27 October 2025
How to manage aggressive patients
It is becoming increasingly common that dentists are dealing with aggressive patients. This can be a stressful time for the dentist and the staff alike.
As an employer there is an obligation to make sure all workers are safe in their workplace. The Occupational Health and Safety Act 2004, which is also supported by the Occupational Health and Safety Regulations 2017 is Victoria’s main workplace safety legislation that needs to be adhered to.
Health care practitioners are also required to meet obligations of the AHPRA Code of Conduct and show professionalism. Health care practitioners should always prioritise the safety of themselves, the patient, staff and others. This includes other patients in the waiting room.
De-escalation techniques can be used whilst staying calm. It is important to communicate in a clear, calm, non-confrontational manner. Always respect personal space and be mindful of
threatening body language. The patient should feel listened to and have their feelings acknowledged. Avoid becoming defensive or become involved in an argument. Try and work out what has caused the patient to become angry by asking open ended questions. Also, clearly and calmly state what is unacceptable behaviour. Consider flagging this in the records using objective, non-emotive language. It is worth considering scheduling patients with a history of being difficult at the end of the morning or afternoon session so there are no other patients in the waiting room. Two staff members should always be present.
There is sometimes no warning that a situation with an aggressive patient will occur. Occasionally a particular patient may have a history of behaving in this manner, and the practice can prepare to mitigate the harm. Being prepared is the best way to do this.
A staff meeting is a good time to document what process should be followed and to make sure all staff members are aware of what they need to do when dealing with aggressive patients. It is advisable to have a clear workplace policy and plan in place. For instance, there may be a buzzer that sounds in another part of the practice, or a key word which can alert the rest of the staff that the patient does not recognise.
Should the situation escalate, the patient should be asked to leave the premises and if they refuse then assistance from security (if available) or police should be considered. When there have been threats or abusive behaviour, the dentist needs to alert the local police station about this behaviour or threat. The ADAVB has had feedback from members that local police have been supportive when this avenue is taken.
The Dental Consultants recommend you visit Responding to aggressive customers | Victoria Police which is also a helpful staff training tool. Practice Plus also provide very helpful resources which can be found on the ADAVB website here.
It is difficult to continue to treat a patient once they have behaved in such a manner. In these circumstances it may be necessary to terminate treating the patient.
This may not be straight forward when the patient is having a long course of treatment such as orthodontics or complex restorative work. It is important to take note of the wording of the AHPRA Code of Conduct which is:
In some circumstances, the relationship between a practitioner and a patient may become ineffective or compromised and may need to end. Good practice involves ensuring that the patient is informed adequately of your decision to end the relationship and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information.
The ADAVB Dental Consultants can help by discussing how these patients can be handled professionally. Please do not hesitate to call on 03 8825 4600.
By Dr Loula Konidaris
B.DSc. Master of Health and Medical Law (Melb)
ADAVB Dental Consultant (Wed & Fri)
Practising General Dentist
