British Orthodontic Society Holds Its Most Successful Conference Yet, As Press Conference Reveals The GDC Hasn’t Engaged With Direct-To-Consumer Orthodontics Since 2021
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- Published: Friday, 23 September 2022 09:18
- Written by Chris Tapper
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The British Orthodontic Society attracted its largest number of participants yet to the annual British Orthodontic Conference (BOC), at Birmingham’s International Conference Centre.
An estimated 1500 orthodontists and dental professionals attended the three-day conference, with more than 100 participating online.
BOS president Dr Nikki Atack is in her first year of office.
Dr Atack told a press conference on Friday, “In the expanding digital world of medical and dental care, I hope that the Society will continue to educate and promote high quality dental care.”
“So, across this ever changing landscape with the collaborations and links formed when producing the Society’s advice on the use of tele-dentistry and the remote interactions that of orthodontic care.”
“This is one way we’ve demonstrated our leadership and the drive to educate and inform. As a Society we’ve opted to continue with the hybrid conference started so successfully last year, enabling the opportunity for the widest possible participation.”
At the BOC conference in 2021, the British Orthodontic Society and the Oral Health Foundation announced the launch of their joint initiative Safe Smiles, to highlight the benefits of safe dentistry and treatment when carried out in dental practices by trained and registered professionals.
The campaign was launched in response to the mounting concerns at the rapid growth of direct-to-consumer (DTC) orthodontics in the UK.
Many dental professionals have expressed alarm that consumers have been prescribed treatment without having been directly examined by a dentist or orthodontist before being prescribed a course of treatment.
A particular worry is that often, no periodontal examination is carried out, or checks performed on mobility. Alarm has also been raised since many patients are prescribed treatment before knowing who their treating clinician is.
GDPUK asked the BOS press conference panel if there had been any progress in its discussions with the General Dental Council about the perceived problems with DTC orthodontics.
In 2021, the GDC made a statement on its website, stating “In line with current authoritative clinical guidance, and orthodontic training, clinical judgements about the suitability of a proposed course of orthodontic treatment must be based on a full assessment of the patient’s oral health. At present, there is no effective substitute for a physical, clinical examination as the foundation for that assessment.”
“Should a dentist rely upon information from another source, for example information from another dental professional about a clinical examination they have conducted, to inform their own clinical judgement, the responsibility for that judgement rests wholly with the prescribing dentist. As in all cases, the treating dentist must make and keep a full patient record, including the reasons for any decision to deviate from established practice and guidance.”
At the time of its release, the GDC’s statement received derision online from dental professionals. Many felt that the GDC didn’t go anywhere near far enough. In particular, the GDC was criticised for failing to commit to taking action on companies who provide such treatment often with no direct initial examination being carried out on clients by the supervising clinician.
BOS Director of External Relations Dr Anjli Patel told GDPUK that apart from the press release from the GDC last year “We’ve heard no more.”
Dr Patel said that BOS had engaged with the Care Quality Commission, “It was mainly about teledentistry, but we also addressed the fact that there were risks of having direct consumer treatment.”
Dr Patel added “We wanted them to help us with our education campaign but for them as regulators to be able to monitor the practices that are being carried out. We haven’t heard any more.”
Dr Atack told GDPUK “There’s been no more engagement since that meeting.”
“Fortunately, we have a team that that produced a document on teledentistry - just to show what’s safe and what’s not. We want to educate our patients and the public on making the right choices and that’s our role in the British Orthodontic Society.
“And that’s where the Safe Smile campaign comes in with the Oral Health Foundation”
Dr Atack said that a meeting will be held later in September where the BOS will be joining different stakeholders in order to explore how the public can be educated in order to make the right choices.
Reduction In GDPs Carrying Out NHS Treatment And Its Effects On Orthodontics
Although it was felt that orthodontists working in the NHS are generally managing to hit their Units of Orthodontic Activity (UOAs), orthodontists are experiencing practical difficulties as a result of problems in general practice.
BOS Director of Professional Development Dr Trevor Hodge said that orthodontists had been fortunate not to be affected in quite the same way as GDPs.
Dr Hodge said that orthodontic practice had been able to recover more quickly than general practice because the branch of the profession “Doesn’t do much in the way of aerosol procedures so we were able to resume treatments and cover a full range of treatments much quicker, post-pandemic.”
“There are other issues surrounding around commissioning of contracts, that has disrupted dental care, but where people have contracts and there’s a stable service, I think the delivery of UOAs hasn’t been achieved in orthodontics.”
“The case is different in general dentistry, and I think where it affects us as orthodontists is when our general dental colleagues are no longer taking NHS patients on.”
“We have difficulty then delivering treatments when people can’t get extractions and routine dental care during treatments. That’s the biggest problem.”
But orthodontic consultant Dr Patel said there were variations in delivery.
“The releases of how much we were supposed to achieve in each quarter were quite late in the day.”
“In orthodontics, we were booked up for twelve weeks ahead. If you’ve got to plan for the next twelve weeks and they told you two days before we start, it’s very difficult to deliver that activity in a timely manner.”
“The other thing that’s slightly different (to general practice) is that the demand for orthodontics has gone through the roof and the Units of Orthodontic Activity haven’t, so people are having to wait longer. There’s not normally any harm in waiting, but it does mean that people have to accept they’re having to wait longer if they wish to have that treatment on the image.”
When GDPUK asked if there had been a move in orthodontics towards totally private practice, as general dental practice has experienced over the past couple of years, Dr Hodge said
“I think there’s definitely been an increase in the amount of private work that has been done and the demand for it, but I don’t think that’s been at the expense of NHS delivery.
Dr Hodge added “I think it’s quite bold, particularly at the time of a cost of living crisis, to go from children not paying for treatment under 18 to paying thousands of pounds for treatment.
“Whereas in general dentistry, the gap between what you paid as an over-18 adult for bands one, two and three and what you might pay privately, the differential is perhaps not so great. That’s made it easier perhaps to convert NHS to private dentistry.”
Also present at the BOC press conference was former physician Dr Michael Mosley, who is now well-known as a TV science presenter and journalist.
Dr Moseley said that his family all owed their ‘great smiles’ to orthodontics.
The presenter, who admitted he knew “Almost nothing about orthodontics,” later delivered a talk in the ICC’s main conference hall in which he gave tips on everyday ways attendees could boost their mood.
Dr Moseley told the audience “All my family has benefited from orthodontic treatment so I was delighted to speak at the British Orthodontic Society Conference this year. A big smile that can light up the room will not only make you feel good but other people as well.” Dr Michael Mosley speaking at The British Orthodontic Conference.
He highlighted research in The Journal of Experimental Psychology that revealed how even a fake smile can have a positive impact on mood by triggering certain facial muscles that ‘trick’ your brain into thinking you’re happy.
A spokesperson for the the British Orthodontic Society said "Never before has there been such a strong desire for a smile that not only feels healthy but looks good as well. Statistics from The British Orthodontic Society show that the demand for orthodontics continues to rise with 75% of orthodontists reporting an increase in patients."
Orthodontists generally hold dental degrees (BDS/DDS) so will have been taught how to extract teeth, and will have done a reasonable number at Uni or in the early years post-graduation. Most requests are for premolars, with incomplete roots - not exactly minor oral surgery territory!
Perhaps it's time they buy some luxators & forceps, go on a refresher course, and just do the extractions themselves!
Failing to 'Protect the Public' when it matters.
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