We’ve been working recently with a successful specialist orthodontist called Dr Kalim Sadiq who has great ideas about how GDPs can get the most out of their orthodontic referrals, and avoid things going wrong.
Here the British Orthodontic Society gold medal recipient, who founded Orchard Orthodontics shares his perspective.
Demand for adult orthodontics is increasing and this is being fuelled in part by the increasing range of treatments on offer which differ in appearance, speed, comfort, cost and in the need for extractions.
Ever since two MIT graduates enlisted the help of computer scientists, mathematicians and orthodontists to come up with Invisalign about 15 years ago, the aesthetic appliances market has exploded, and it’s easy to understand why: adults want discreet and removable just as much as they want straight.
Other key developments are self litigating braces which have reduced friction within the appliance and there are also lingual braces that go behind teeth such as the Incognito system that combines the technical ability to treat complex cases with invisibility and comfort.
One impact of all these new orthodontic technologies has been to deliver happiness to an increasing number of people who, less than a generation ago, would most likely have accepted their crooked teeth as a fact of life.
However, it’s really important to understand and respect the limitations of each orthodontic system. Proceed with caution, for example, with clear aligners. You may still need to use a phase of fixed appliance because rotations and extrusions can be difficult. These systems can produce poor computer simulations and technical support, and the companies can and do go bust (think Orthoclear and Clear Step).
When the wrong system is used it’s no surprise that complaints happen, and judging by the quadrupling of claims against dentists, it’s clear this is a genuine problem. In fact, GDPs account for 80 to 90 per cent of aligner related complaints and claims, according to Dental Protection.
By far the most common reason for complaints is dissatisfaction with the outcome, and in more than half of cases this is put down to poor diagnosis, assessment and treatment planning.
GDPs performing orthodontic work can be in danger of neglecting their responsibilities around informed consent, which are spelled out in the GDC Standards: “Explain the options (including those of delaying treatment or doing nothing) with the risks and benefits of each.” Where GDPs have limited knowledge, or a working knowledge of only one treatment type, they may be putting themselves in a vulnerable situation.
As a specialist orthodontist it’s easy for me to see there is an over-reliance on third party and computer simulations, where the key competences of diagnosis, treatment planning and training can be neglected. Because of this, GDPs should protect themselves by always adhering to core principals to avoid problems and approaching multidisciplinary cases in the spirit of cooperation with orthodontists. Working with this awareness in mind we can improve the quality of care for patients.
For further advice on protecting yourself from ortho complaints, contact JJF on firstname.lastname@example.org or 07860 672727.