Ortho Mistake?

[BaliGirl]

Does anyone else feel like they chose the wrong orthodontist?

I have been subject to one too many mistakes and had one too many questions dodged with non-answers that I have completely lost faith in my ortho and his staff.

Starting at the beginning (this should have been my first indication): the tech took my wax bite incorrectly. Ortho caught the error and used this as teaching opportunity for staff on how to take a wax bite correctly. Minor mistake, and it didn't bother me at the time, but looking back, this was my first clue to RUN. It was made by a tech w/ 10 years of experience.

At each appointment, the extent of my interaction with the ortho is as follows: Tech takes off my wires, ortho comes over and says to open, close, open close, congratulates himself at how well my teeth are moving, then he barks out a few orders to the assistant in ortho speak and he moves on to the next patient. If I get a chance to ask what is being done and why, he says they're trying to align my teeth to create a stable bite and get me ready for surgery. When I ask what needs to move where to be ready for surgery I get the same answer, they're trying to align my teeth to create a stable bite. Well DUH, I know that, but what I want to know is which teeth need to move? Where do they need to go? What will success look like? Is it unreasonable to ask what your orthodontist is doing and why? I'm not being disrespectful in asking, I genuinely want to know what is happening in my mouth. I wouldn't let a doctor treat me without knowing what they were doing and why, so why should the orthodontist be any different?

Space for a future implant (to replace a missing tooth) was not built into my treatment plan, even though the ortho knew it was important to me (whole reason for doing the ortho/jaw surgery thing was to create a stable bite to place implants into my missing spaces). Since nothing was being done to hold the space open, it partially closed during the leveling and aligning phase. Ortho suggested closing it completely and pulling the corresponding tooth on the other side because that would be easier than re-opening it. I declined that option - I'm trying to save the teeth I have and replace the ones I'm missing, not pull another one. Ortho grudgingly placed a spring across the opening to open up space, but the tech put the wire stop on the wrong side of the tooth, so no movement was possible. Went 4 months with this configuration until the ortho noticed this error and wondered aloud why the stop was put on the wrong side of the tooth. Several appointments later I called out that the space was not getting bigger and asked what was planned to create more space. He just shrugged and said "I don't know how to re-open that space." So I asked about appliances that can open up space and my ortho shrugged. No response, just a shrug, then he began a conversation with the patient in the next chair.

One tooth had a perfectly aligned root to begin with, but the bracket was applied crookedly, and the tooth tipped so far that its root is now slanted and touching the root of the tooth next to it. I noticed this on x-rays 4 months ago but didn't say anything, figuring it would be addressed at the next appointment. And the next appointment. I also didn't want to be a pain in the butt patient who complains all the time and asks a million stupid questions. It still hadn't been addressed on the 3rd appt after the xrays, so I asked him to review my xray and tell me if it was supposed to be that way (trying very hard not to be a know-it-all) , and of course, it isn't. Now there's a bend in the wire to put that tooth back where it came from (round-tripping, something that most orthodontists try to avoid because it's bad for teeth). Nothing would have been done to fix this tooth's alignment if I hadn't mentioned it. Now I'm wondering what else is wrong that I don't know about and that he hasn't noticed.

Other spaces between teeth were created and then closed because it was a mistake to open them in the first place. More unnecessary tooth round-tripping.

OK, enough venting from me (and this is just the tip of the iceberg). I'm just soooooo frustrated. I've reached the point where I am actively searching for a new orthodontist and trying to figure out how NOT to select poorly again.

Am I overreacting?

Does anyone have any tips on how to select a good orthodontist?

Thanks for any input!

[Robot Teeth]

I can sympathize with you. Not because my orthodontist sucks (It's only been a week since my braces went on), but because I'm a bit of a know-it-all/control freak/demander-of-good-customer-service. And when people don't reciprocate the level and quality of communication you require, it is frustrating as hell.

Here's what I would do if I were you: Since you are an articulate, efficient communicator, write down your exact concerns in bullet-point form on a sheet of paper. Reword the questions and issues in as simple and direct a manner as possible. One of the first things on the list should be the fact that you are very dissatisfied with the quality of communication with the doctor, and that you are seriously considering leaving. You might even want to use this post as an outline to create your list. Make yourself a copy and keep it. When you go in next time, verbally bring your concern to his attention, and give him the list, explaining that you know he's too busy to address each item in detail with you now. Make sure he keeps the list.

If he blows you off (either when you give him the list or later when you see that he has not acknowledged your concerns), fire him. He probably makes at least a quarter million dollars a year - you don't need someone who acts like they don't need you.

[Englishgirl]

Hey BaliGirl - I'm so sorry to hear about what you're going through - it sounds incredibly frustrating and upsetting. How long have you been in treatment for and how much money have you spent already?

My gut feeling is that the health of your teeth and jaw are the most important things - worth way more than any money you will have spent, and that you should should cut your losses and run. The mistakes the ortho has made sound completely unforgiveable and worrying. Perhaps you should also consider filing a complaint with some sort of Orthodontist's overseeing body which might look in to their practice?

It's hard to find a reliable ortho - when I was looking I couldn't find any posts recommending or warning against orthos in London. Maybe no one wants to talk about their dentist online in case the dentist reads it!

Best bet is to ask on here and try and find someone else from Texas who has a good ortho - then try and back that up with other reports. Maybe post a topic with that heading?

The only advice I have is to do with cost. When I was looking, I visited a woman who offered braces for half the price of the place I'd had my first consultation. Excellent, I thought! Same job, half the money. Her office was grubby, she was wearing braces (for the third time she told me proudly - not something to boast about when you're an ortho) and she told me she wanted to remove four teeth. I went with the original guys, and I'm now nearly finished with no teeth removed, so I think that perhaps the cheaper dentists are to be avoided.

Sorry that I can't be more help. My instinct is that you shouldn't stay with this guy. He sounds really ungifted at his job.

[poppy123]

Aww I feel for you and no you are definitely not over reacting at all. Can I ask, Ive wondered this for ages, a lot of people on here say about how the assistant does all the work and the ortho just 'checks', is this normal practice where you live? In the uk that never happens, you have one-on-one ortho plus an assistant who just passes ortho stuff. And you said he talked to the person in the next chair?... are you all like in a big room together? lined up on chairs? ... or have I got this wrong?

With regard to your situation I'd go for a second opinion,as you quite rightly said the tipped root wouldn't have even been dealt with if you hadn't said anything and that's just shocking!! I'd want a new ortho I think. in the uk a lot of consultations are free but I know that's not the case everywhere. Good luck, I really do feel your frustration x

[LoveOrtho]

Aww I feel for you and no you are definitely not over reacting at all. Can I ask, Ive wondered this for ages, a lot of people on here say about how the assistant does all the work and the ortho just 'checks', is this normal practice where you live? In the uk that never happens, you have one-on-one ortho plus an assistant who just passes ortho stuff. And you said he talked to the person in the next chair?... are you all like in a big room together? lined up on chairs? ... or have I got this wrong?

Hi poppy123,

Um, I'm not sure about other offices, but yes, its usually the assistant that works on me. I'm ok with it cuz she is super nice, but ocasionally the ortho will work on me when there is something "big" happening... I come in and the assistant takes off my ligs, then the ortho comes and checks on everything, and tells the assistant what to do. And that brings me to the next question, in my office, all the chairs are in a big room... I can see everyone!

Hope that helped...

[TumbleDryLow]

Can I ask, Ive wondered this for ages, a lot of people on here say about how the assistant does all the work and the ortho just 'checks', is this normal practice where you live? In the uk that never happens, you have one-on-one ortho plus an assistant who just passes ortho stuff. And you said he talked to the person in the next chair?... are you all like in a big room together? lined up on chairs? ... or have I got this wrong?

In the US is is common practice (and legal) for the assistant to do all the manual labor and the only thing the Dr does is "look and tell". It is also very common in the US for ortho offices to be "assembly line". Many chairs lined up in one big room, one Dr flitting from chair to chair and an assistant to doctor ratio of many to one.

[klobird]

In all the offices where I live the chairs are lined up--we are like cars on an assembly line--maybe it's so the ortho can move faster from patient to patient.???

I was having problems with my ortho too--Finally, I made an appointment with the office manager. I took my list, and very nicely said that I had some concerns that I would like to discuss. She was extremely receptive, told me that she had just discussed some of the problems with the ortho, and then went right in and talked to him. I had my regular appointment a few minutes later---EVERYONE was on their toes--falling over to be accommodating. That was a couple of days ago.
I am waiting for my appointment next week to see how it goes. But it was really nice to have at least one really good appointment.

Do you have a good relationship with your regular dentist? I do, and she told me that whatever I need as far as the ortho goes, that she has my back (I told her about my problems with the ortho). I know that if I needed her help, she would talk to the ortho herself to get some action.

As far as all of the mistakes, I would make an appointment with another ortho just to explain your concerns and ask for their opinion....

[loradora]

Aww I feel for you and no you are definitely not over reacting at all. Can I ask, Ive wondered this for ages, a lot of people on here say about how the assistant does all the work and the ortho just 'checks', is this normal practice where you live? In the uk that never happens, you have one-on-one ortho plus an assistant who just passes ortho stuff. And you said he talked to the person in the next chair?... are you all like in a big room together? lined up on chairs? ... or have I got this wrong?

Hi poppy123,

Um, I'm not sure about other offices, but yes, its usually the assistant that works on me. I'm ok with it cuz she is super nice, but ocasionally the ortho will work on me when there is something "big" happening... I come in and the assistant takes off my ligs, then the ortho comes and checks on everything, and tells the assistant what to do. And that brings me to the next question, in my office, all the chairs are in a big room... I can see everyone!

Hope that helped...

Agree with LoveOrtho. The assistant does most of the work, but the ortho tells them what to do and he does the "tweaking" of the wires, etc. My ortho was recommended by my dentist and I thought he was great. There were about 5 chairs in a row in the room.

[BaliGirl]

Thanks so much for the input and suggestions.

Robot Teeth: great idea to write down my concerns in a short, simple, clear list and share it with the ortho. I am so disturbed by the technical errors that have been made by my ortho and his staff that I don't think there's anything that could be said or done to win back my trust. However, I do want to put all of my concerns in writing to him so that he knows exactly why he lost me as a patient. Hopefully he will take it to heart and do better with his other patients.

Englishgirl: Haha, "ungifted" is a good way to describe my ortho. I've been in treatment for 10 months and have spent close to $4,000 USD already. I'm sure I won't get any of that back if I leave, but I have already made peace with losing money if it means I will have good care going forward. I completely agree that the health of my teeth and jaws are the most important things, and I need a provider who also believes it. There is not a whole lot of info for or against any dental providers available in my town, and the people I knew who used my current ortho love him and their teeth all turned out well as far as anyone knows. Maybe this poor performance is a recent thing. Or maybe complicated cases like mine are not his "thing." Or maybe he's overworked and can't keep up. Or maybe he just doesn't care. Or maybe this kind of thing happens all the time but nobody notices, and I'm just hyper aware and overly critical. I might ask for recommendations in my area to see what turns up. It can't hurt, anyway! Good advice on the cost, too. Not that I want to spend a fortune on my teeth, but I have already ruled out the cheap providers - they are all part of a chain with high orthodontist turnover. I'm glad you're almost finished with your treatment and are happy with your results (and with all of your teeth!).

poppy123: in my area (for the orthos I evaluated, anyway), the assistants do all of the work and the ortho just tells them what to do. I would like to say that mine "checks" their work, but he doesn't even do that. If he did, maybe less errors would be made. The treatment room is one big room with 4 chairs lined up next to each other. You can see and hear everything going on in the room and every chair is always full when I've been there (when someone gets up, a new person sits down). I was treated 25 years ago by an ortho who did his own work and saw only one patient at a time. I sure wish I could find one like that now!

klobird: I brought my concerns about the lack of communication to the office manager's attention 2 adjustments ago. She said she would talk to the ortho and put a note in my record (which I could see when I sat down in the chair) very nicely asking him to explain what he was doing and why because I was interested in the mechanical process of my treatment. At my last adjustment, he was more dismissive and uncommunicative, and I didn't think that was even possible. I do have a good relationship with my regular dentist, and if the issues were just poor communication I might bring it up to try to improve things. The issue is also one of skill and competence - of which neither has been demonstrated. I will definitely be sharing that feedback. I have already made an appointment with another ortho and hope that it works out. I've heard that sometimes "new" orthos don't like to take over a case in progress for fear of offending the "old" ortho, or inheriting their problem patients (I wouldn't doubt if every patient who leaves treatment is labeled a "problem patient").

Again, thanks to everyone for responding and for the great suggestions.

[ArchWired28]

Hi BaliGirl,

such a story, please update us on what is going on since July! I am interested myself, since I need to hold the spaces open for 2 implants. He is not holding them open now, but he's very well aware that this is the plan, since he mentions it at every appointment. He specifically told an assistant to not worry about it now and that it would be easy to open later. I do notice that both spaces have closed a little already and will probably close more. I thought, it won't be a big deal to open them later (since the spaces WERE there so my jaw is big enough, right?), but now I don't know and freak out.

[BraceFace2o1o]

Can I ask, Ive wondered this for ages, a lot of people on here say about how the assistant does all the work and the ortho just 'checks', is this normal practice where you live? In the uk that never happens, you have one-on-one ortho plus an assistant who just passes ortho stuff. And you said he talked to the person in the next chair?... are you all like in a big room together? lined up on chairs? ... or have I got this wrong?

I believe it is in the US. I am in the UK too and like yourself the Ortho does all the work and the assistant just enters things into the PC and passes him the tools etc. Also there is only one room and one patient in there at one time. I am glad it's like this though.