In this blog, Paula Buffham outlines what aspects of an orthodontic consultation are essential to allow patients to decide what teeth straightening treatment is required, and also what information she feels needs to be collected during the appointment.
It is important to remember that different clinicians will have a favoured approach to carrying out the consultation, but the below is what HAS to be done, in my experience, to get the right conversations happening with the patient and all of the information that is necessary to make a good clinical decision.
Introduction and discussion:
The first stage, for me, is really important. I need to get to know my prospective client. Essentially I want to get a feel of that person and they need to get to know me as well. After all they are considering spending a fair bit of money and are putting themselves in my hands. I want to know what they are looking to get out of their treatment and what they are prepared to go through to get that result. I also want to know their circumstances – can they only come after work/school, how flexible are they around appointments etc.
Examination:
This is crucial. The examination should be thorough and specifically related to orthodontics. The soft tissues of the mouth and the jaw joint should be examined to see if there are underlying problems. This is especially important in adults. We carry out both a full mouth charting (including periodontal health screening) and a full orthodontic assessment (looking at the jaw relationship as well as teeth).
Records:
These don’t always have to be done at the first assessment, but a scanning x-ray to check the health of the teeth and jaws, as well as to look for any anomalies, is essential when going forwards with treatment. Photographs are extremely helpful in diagnosis and help show patients the issues with their teeth and jaw relationship. Lastly a cast of the teeth is required to record the pre-treatment position of the teeth and is helpful when the clinician is considering the need for tooth extractions. We routinely take x-rays and photos at the first visit.
Treatment plan and discussion:
Once all of the information is collated, the orthodontist can plan the treatment with the patient. It’s important to take into account what they have told the clinician in the initial discussions. Where possible, the orthodontist needs to meet the potential patient’s requirements, and give advice or explanations when they can’t. It’s best not to present too many options, but bad to only offer one. After all, the whole purpose of the consultation is patient choice and making them involved in the decision making process. We will often offer an “ideal” treatment and an alternative “compromise” treatment and explain the pros and cons of each.
Follow up:
Not everyone is confident in making a decision to go ahead straight away, so it’s good to have one of the team call them a few days later, after they have had time to mull things over. This allows any concerns or questions the patient may not have thought of on the day to be answered. We routinely give every client a follow-up call to provide more information if needed.
So as you can see the process is quite involved. We allow a minimum of 50 minutes for a new patient consultation as we have found that this gives the time to follow the processes above. If you have had a consultation before, I would be really interested in your experiences and what effect that had on making your treatment decision. If you are looking for a consultation, I would ask the practice what it involves and compare it to my outline above and see if you are getting value for your money!