students. Schools may also request paper-based consent forms if preferred
• verbal consent sought from parents/carers (usually via telephone) or from the students themselves for any follow-up treatment at the end of the dental examination.

Electronic consent

All parents and carers who have a child at a school participating in Smile Squad will be informed about the program prior to the program visiting their child’s school.

All students will receive a link to an electronic consent form which will include:

• Smile Squad information sheet
• Smile Squad consent form
• financial consent form for CDBS bulk-billing
• medical questionnaire
• oral health questionnaire.

The purpose of the consent pack is to provide parents/carers/students with information about Smile Squad, to obtain health information about students, and to obtain informed parent/carer/mature minor consent to provide oral health examinations.

Smile Squad will provide a link to the electronic consent form to the participating school for them to distribute to students prior to Smile Squad’s visit to the school.

Consent requirements for primary school aged students

Parent/carer consent must be sought for primary school aged students to receive an examination or follow up treatment from the Smile Squad school dental program.

Consent to receive Smile Squad dental services can be obtained from parents/carers using the ‘Smile Squad consent form’.

Consent requirements for secondary school aged students

Students aged 18 years and over can generally consent to an examination and/or treatment themselves.

Consent for secondary school students may be provided by a parent/carer or the student if they are considered to be a ‘mature minor’ for this purpose by a Smile Squad clinician.

In circumstances where the Smile Squad dental clinician does not consider the student to be a mature minor, the clinician will discuss this with the student and seek consent from the parent or carer prior to any dental treatment. The clinician may also encourage the student to attend the local community dental agency with a parent/carer. Consent cannot be sought from or provided by principals or school staff.

Consent to receive Smile Squad dental services can be obtained from the parent/carer/student using the ‘Smile Squad consent form’.

If a student is accessing Smile Squad and has consented as a mature minor, they must be informed that their parent may be able to see in their student profile that they attended a health and wellbeing – Smile Squad appointment.

Students attending specialist schools

All students attending specialist schools will receive Smile Squad consent forms as above.

Primary school aged students attending specialist schools must receive parent/carer consent to receive an examination or follow up treatment from the Smile Squad school dental program.

Secondary school aged students attending specialist schools are able to complete the ‘Smile Squad consent form’ themselves (or with assistance) to provide consent for their own dental examination and follow up treatment.

It will then be the responsibility of the Smile Squad clinician to assess whether the student is considered to be a mature minor for the purpose of consenting to receive Smile Squad dental services at schools.

To be considered a mature minor, the Smile Squad clinician must be satisfied that the student has sufficient understanding of the risks, benefits, and possible complications of their condition and proposed treatment to give informed consent. A student may be considered capable of making some dental treatment decisions but not others.

In circumstances where the Smile Squad dental clinician does not consider the student to be a mature minor, the clinician will discuss this with the student and seek consent from the parent or carer prior to any dental treatment. The clinician may also encourage the student to attend the local community dental agency with a parent/carer. Consent cannot be sought from or provided by principals or school staff.

Consent to receive Smile Squad dental services can be obtained from the parent/carer/student using the ‘Smile Squad consent form’.

Consent for follow up treatment

Each student will receive a post-care report from the Smile Squad clinician at the end of the dental examination to take home.

Verbal consent for any follow-up treatment will be sought from parents/carers (usually via telephone) or from the student themselves (in the case of a mature minor) at the end of the dental examination. Smile Squad staff will discuss the specific type of follow-up treatment that is recommended as part of the post-care report, including the risks and benefits, and seek verbal consent.

In the case of where a student has been deemed a mature minor for the purpose of consenting for their oral examination, the dental clinician will assess whether the student is capable of providing consent for further follow-up treatment. They will also be provided with an individual care plan and will be encouraged to discuss this with their parents/carers.

School responsibilities to manage absences from class

Consistent with duty of care obligations, schools must monitor student attendance records of when students are absent from class to attend a health and wellbeing appointment. This includes a Smile Squad school dental program visit.

Primary school aged students

As part of this process, schools with primary school aged students can choose to maintain their own record of parent/carer consent for their child to leave class to attend the program.

When informing parents/carers about Smile Squad visiting the school, schools can choose to ensure parents/carers are aware and informed that when they are consenting to their child receiving dental services from Smile Squad, their child will be withdrawn from class to receive dental services in a room in the school/dental van during school hours.

Schools can choose to make a note on the student’s record via their school’s student management software system that the student attend a health and wellbeing – Smile Squad appointment.

Secondary school aged students

Secondary school aged students are considered mature minors for the purposes of leaving class to attend onsite appointments. This is only for the purpose of leaving class to attend an appointment.

Schools can choose to make a note on the student’s record that the student was out of class to attend a health and wellbeing – Smile Squad appointment.

Schools may also:

• work closely with Smile Squad to establish processes for managing student examinations and treatment
• obtain, for their records, a list of students who have received or provided consent to be seen, supplied by Smile Squad
• document a student’s absence from class to attend Smile Squad services as ‘attending a health and wellbeing – Smile Squad appointment’ in their school’s student management software
• be aware of when Smile Squad is going to be at the school and students who will attend Smile Squad services – this can be clearly communicated to all staff (including casual relief teachers, specialist teachers and ES staff)
• include reminders in school newsletters, encouraging parents/carers to complete the consent form
• remind parents/carers of Smile Squad’s arrival when services commence on the school grounds.

Related departmental policies

Mature Minors and Decision Making

Information sharing and privacy

Smile Squad will:

• only collect, use and share personal and health information about students where necessary to determine a student’s dental health needs, provide health services, meet duty of care obligations and where required or authorised by law to do so
• store this information in the student’s dental record, managed by Dental Health Services Victoria (DHSV), and keep it confidential and secure
• store, maintain and use this information consistently with the Privacy and Data Protection Act 2014 and the Health Records Act 2001
• in some circumstances share student information with school staff if it is necessary to support the student’s safety, health or wellbeing.

School staff will not have access to a student’s dental record. Only authorised Smile Squad personnel (from DHSV and Victorian community dental clinics) have access to this.

School staff will:

• use and manage any student information collected by the school (including information collected in connection with the Smile Squad program in accordance with the department's Schools’ privacy policy)
• share information about a student with Smile Squad if it is necessary to support a student’s safety, health and wellbeing whilst they are accessing Smile Squad services at school.

Smile Squad employees will not have access to school or department systems such as CASES21, Compass, HART or SOCS (or any other student information management system or student files), and school staff must not provide Smile Squad employees access.

Further information and contacts

Visit the Smile Squad website.

For general queries about Smile Squad, please contact: smilesquad@health.vic.gov.au

For queries about specific dental issues, schools can contact their local Smile Squad team – please email: smilesquad@dhsv.org.au

For school-related questions about school requirements or responsibilities, please contact the department's Physical Activity and Healthy Eating team, Wellbeing Health and Engagement Division: health.advice@edumail.vic.gov.au