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ADC Practice Question — Delegation, Teamwork & Risk Management

dentist's accountability for the complication is BEST…

Paediatric dentistry questions combine clinical management with age-appropriate considerations — LA dosing by weight, behaviour management. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

A dentist delegates the administration of local anaesthesia to a dental therapist who is trained and authorised to provide inferior alveolar nerve blocks under the relevant state scope of practice. During the block, the therapist inadvertently damages the lingual nerve, causing the patient temporary paraesthesia. The patient asks the dentist who is responsible. The dentist's accountability for the complication is BEST described as:

  • A. The dentist is fully liable for all clinical outcomes because they delegated the procedure — delegation transfers the task but not the accountability
  • B. The dentist bears no responsibility because the dental therapist is independently registered, trained, and authorised — they are accountable for their own clinical decisions and actions
  • C. The dentist is responsible for the overall management of the patient and for the decision to delegate, but is not accountable for the specific clinical decisions and actions of the delegatee
  • D. Responsibility depends entirely on whether the dentist was physically present in the room during the procedure — direct supervision transfers accountability to the supervisor
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Sources cited
Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more
Show the answer and cited explanation
Correct answer: C

Section 4.3b draws a specific distinction: the delegating practitioner is not accountable for the decisions and actions of those to whom they delegate, BUT remains responsible for the overall management of the patient and for the decision to delegate. This means the dentist must answer for whether delegation was appropriate (was the therapist qualified? was the task within their scope?) but the therapist answers for how they performed the procedure. Option A conflates responsibility for delegation with accountability for execution. Option B eliminates the dentist's retained responsibility for overall management and the delegation decision. Option D fabricates a physical presence test that doesn't exist in the Code — the distinction is about delegation decision vs clinical execution, not supervision proximity.

Source: Section 4.3(a)(b) — delegation, referral and handover
Remy's study tip — Always note the child’s age and which tooth is involved. Primary vs permanent changes everything.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Delegation, Teamwork & Risk Management?
Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.
How are Delegation, Teamwork & Risk Management questions structured in the ADC written exam?
ADC Delegation, Teamwork & Risk Management questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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