Why Are Orthos So Un-Communicative? Any Orthos Here?

[missingu]

Not that you have any way of knowing this, but my mother is a board-certified pathologist. Maybe not as good at communicating as social workers, but still...

[jennielee81]

My ortho did a fantastic job of mapping out my treatment in the beginning..before I met all of you wonderful people!

Now I want MORE infomation.

He and the assistant I have tell me exactly what they are doing, "now we will be using a # .16 (or what ever) rectangular wire to correct.."----"...you will have more pain from this than anything else" or " the elastics will be used to open your bite"...but because of this website what I want to know is HOW the rectangular wire works and HOW these elastics open a bite.

They're catching on to me, my last appointment I got a great lecture of orthodontic torque!

[JumpTheDitch]

Defintely an interesting thread. I'm in the boat of not knowing a great deal about my own orthodontic treatment, but then I wonder how much I can blame my ortho for that. Like a lot of people here, I didn't find this website til AFTER I started my treatment, and I'm guessing like quite a few people (from other threads I've read), I didn't ask many questions in my inital consult. To be honest, I had no idea about orthodontia, and wasn't savvy enough about the whole process to get a second opinion (not that I have any complaints about my treatment so far but I think it's smart to at least have two proposals to compare before you commit to one. Again, NOW I realise that!).

So I'm thinking I really set the tone of the relationship with my ortho; in that I didn't ask for details, didn't present myself as needing to know exactly what the plan was and how my goals were going to be achieved. To be fair, based on how much I DIDN'T say, DIDN'T ask and DIDN'T specify clear goals (other than "straight teeth"), he could be forgiven for thinking me somewhat uninterested in my treatment. I know that I'm not, but how is he to know if I haven't told him?

So how much can I blame him for perhaps not involving me in my treatment as much as I (now) would like?

Just a thought...

[braceface1230]

Very good topic. I've noticed the same thing with mine at first... he didn't say too much. And the reason, I believe, they don't tell to much is, that they're working with kids mostly and they don't care all that much about the details. Plus, they've spent years learning all the different techniques to orthodontia... I just don't think they want to spend all the additional time explaining ever minut detail.

But with me, when I get to the ortho's office, if I have a few questions, I make sure that when the assistant gets me in the chair, the first thing I do is mention to her that I have a couple of questions. If she can answer them, great. If not, then I make sure to tell her to let the ortho know I have questions. That way, he has a heads-up. Then, the first thing he does when he comes over is get me up to speed.

It took a little while for me to "feel the situation out" with how to approach him about the questions I've had, but the more we see each other, the better our doctor/patient relationship has gotten. Sometimes he'll even anticipate that I have questions; actually, I think he's come to expect it.

[payoki]

although my ortho is really nice, I don't like to ask questions because he usually has this attitude like..."it's nothing, don't worry about it" so I usually try to find answers from HERE, from all of you...I'm paying my braces in cash and I'm spending $150 a month and my ortho can't even spend 5minute answering my questions...

[erica]

Just to bring up a couple of other points in defense of orthos.... First of all, I think dentists and orthos in general probably actively avoid too much conversation because it puts patients in the awkward position of trying to talk when their mouths are being held open! Also, I think a lot of orthos want to avoid having their comments interpreted as promises. I think many of us here are guilty of latching on to any positive comments that come out of our orthos' mouths while ignoring the balancing negative comments. It's human nature - but for an ortho, it can create a very unpleasant situation when a patient starts yelling "but you said..." Finally, it sounds like some orthos have tried to respond to questions in detail but have been labeled as "defensive" as a result. A bit of a catch 22!

My ortho is definitely a relatively quiet person, but he always responds thoughtfully if I bring up a question. After all, it's ultimately my job to let him know that I care whether I'm likely to get a Hawley or an Essix retainer, but it makes no difference to me what torque forces are at work in my mouth. It's different for every patient, so he shouldn't be obligated to launch into every detail for every patient. Heck, he'd put me to sleep if he did.

[braceface1230]

Erica, I couldn't agree more with your post. Especially when you mention the, "but you said..." part. A lot of times I get the feeling that my ortho is just "trying" something out. Almost a, "lets see if THIS works" kind of approach sometimes. There are sooo many techniques involved and many different ways to move teeth around. And different techniques may work better than others. So I could see where some patients may have that, "but you said.." response when something doesn't quite work as well as expected.

I think it's ok to ask some questions, SOMETIMES, but to drill your ortho every time you go in for adjustments will probably frustrate both him/her and yourself. I just think it best to be as patient as possible with your progress, and sure, ask questions from time to time, but within reason. And when there is obvious reason for concern.

[ingyandbert]

No one said anything about "drilling" the ortho for information. I was referring to posts where the patient is not provided even BASIC information, like "What do elastics do?"

I do understand the point about not wanting to make promises. But I don't think it's an excuse not to communicate with the patient (which obviously can be done at either the beginning or end of the session when the patient does not have to keep their mouth open). Lots of different professionals -- doctors, lawyers, accountants, etc. -- are in the position every day of having to explain information in lay terms without "making promises" about the ultimate outcome. why should orthos be any different?

[JoeMama]

I agree with Ingyandbert (again). "Drilling" is different than asking questions. Erica, you make some good points, especially about the promise problem. But patients are entitled to ask questions about their treatment, or to have an idea of what the plan is and what's going on. To ask those questions or to expect some explaination is something very different than "drilling".

[jennielee81]

Oh I get the drilling thing because there is a woman (patient) at my ortho's office, who seems to have appointments at the same time as I, who drills him and the assistant.

I always feel bad for them and wish she'd check in here! Most of her quesitons could be answered by any number of us and leave him to more technical questions.

they do seem to answer her questions satisfactorily so who am I to judge

[braceface1230]

Personally, I don't let my orthos off the hook. I make them answer all my questions

Sounds like drilling to me.

If you can't get your ortho to answer even BASIC questions, then either find a different one, or find a different way of asking. Besides, are they getting paid to play 20 questions or straighten your teeth? Jeez, lighten up.

[braceface1230]

[quote]Personally, I don't let my orthos off the hook. I make them answer all my questions[quote]

Sounds like drilling to me.

If you can't get your ortho to answer even BASIC questions, then either find a different one, or find a different way of asking. Besides, are they getting paid to play 20 questions or straighten your teeth? Jeez, lighten up.

[missingu]

For the record, maybe the reason it takes 20 questions for an ortho to finally explain a procedure is that they are NOT communicating the information well in the first 19 questions, and the patient is in a situation to keep asking until they finally find a question to which the ortho will respond. Dentistry and orthodontics are not generally professions people go into for the sake of interpersonal communication, so there's no reason to think they will communicate well. Some do, many don't.

Regarding the comment about the woman who the person posting commented does "drill" the assistant for information - while this forum provides valuable information, to suggest someone forego getting professional direction or advice in favor of getting the information from an internet message board to me is not wise. Even the webmaster has some kind of disclaimer that the board isn't professional advice, so if the woman has questions, I think the best place for her to go is the ortho or an assistant. Considering the vast majority of the cost of braces is for personnel, and not hardware, I don't think asking questions is out of line.

[Marzipan]

Great topic, many interesting responses. The notion that orthos have traditionally treated many more children than adults is probably a reason they can be less communicative. KK is also right in that we should teach children to ask questions and take an interest in their own health care.

My ortho is very user-friendly - communicative and personable. I don't feel a need to know every detail, but each time she gives me a brief explanation of what is being done. Then if I have a question or two, she answers readily. On the other hand she does tell me I'm doing "A plus plus" (for following the rubber-band regime or flossing well) which is probably what she says to kids, also! LOL

I am in complete agreement with those here who say orthos are professionals who ought to be ready and willing to explain what they are doing. Their clientele deserves no less. If one patient doesn't want an explanation, fine. If the next one wants more information, he/she deserves to be given that respect.

[alexa]

Finally, it sounds like some orthos have tried to respond to questions in detail but have been labeled as "defensive" as a result. A bit of a catch 22!

Just to point out that in my own case, I labeled my ortho as defensive because she literally freaked out. Her tone of voice got raised, and she pulled out all of these photos and called all of these people over to come tell me that my teeth look better. That would be fine if I had said that I didn't think I had progress, but what I had said was, "What do these elastics do?" She automatically assumed that the question was my way of downing her treatment plan, when in fact I had meant exactly what I said: What do these things do?!

Even after I explained that this is what I meant, she STILL didn't answer the question, just went on and on about how SHE is happy with the progress and how much better everything is. That, in my books, is defensive.

Anyway, my ortho is a very nice lady, and her treatment plan is working well...I just wish she didn't assume that I was criticizing her work everytime I ask a simple question about what is going on in my mouth!