PPE CASE D: TREAT WITHOUT CONSENT?

It is mid-morning in the school dental clinic at Mt Firth Primary School.

You have a busy day ahead because your colleague has called in sick. In between examinations a Year 3 teacher brings Gordon to see you. Gordon is 7 years old. He is not scheduled to see you, however his teacher noticed that he was in pain, and when she enquired further he told her that he had a very sore tooth. Apparently it had been troubling him for a few days but he didn't want to bother either of his parents, as they were always busy.

Upon examination you quickly discover that Gordon has quite an advanced dentoalveolar abscess in an upper first molar. This acute lesion has pus in the structures that surrounds the tooth and will be causing Gordon a lot of pain.

It is essential that he receives some form of treatment immediately. While he may need antibiotics, the initial plan would be to drain the abscess. As this is an invasive procedure, parental consent is required. However, despite several attempts to call Gordon's parents, no contact can be made. Without consent, going ahead with treatment would potentially be a breach of the patient Code of Rights. However, it is Friday and without some form of immediate treatment there is a risk that Gordon's pain will increase and you are aware of potential complications of dentoalveolar abscesses and you want to minimise further risk to the child.

Gordon is now crying, asking you to take the pain away. What should you do?