how involved is the ortho

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#16 Post by **sjsarre** » Thu Sep 14, 2006 9:17 am

My ortho is the one that does all the work. His assistant hands him the ligs to change and helps out with anything that he asks her to provide but he is the only one that does anything with my teeth.

I can't believe that Ortho's can still charge so much when it appears in some countries that its their assistants which do the majority of the work. I bet you the assistants don't get paid that well either!!

If I was paying the money I am now to the Ortho's office and found it was an assistant doing the work I would complain. Mind you my treatment is costing me GBP3000..

#17 Post by **Chris** » Thu Sep 14, 2006 12:46 pm

. It will not surprise me, for example, if we see nurse practitioners popping up in the UK and starting to take over on a routine basis the same sorts of responsibilities they have over here.

Thats exactly whats happening here in California!!! Now when I make an appt at a new office I have to ask "will I be seeing an MD or a NP?" Lots of shortages all around in the medical field. Takes FOREVER to get appts sometimes.

#18 Post by **JoeMama** » Thu Sep 14, 2006 8:08 pm

I don't mind the "assistant" or NP in most cases, but one thing I like is seeing the same person everytime I'm there. If I can see the same NP the same way I can see the same stylist everytime I have an appointment, that makes me feel like I'll be getting more cohesive service.

Although, I wanted a hands-on ortho. Since I had to pay for the braces myself, that's what I got. For some reason it makes me feel better to have the ortho there. She's part of everything that goes on and I like that.

#19 Post by **Eleni** » Thu Sep 14, 2006 8:18 pm

To me Meryaten, stylists and cooks just donâ€™t make a good analogy in this particular discussion.

Iâ€™m not knocking assistants as a profession or saying their specialized knowledge is inferior. I can say this with confidence as I worked for a doctor for 2 years as an assistant before I changed careers. I think that is a poor interpretation of the one sentence you quoted. What I am questioning here is what you define as â€œprep-workâ€

#20 Post by **londonchick** » Fri Sep 15, 2006 3:55 am

I think i'm right that i'm the only Brit replying (or maybe i just haven't read it all correctly) and so can give an answer relating to UK

My ortho does (or at least did) everything herself. She has a good assistant who passes her things, holds things etc. When i actually asked them what that was all about they explained that here a dental assistant is not allowed to enter the mouth of a patient, by law.

I realise there must be different levels of training/qualifications and therefore must be something above a dental assisant but not not a qualified dentist and maybe the law allows them more access, but i've not come across one.

#21 Post by **Lisa65** » Fri Sep 15, 2006 4:04 am

Ditto, Londonchick

I'm in the UK too and I never heard of a dental assistant doing any orthodontic work. My ortho does everything himself. The only thing he didn't do was my X-rays. His dental nurse did those.

When I'm in the chair all the assistant does is pass him the things he asks for.

#22 Post by **Ronsie** » Sun Oct 08, 2006 7:41 am

I feel lucky as everything is done by my ortho with the assistants only preparing the tools for her. My ortho is quiet so I try not to bombard her with too many questions. She does answer my questions completely. And after once having a different ortho at the same clinic for an emergency, I really do appreciate my own ortho's skill and gentle handling of my mouth.

My mother-in-law (who is Chilean; I'm from the US) told me that the culture here is not to ask questions of doctors so I'm careful to point out to the doctor that my questions are due to enthusiasm and not questioning the doctor's decisions.

Thank goodness for archedwire because 99% of what I learned about braces is from this site!

#23 Post by **jenfire** » Sun Oct 08, 2006 7:59 am

In my case, the assistant is with me the most because she is actually putting the wire and ligs on. The orthodontist makes the major decisions though in terms of which size/type wire to put on, bracket positioning when they were first placed, etc.

#24 Post by **Gennel** » Sun Oct 08, 2006 10:13 am

I've been to about 4 adjustments already.

My ortho has been present at all of them. He put on the brackets and his assistant put the wire and ligs on. The ortho put spacers at my next visit. He always comes in first and checks my progress and he makes the assesment of what comes next. The assistant takes over and does as he said. My ortho then comes in again and checks everything and then I'm on my way home

The assistant has NEVER made assessments she simply follows orders ,I would NOT feel comfortable if I just went in and the ortho was not there at my adjustment. I have heard several people mention that their ortho leaves written instructions on what to do for the next adjustment. Honestly I would not like this either because in 4weeks or 6 weeks the ortho can't predict 100% what will happen unless he sees your teeth to confirm what he expected .

Gennel

#25 Post by **xtrememkovr** » Sun Oct 08, 2006 10:29 pm

My ortho pops in (so far) and checks the work of his assistant. The assistant and I have become quite close - I know how she is - I like her demeanor, and she is very gentle but firm when doing things. I think she is very competent, and the Ortho will often come by - look at how I am doing and tell her "good work". I don't need his "vote of confidence" but I think he does it for 2 reasons: 1. To let my assistant know that she is doing well according to his specifications and 2. To let me know that my assistance is doing well according to his specifications.

From what I understand - He has prescribed my treatment based on my x-rays, my molds and so forth - and the assistant is the one who follows through with the treatment. I don't think I would feel any better having my ortho do the work - just as long as I know that he is involved in my treatment and is taking a look at my records and knows me (or my teeth) then I trust his judgement and staff - and know that I am in good hands.

My treatment costs for braces is about 4 thousand dollars - I never wait more than 2 -3 minutes for appointment times - and I'm usually out of the door (the last 3 times I've seen him anyways) with in an hour - at most an hour and a half if I have to speak to him, pay up, or whatever. (please note that these appointments may indeed be a bit longer due to spacers, banding, brackets, etc. Have not had an adjustment yet - still in the preliminary stages of my treatment...)

Also before I end this book (lol) - I can understand why there is a bit of an issue about whether or not your ortho sees you or not. I think that it is good if your ortho sees you if you need that type of assurance - but I think that it is wrong to insinuate or suggest that care by an ASSISTANT is some what lacking in care, etc. If that is one's personal belief - then by all means - find an office where you will only be treated by the ORTHO himself . But I think it's somewhat false to assume that an assistant is not well trained and not well directed by the ORTHO's themselves and quite capable of giving those of us in their care the perfect smile of our dreams...

X.

#26 Post by **Zondrae** » Sun Oct 08, 2006 11:49 pm

My ortho does most of the work himself. The assistants take impressions & xrays, pass him instruments & generally help out. He's quite snappy with them sometimes too - a bit rude really. But he's always nice to me.

I have been told if I get too stained I can pop in & the assistant can do a lig change for me between adjustments.

#27 Post by **niknikc** » Mon Oct 09, 2006 1:19 am

The assistants done everything but my consult and attaching the brackets so far. My ortho supervises all of them cause her office is one large open space with 5 chairs in a circle and in the center is where the sink and everything is. She rotates around when she is needed and it makes all the office visits really quick.

#28 Post by **GemGal** » Mon Oct 09, 2006 6:29 am

niknikc, my orthos office is setup the same way. My ortho and his assistant worked together in putting on my braces.