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A guide on what to consider if embarking upon orthodontic treatment.
By Steve Wake
More and more enquiries are being made alleging that orthodontic treatment has been negligent. The majority of these claims are against dentists who are conducting orthodontics in private practice but without being formally recognised as a specialist. This is our guide on what to expect when you’re thinking of embarking on orthodontic treatment.
The initial consultation
There is nothing wrong with a general dentist conducting orthodontic work. General dentists are just that; generalists. The majority carry out this treatment without any complications. However, regardless of whether you are seeing a general dentist or a specialist orthodontist you should expect a thorough initial consultation.
Generally speaking this initial consultation should consist of a full assessment of your bite taking into consideration the relationship between your top and bottom arches (usually by taking study models using putty). Radiographs should also be taken. Many experts would say that a special x-ray, called a lateral cephalometric radiograph, should be taken and discussed with you.
I would be very wary of digital representations of the possible results, which are presented by some brands of invisible braces. In my experience these rarely represent the final result and are nothing more than a fancy marketing tool to convince you into signing up for treatment.
Again, in my experience, Invisalign or 6 Month Smiles type treatment is only suitable for small movements in your teeth. Even so I don’t think I have ever seen one of these treatments succeed in concluding treatment within 6 months. But I am seeing only treatment which goes wrong. I think that slow movements of teeth would be preferable to reduce damage to the roots.
Follow up treatment plan
You should be sent a detailed treatment plan which includes a detailed diagnosis of your condition or issues and all the treatment options. The treatment options should include doing nothing because without all of the options there is no way you can fully consent to the treatment. If you have enquired about a specific treatment or product the provider should also discuss other options which might achieve a better result. All of the costs of each option should be laid out including future retention.
Retention is an important part of the treatment. Following completion of your orthodontic treatment it is normal for a period of retention to be needed. Retention is either by way of fixed or removable retainers. A fixed retainer is bonded to the back of the teeth and should last a considerable period of time but it is likely to need replacement at some point. The cost of these should be included.
Removable retention, a retainer used only at night or for certain periods, are common too and are sometimes included in the treatment plan but usually only cover a few years following treatment. In a recent case I handled the provider failed to mention that over a lifetime the removable retainers would cost over £30,000. A significant consideration when embarking on treatment.
In summary, you should expect a very detailed plan from a general dentist or a specialist orthodontist. You should be aware of all the treatment options and be told about all of the costs and the length of treatment. Of course treatment plans may change but again, this should be done with your consent. Every element of treatment should be explained to you because, it is likely that you are spending considerable amount of time and money in trying to get a smile you are pleased with.
If you have any concerns about substandard orthodontic treatment please get in touch with us.