Parents are upset that their child's teeth turned black after treatment with silver diamine fluoride. They state they were never told this would happen. Which failure does this MOST directly represent?

Correct answer: B. Inadequate informed consent

• A. No patient information was improperly disclosed to a third party.
• B. Correct. Black staining of the arrested lesion is an EXPECTED, unavoidable and well-documented consequence of silver diamine fluoride, not a complication. Because it is foreseeable, disclosing it — along with alternatives and the option of no treatment — is a required element of informed consent. Failure to disclose is an informed-consent failure, regardless of how well the procedure was performed.
• C. The treatment itself was performed correctly and produced its intended effect; the deficiency is in communication before treatment, not in technique.
• D. Abandonment is termination of care without notice or referral during active treatment; that did not occur here.

Note: Consent must cover the nature of the procedure, risks and expected outcomes, alternatives, and the consequences of declining — and for a minor it must be obtained from the parent or legal guardian.