The Royal College of Dental Surgeons of Ontario (RCDSO) has released a revised draft Standard of Practice on Managing Conflicts and Ending the Dentist-Patient Relationship. The proposed standard introduces clearer guidelines around dismissal procedures, documentation requirements, and patient continuity obligations. Ontario dentists should review the draft and provide feedback before it is finalized.
As of May 2026, the RCDSO is seeking public and professional feedback on its revised draft Standard of Practice for Managing Conflicts and Ending the Dentist-Patient Relationship. This standard, which has gone through an initial consultation round and subsequent revisions, addresses one of the most sensitive areas of clinical practice: when and how a dentist may ethically and legally end care for a patient.
Why the RCDSO Is Updating This Standard
The existing guidance on patient dismissal has long been a source of uncertainty for Ontario dentists. While every practitioner understands the obligation to provide care, the boundaries around ending a treatment relationship — particularly in cases involving patient non-compliance, disruptive behaviour, or irreconcilable conflicts — have not been clearly codified. The result has been inconsistent practice across the province, with some dentists maintaining relationships that compromise care quality and others dismissing patients without adequate documentation or transition support.
The RCDSO's updated standard aims to resolve this ambiguity by providing a structured framework that balances professional judgment with patient protection. The revisions reflect feedback from the initial public consultation, which highlighted concerns about administrative burden, clinical autonomy, and the practical realities of managing difficult patient relationships in busy practices.
Key Changes in the Revised Draft
Greater Emphasis on Professional Judgment
The revised draft places greater weight on the dentist's professional judgment when managing conflicts and deciding whether to end a patient relationship. Rather than prescribing rigid criteria for when dismissal is appropriate, the standard acknowledges that each situation involves unique clinical and interpersonal factors. This shift responds directly to feedback from Ontario dentists who felt the initial draft was overly prescriptive and did not account for the complexity of real-world practice.
Reduced Administrative Burden
One of the most significant changes in the revised standard is the effort to reduce documentation requirements to what is clinically and legally necessary without creating excessive paperwork. The RCDSO has streamlined the process while still requiring that dismissal decisions be documented clearly enough to withstand regulatory scrutiny if a complaint is filed.
Template Dismissal Letters
The RCDSO has released accompanying Template Dismissal Letters designed to give practitioners a ready-to-use starting point for written patient notification. These templates cover common dismissal scenarios and include the essential elements — notice period, emergency care provisions, record transfer instructions, and referral information — that the standard requires. For practice owners in Toronto, Mississauga, Markham, and across the GTA, these templates can significantly reduce the time and legal cost associated with drafting dismissal correspondence from scratch.
FAQ and Case Scenarios
Alongside the revised standard, the RCDSO has proposed a series of FAQ and case scenario topics intended to illustrate how the standard applies in practice. These scenarios are expected to cover common situations such as patient non-compliance with treatment plans, verbal abuse toward staff, chronic no-shows, and disputes over billing or insurance coverage. The case scenarios are not yet finalized, and the RCDSO is seeking input on which topics would be most useful to the profession.
Pro Tip: Review the RCDSO's Template Dismissal Letters now, even if you do not anticipate dismissing a patient soon. Having a vetted template on file means you can respond quickly and confidently if a situation escalates, rather than drafting correspondence under pressure.
What Ontario Dentists Should Know About Patient Dismissal Obligations
Even under the revised standard, ending a dentist-patient relationship in Ontario comes with specific obligations that practitioners must follow to avoid regulatory complaints or legal exposure.
First, dentists must provide reasonable notice before terminating care. The standard does not prescribe a specific number of days, but the notice period must be sufficient for the patient to find alternative care, particularly if the patient is mid-treatment or has an acute condition. Practices in densely served areas like North York or Etobicoke may have shorter practical notice periods than those in underserved communities.
Second, emergency care must be provided during the notice period. A dentist who has initiated the dismissal process cannot refuse to treat a patient experiencing a dental emergency until the notice period has elapsed and the patient has had a reasonable opportunity to establish care elsewhere.
Third, patient records must be transferred promptly upon request. Under the Personal Health Information Protection Act (PHIPA), patients have the right to access their dental records, and practices must facilitate timely transfer to a new provider.
Pro Tip: Document every step of the conflict management and dismissal process in the patient's clinical record — including verbal conversations, missed appointments, and behavioural incidents. Contemporaneous notes are your strongest defence if a complaint is filed with the RCDSO.
How This Affects CDCP Patients
With the Canadian Dental Care Plan (CDCP) bringing millions of previously uninsured Canadians into dental offices, the question of patient dismissal takes on additional complexity. Practices that have opted into the CDCP may face situations where new patients present with significant unmet dental needs, complex treatment plans, and expectations shaped by years without regular care. Managing these relationships requires patience, clear communication, and — when necessary — a structured process for ending care that complies with both the RCDSO standard and any CDCP provider obligations.
The RCDSO has not yet clarified whether CDCP participation creates additional restrictions on patient dismissal. Ontario dentists should monitor updates from both the RCDSO and Sun Life, the CDCP administrator, for guidance on this intersection.
How to Provide Feedback
The RCDSO is accepting feedback on the revised draft standard through its public consultation portal. Ontario dentists, dental hygienists, dental assistants, and members of the public are all invited to comment. The Ontario Dental Association (ODA) and the Canadian Dental Association (CDA) have encouraged their members to participate in the consultation process to ensure the final standard reflects the practical realities of clinical practice.
Pro Tip: Submit your feedback through the RCDSO's official consultation portal rather than social media or informal channels. Formal submissions carry more weight in the standard-setting process and ensure your perspective is part of the official record.
Frequently Asked Questions
Q: Can a dentist in Ontario dismiss a patient from their practice?
Yes, Ontario dentists have the right to end a patient relationship, but they must follow RCDSO guidelines. This includes providing reasonable written notice, continuing emergency care during the notice period, facilitating record transfers, and documenting the reasons for dismissal in the clinical record.
Q: What is the RCDSO's new draft standard on ending patient relationships?
The RCDSO has released a revised draft Standard of Practice on Managing Conflicts and Ending the Dentist-Patient Relationship. It emphasizes professional judgment, reduces administrative burden compared to earlier drafts, and includes template dismissal letters and case scenarios to guide practitioners.
Q: Does the CDCP affect a dentist's ability to dismiss a patient?
The RCDSO has not yet issued specific guidance on whether participation in the Canadian Dental Care Plan creates additional obligations around patient dismissal. Dentists who are CDCP providers should monitor updates from both the RCDSO and Sun Life for clarification on this issue.
EBIKO Dental will continue monitoring regulatory developments from the RCDSO and other Canadian dental regulatory bodies to keep Ontario practices informed.