Can you fire a dental patient? Yes. But Ontario’s new patient dismissal standard means dentists need to be more careful about how they end a dentist-patient relationship.
Every dentist has dealt with a difficult patient. Perhaps the patient repeatedly misses appointments, refuses recommended treatment, becomes aggressive toward staff or simply refuses to pay their bills. Sometimes, despite your best efforts, the relationship breaks down. But dentists cannot simply tell patients to leave without considering their professional responsibilities. In July 2026, the Royal College of Dental Surgeons of Ontario (“RCDSO“) introduced a new Standard of Practice addressing patient conflicts and the termination of dentist-patient relationships.
Here’s what Ontario dentists need to know….
1. Try to Resolve the Problem First
The new standard generally expects dentists to make reasonable efforts to resolve conflicts before dismissing patients. For example, if a patient repeatedly misses appointments, consider explaining your cancellation policy and giving the patient an opportunity to improve. If a patient disputes a bill or treatment recommendation, try discussing the issue and addressing their concerns. Of course, there may be situations involving threats, harassment or serious safety concerns where continuing the relationship is unreasonable. The key is to act professionally and document what happened.
2. Put the Dismissal in Writing
When ending a dentist-patient relationship, dentists should provide written notice that clearly explains the decision. The notice should address:
- When the relationship will end and why.
- How the patient can obtain their dental records.
- How emergency care, unfinished treatment and outstanding deposits will be handled.
- How the patient can find another dentist.
A simple statement telling a patient they are no longer welcome may not be enough.
3. Be Especially Careful With Unfinished Treatment
Dismissing a patient halfway through treatment creates additional risks. Imagine a patient who has started orthodontic treatment, is waiting for a permanent crown or has undergone the first stage of implant treatment. Dentists generally must offer to complete or refer patients for temporary, time-sensitive treatment already underway. Patients undergoing long-term treatment must also receive information about their current condition, necessary interim care and the risks of stopping treatment. There are limited exceptions involving abuse, harassment or risks of harm. The goal is to avoid abandoning patients who still need professional care.
4. Keep Good Records
If a dismissed patient complains to the RCDSO, your records may become extremely important. Dentists must document the conflict, attempts to resolve it, the patient’s condition, unfinished treatment, the dismissal notice and relevant communications. Good records can help demonstrate that your decision was reasonable and professionally handled.
5. Selling Your Dental Practice? Pay Attention
Patient dismissal policies can also affect dental practice sales. Buyers may review patient complaints, incomplete treatment, prepaid services and outstanding obligations. Poorly documented dismissals can create concerns during due diligence and potentially affect the sale.
6. You Cannot Dismiss Patients for Discriminatory Reasons
Dentists cannot end a patient relationship where doing so would violate legislation, including Ontario’s Human Rights Code. For example, dismissing a patient because of a protected characteristic, such as disability, race or religion, may amount to unlawful discrimination. Dentists must have a clear, defensible reason for ending the relationship and consider the patient’s best interests. A difficult interaction does not automatically justify dismissal.
7. Emergency Care Must Be Addressed
Another important requirement concerns emergency treatment after dismissal. When a dismissed patient will no longer have access to care at the practice, the dentist must offer at least one emergency-care option. This can include providing contact information for an emergency dental provider or hospital with a dental department, referring the patient to another dentist, or offering emergency treatment directly. Dentists do not necessarily have to personally provide emergency care after dismissal. However, they must consider how the patient can obtain appropriate emergency services.
8. Protect Your Staff, Too
Dentists are not expected to tolerate threats, harassment or abusive behaviour. Dentists may end a relationship involving abusive or harassing behaviour, or a risk of harm, without having to offer, refer or provide further care under the usual requirements. Notice must still be given. Dentists must also remember their responsibilities to employees under Ontario’s Occupational Health and Safety Act, where applicable. Protecting patients and maintaining a safe workplace are both important professional obligations.
Final Thoughts
Dentists have the right to end a patient relationship, but that right comes with professional responsibilities. Before dismissing a patient, consider whether the problem can be resolved, whether treatment remains unfinished and whether the patient will have reasonable access to ongoing care. A clear written policy, proper documentation and a carefully drafted dismissal letter can help protect both your patients and your practice.
At DMC | DentistLawyers.ca, we’ve been helping Ontario dentists with their legal needs since 2009.
Source: Royal College of Dental Surgeons of Ontario, Standard of Practice: Managing Conflicts and Ending the Dentist-Patient Relationship, effective July 3, 2026, particularly Provisions 1, 5, 8–9, 12–17 and 19–20.
