Not sure if my Ortho is competent

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#1 Post by **trident58** » Sun Aug 10, 2008 9:07 pm

I'm currently in my 9th month with braces, and I'm starting to have serious doubts about my orthodontist. In his practice, he supervises a number of technicians who do most of the actual work on patients- the ortho tells the techs what to do, and that's that. What worries me is that what the ortho tells me is going to be done is often not what the tech does. Also, I've had to go into the office a number of times for broken brackets and bands, and instead, I have a bunch of other things done instead. I often have to tell the tech that something is broken and needs to be fixed, even if it is right in front of his face!
What really got me worried was my last visit 2 weeks ago. When I came in, the ortho said: "Congratulations! You're just about done. We'll take impressions today for your retainers." I was a bit taken aback because this appointment was for me to have a band reattached. Then, when the tech came in, all he did was replace the elastics on my archwires and then say "You're done!". I had to tell him 3 times to fix the band, and then when I asked him about the impressions the ortho said I needed, he looked confused. He ran out for a few minutes, then came back, removed the archwires and elestics, took the impressions, and then reinstalled everything.
Finally, I noticed last night that two of my teeth are severely overlapping, and a few others are very crooked-worse than they were 6 months ago.
Am I right to be wondering what is going on here?

#2 Post by **Lola** » Mon Aug 11, 2008 12:32 am

9 months seems very short. What was your initial estimate? If its much longer than 9 months I'd worry

#3 Post by **purpleteeth** » Mon Aug 11, 2008 1:43 am

Sometimes an ortho will tell you what HE is doing, but he doesn't necessarily have to explain to you what the tech is going to do. Good bedside manners are developed and if you want the tech to tell you what they are doing to, ASK THEM to tell you --- I told my ortho this when I was getting my inital eval because if they didn't tell me what they were going to do, I would freak out in the chair. They don't always tell me the techincal stuff, but they do tell me what is going on. As long as they keep me informed such as I am going to pop your brackets open and take the wire out (vs I am going to manually blah blah and insert a 67foot pole etc). I don't care about the minor details when they are working per-say, I just want to know why I am hearing or feeling or tasting something. I was VERY upfront about needing things explained... so you might want to take the initative here and insist upon it. You are your best advocate.

I have a fair share of SOS appointments under my belt. When I come in, they always ask me specifically what is wrong -- even before they examine me. I like it when they do this because it gives me the chance to speak first and express my concerns, increasing me to be the proactive patient. I have had additional work done at SOS appointments not related to my chief concern too, but I have always considered this a plus because it means they are doing their job by looking around and evaluating my changing condition.

It is YOUR RESPONSIBLITY as a patient to express these concerns. If you aren't happy with your teeth, then tell your ortho.
- you can be in braces for less than a year, that is possible
- retainers can fix some problems after the braces are taken off
- I have always had the ortho check my teeth after a tech was finished, unless I was there for a wire clipping only

I have complained to my ortho about techs before who have worked on my teeth. I had one who was just plain inconsiderate and very rude -- I left the office shaking and feeling guilty... the next time I was in the office, I made sure I never had her again and then found out she was no longer employed there

Bottom line, the ortho works for YOU -- take action with your braces. You are your best advocate and if you don't say something is going wrong or is making you feeling uncomfortable, they aren't going to necessarily do anything. You have to say something. Don't want for someone else to do it for you.

#4 Post by **rolo** » Mon Aug 11, 2008 3:30 am

I completely agree that you should insist they tell you what they are doing. It's your mouth and you are paying! I have gone in with a list of questions written down before. Although I am well informed I have had sos appointments too, three since April, although two were related to powerchains breaking, which I knew was a possiblity in my situation, but choose that option to get the job done faster.

Some practices allow you to book an appointment just for a consultation, to ask questions without having work done, so maybe that's an option open to you. At my practice they make notes on the computer, so if I forget something or want to know if I will need an X-ray etc next time, if I should that gap open up etc, the receptionist and I can read the notes, and check with the ortho if the issue isn't covered. Maybe you could ask if you could email or phone for a chat.

Hope you get sorted. If all else fails you could go to another ortho for a second opinion

#5 Post by **Folk Ballad** » Mon Aug 11, 2008 6:50 am

I agree with what everyone else above me has said.
And I think if the techs/ortho don't start shaping up after you put forth your concerns, to consider switching to another orthodontist. Or at the very least, get a second opinion from another orthodontist. You're paying good money for your smile! You don't want to have to come to the end of your braces journey and discover you've had second-rate work done.

#6 Post by **jaswi** » Mon Aug 11, 2008 8:51 am

I guess that is one thing my ortho is generally very good at. The tech explains what is going on as he is doing it, and makes sure you understand(not hard for me). Its not unusual to see a kid walk back out into the waiting room and explain what their new piece of hardware is doing to their parent.

#7 Post by **purpleteeth** » Mon Aug 11, 2008 1:01 pm

I was really confused today as to what they were doing... and when I asked the ortho, he gave a brief explanation and then the tech explained it in more detail. She even gave me the mirror and showed me what she was doing and what it would look like. I'm still not completely sure HOW it will work, but now I know what is in my mouth and what they are trying to accomplish. The ortho appeared really busy this morning (I think someone was getting their braces on next to me), but the tech really did show me in more detail --- so I'm more comfortable now with what they tied and twisted up in my mouth

You have to ask, bottom line. If they won't explain, don't get up until they do explain. It is YOUR mouth and you deserve to know what is going on. If you don't know what they are doing, how will you know if something has gone wrong or has broken or is moving in a different direction from planned (for example a gap opening that shouldn't be there, as I have had this happen).

#8 Post by **trident58** » Mon Aug 11, 2008 2:00 pm

Thanks everyone for your feedback. I called my ortho today and talked to him about my concerns. I feel that while he wasn't being overly defensive with me, he did seem like he was making some evasive answers. For example, when I asked him about some brackets that had broken off and where not replaced when I asked about them, he replied that it is sometimes better just to leave broken brackets off (never mind that the teeth with the missing brackets are now very crooked).
Not sure what to think at this point, but my next visit with him is in about a month, so maybe then we can square things away.