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As a practising dentist you may find yourself in the position where a patient has requested that their assistance dog be present at the time of their dental treatment. An assistance dog (a guide dog for the vision impaired being the most common example) is trained to assist persons with a disability to alleviate the effect of the disability.

Advisory Services has sought guidance on this issue from various bodies including NSW Health, Vision Australia, Guide Dogs NSW/ACT and the NSW Anti-Discrimination Board. The guiding principle was the Anti-Discrimination Act which stated that people should not be refused a service (dental treatment falling within the definition of ‘a service’) because they have an assistance dog (whether for seeing, hearing or mobility). Essentially, all assistance dogs must be allowed to accompany their owners.

Of course, you may have the following concerns about a dog being present whilst dental treatment is being performed:

• In a small treatment room, the dog may present a potential trip hazard for practice staff (Workplace Health and Safety considerations);
• There is the potential risk of injury to the animal (e.g. a dropped instrument);
• Other patients may question the hygiene aspects (infection control considerations) of having a dog in the treatment room (we know of circumstances where this has been raised by other patients when the dog was only in the reception area); or
• The view that a guide dog would not be permitted into a hospital operating theatre.

There is no clear legal answer to the issue. Dentists are encouraged to discuss the matter with the patient prior to the patient arriving for their appointment.  In an ideal world the assistance dog would remain at reception whilst their owner received treatment and during this time the patient would be assisted by the dentist and other support staff. If the patient requires the dog to be present during treatment it should be allowed. The following points should be taken into consideration when allowing an assistance dog into the treatment room:

• It should be explained to the patient that the dog is being permitted to come in at their request, that a potential trip hazard exists for staff and that there is a remote/unlikely risk of injury to the animal;
• A “preferred” location for the dog in the treatment room should be nominated by the practice;
• The practice should undertake to thoroughly clean the treatment room after the patient and dog have departed, allowing additional time to do so;
• Any questions from other patients about the presence of the dog should be answered by explaining that people with an assistance dog have a legal right to be accompanied by that trained dog given that they effectively function as the patient’s eyes or ears or assist with the patient’s mobility and that additional time has been allocated to thoroughly clean the room post-appointment; and
• Practitioners should consider making future appointments for the patient towards the end of the day – even as the last patient of the day – to minimise cleaning issues and perhaps reduce the number of waiting patients who may express concern.

In conclusion, a dentist should consider all circumstances from the patient’s perspective as well as that of the operational needs of your practice. It is very important to avoid being discriminatory in your comments or actions. If you are unsure of your obligations, please seek the advice of Advisory Services.