Metal Mouth Message Board

Hi,

For anyone who read my previous post I wrote about how my ortho doesn't take time to answer questions and at today's adjustment, even tho I previously requested to speak with her before any work was done, the tech said "Well, we have to put on a thicker wire." My teeth had shifted dramatically and I wanted to see what the Dr had to say and I asked the tech "how do you know what to do."

She said "Well usually there are notes from the previous visit but the tech who changed your wire before forgot to write any, we just know what to do." If I hadn't asked to see the Dr before leaving, I wouldn't have seen her. Is this typical? I have questions about where I am in my treatment but I never get to see the dr until the work is done and then I have to request it and that act all put out.

Does your Dr see you before adjustments/wire changes and if not, how do the techs know what to do? The Dr doesn't do any of the actual work. The techs put notes in the computer about what may need to be done at the next visit, but things can change a lot in 7 wks.

I want to write a letter to my Dr requesting that she look at my teeth BEFORE any work is done. I am paying for her expertise, not the technicians.

Any thoughts? I can't imagine asking the Dr to take 5 min to look at my teeth and answer any questions I have and let me know what the treatmen for the day is, is asking too much.

Still frustrated,
Cindy

At my ortho, the ortho makes notes on my chart at the end of the appt., and when I come in the next time, the materials required for the work stated in the charts is already sitting by the chair. Usually I sit down and the techs take off my ligs and wires, then the ortho comes by, looks at the chart, checks my teeth and varifies whether she wants them to follow the chart, or if she's changed her mind.

So I guess it's a little of both methods at my ortho. My ortho doesn't answer questions though...especially THE question: When are these things ever going to come off?? lol...

I actually have 2 orthos, and I can NEVER decide who is the sweetest/funniest/nicest.

Anyway, when I come in there is a chair ready with supplies already on the table. My computer chart is up with my picture (just a facial shot of me smiling, I guess so they know it's me? lol)

The tech takes off any paraphenalia and then an ortho comes over to exam and explain where we are at, what we are doing next, etc etc.

My last appt I was not too thrilled over getting a colored powerchain (clear would stain so it's NOT an option). Dr. S actually SAT there as the tech quickly put a few different ones on part of my upper teeth to offer his opinion should I need it. I love where I go even if it is a lot more expensive than other orthos around. In my town *everyone* knows who they are and they get RAVE reviews from my regular dentist and periodontist.

Like KK said, remember who is the paying customer here!! Good luck!

I find that strange, becuase my ortho does all of the work himself, and he even tells me how to clean and so on, the other poepl jsut pass him stuff and write stuff down, Im on the NHS so you would expect better becuase your paying yourself.

At the beginning of my treatment, the assistants did all the work and when I was done, the ortho would come over and check it all out. It seems now that I'm nearing the end (or I'd like to think that ), the orthodontist does all the work, which I prefer. Maybe it's because we're on to details that the assistants cannot do themselves? I think if I were doing this all again I'd want an ortho that takes care of everything.

I really don't talk much with the ortho, though, and she's not really very good about telling me what's going on. This website has helped tremendously!

In my case, the techs take the ligs off and wait for the ortho to stop by and take a look. He then tells her what he wants done, and she will do it. If its something more complicated than changing my ligs, he will stop back over before I leave to check things again.
I go to a big outfit which has some downsides, but have never been rushed and they will always take the time to talk to me if I have questions etc.
I would definitely talk to the ortho and express to him you want to have more one on one time each time to discuss your treatment, etc.

In my final consult I asked my ortho who does the work....him or the assistant. He told me the assistant is qualified to change the archwire,but that is as far as the trainning goes. He also told me, "BY LAW THE ORTHO HAS TO SEE YOU AT EVERY VISIT". I am in Canada so maybe that doesn't apply everywhere, but that is how it works here.

I would definately be requesting to see my ortho each visit. You are right....you are paying for her expertise!

At my appointments, usually the orthodontist checks me out before anything is done. A few times the doors will be opened on my brackets in advance of him seeing me.

As with others, the orthodontist dictates notes of what is to be done at the next visit - and how long in between visits. Everything is on a tray and ready to go for my appointment. At his inspection, he adjusts what needs to be done according to my progress. And then either he or the assitant finishes me up, depends on how busy and what needs doing.

I have the same situation as KJM posted. The assistant removes my ligs & wire then waits for the ortho to examine me and give her instructions. Last time the ortho placed my top wire as well. I guess I would be upset, too if he never was there to look at my progress.

My ortho spends a lot of time with me at adjustments, and sometimes he'll come by during my emergencies (which are usually simple enough for the assistants to figure out). My first adjustment was just changing the wire type and still, he took the time to come in and give instructions in person. Even though I know they have it all charted up on the screen, too.

I wouldn't feel right if he didn't see me at adjustments. Afterall, what if something went wrong, and you'd just be wasting your time.

My ortho has stopped checking me after the work has been done He checks at the start, tells the tech what to do and that's it. The tech takes the notes and does the work. I'm not happy about it because things really should be checked. I'm really disappointed in that respect.

My orthodontist comes by at every visit to take a look at my teeth and bite. If I have any questions, I will ask him then and if I think of other questions later, I ask the assistant and if she can't answer it, she will get the orthodontist and he comes by to answer my additional questions. He always explains what will be done and why. They always make note of what is expected to be done at the next appt. but if the orthodontist doesn't take a look at your teeth how can s/he know you have progressed the way you should have and are ready for the next step?

The assistants at my office are great and highly skilled. The only time the orthodontist comes by after the beginning of the appt. was when I had my brackets placed - he adjusted them before the asst. bonded the brackets and the other time was when I had my expander placed. If I didn't feel the trust in the great assistants at my office, I wouldn't feel the same way. I have not been disappointed yet. They are all registered dental assts. and have all had extensive orthodontic training.

ssfw

My ortho always stops at the chair. In the beginning, instructions were in my chart and the tech just did the work, and often would make decisions on whether to figure-8 a lig or use a wire tie on a particularly stubborn tooth. But my ortho would ALWAYS check the work. As I got further on in treatment and my teeth were getting pretty well aligned, the tech would remove my ligs and the Ortho would then come over and check me and instruct the tech on what to do. I think in the beginning alignment phase, things may be a bit more cut and dried, but as treatment progresses and more expertise and tweaking is involved, the ortho becomes more hands on. For instance, he is the one who puts all the bends in my wires and places them in my brackets, but leaves the lig work to the tech. If I need a new bracket or some such hardware, the tech places it but the Ortho inspects the placement and adjusts if necessary before the special light to harden the glue is applied.

nvcarissa- I am getting the opposite, the tech put all the bends in the wire the last visit. The ortho never even checked anything after all the work was done. I think I had the most experienced tech in the office, so he must trust her but she's not an licensed ortho. Some of the techs in the office are learning on the job, and work with a more experienced tech. I think there's a bit of turnover too.

My orthodontist and the assistant both work on my teeth. The assistant does much of the "grunt" work--placing the wire, putting on ligatures, etc. The orthodontist checks her work and fixes anything as needed.

I do not have any problem with the assistant doing this work. I believe she is a capable and qualified person, and that is why the ortho gives her some additional responsibilities. I do believe there are some patients that do not approve of her having such responsibilities--personally, I think a lot of that attitude stems from patients' beliefs about the capabilities of young women (of course, I am baised because I have to face the same beliefs/stereotypes-- that only old white men can be professors engaged in serious scholarship).