The provision of dental care for children presents some of the greatest challenges and rewards in clinical dental practice. High on the list of challenges is the need to devise a comprehensive yet realistic treatment plan for these young patients. Successful outcomes are very unlikely in the absence of thorough short-and long-term treatment planning. Furthermore, decision-making for children has to take into account many more factors than is the case for adults. This chapter aims to highlight how history-taking, examination, and risk assessment are all critical stages in the treatment planning process. Principles of good treatment planning will also be outlined. When making decisions about children’s dental care, the clinician’s foremost ethical responsibility is to do no harm, to act in the child’s best interests, and to respect the child’s right to refuse treatment. However, reconciling this last principle with the preceding two might well present a dilemma, in which case the clinician should ask him/herself the following questions. • Is what is being proposed really in the child’s best interests? • Is the child happy to go ahead? If not, is there an alternative? • If there is no alternative, what will really be the outcome if treatment does not proceed? In most cases, failure to provide dental care for a child at a specific moment in time will not be life-threatening and a delay will be acceptable. However, there are circumstances in which failure to provide treatment may cause a child pain and distress. On these occasions, the clinician may feel that he/she has no alternative other than to proceed with treatment. Having weighed up the ethical considerations, he/she must then seek valid consent for what is proposed. Valid consent to examination, investigation, or treatment is fundamental to the provision of dental care. The most important element of the consent process is ensuring that the patient/parent understands the nature and purpose of the proposed treatment, together with any alternatives available, and the potential benefits and risks. In this context, where clinician and patient/parent do not share a common language, the assistance of an interpreter is essential.
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