Dentist said he'd report me

[Shmee1988]

So, my son is 13, he has adhd and suspected autism (awaiting assessment). Unfortunately his adult teeth have not grown straight at all. Some are almost twisted in his mouth and some have erupted on top of others. He was referred to an orthodontist 3 years ago. The wait list for NHS treatment is loooong and he finally had his first appointment yesterday. He is not thrilled at the prospect of braces but after alot of discussion he has realised its important and ideal to get it all done whilst hes still at school when some of his peers will also have them. The orthodontist did all of the Xrays and said he needs braces and qualifies for this on the NHS. He then turned to my son and said 'would you like braces?' to which my DS replied 'no'. The orthodontist then said he woukd need to see us again in 2 years time as my DS doesn't want braces so he wont fit them. I asked to have a private word with him and explained that part of DS sen is that he is very literal and that when he asked him if he would LIKE braces, he answered the question literally as if he was being asked if he would like to have to have braces and that he was not refusing treatment. He didn't care and told me that I need to start the referral process all over again and that it would be almost 5 years before he can get them fitted on the NHS due to the wait time. I asked him if I could have another word with DS so that son could explain he wasnt saying he wouldn't have them and he said no. He then went on to say that if I bought my son back and he still said he wouldn't like braces, he will report me. I thanked him for his time and left but I was so upset. Ds was upset and now that upset had turned to anger. Is he suggesting that advocating for a child to receive necessary treatment is akin to abuse if the child is anxious about it? Aren't all kids anxious about braces? I want to take this further and complain. Especially as my son will be almost an adult by the time his next appointment comes around. Opinions please? Thanks in advance.

Haven’t rtft but if he’s got SEN could he be referred to community dentistry?

I have not read all the response but I suspect the answer is not clear cut. Neurodiversity alone is a reason to assume a person doesn't have capacity. However, there probably should be a process to clarify if sone is able to make a decision. I think would be unreasonable for dentist to take your word for unless it was very evident that you child has specific needs.

i had a similar experience when I took my daughter for her referral. After her first appointment the receptionist called to make the next appointment but asked if we even wanted it because the dentist didn’t “feel like she wanted it” at this point he hadn’t explained what she would need at all, so she was obviously nervous after friends telling her horror stories. At the next appointment he just went “do you want a brace?” Again without explaining at all what it would involve for her, what her options would be etc, so she said no not really & he went try again in 2 years. I was fuming, no teenager really wants a brace but most will understand the difference between wanting and needing it. Luckily we were able to wait a year and started the private route & when I explained our experience with the nhs orthodontist to our new one she said it sadly wasn’t the first time she’d heard a similar story about him. It felt like he didn’t want to do the nhs work & jumped on the chance to get her off his list

That dentist sounds like an absolute eejit . Not listening to you when u are explaining that ur son has this diagnosis & has additional support needs is an abuse of his position . You need to make a complaint & report him . Telling u that ur son would have to wait 5 years for treatment ??? Sounds like he was enjoying that power that he had over u . Horrible man

That.

I would push and literally ask for the appt back as your son has additional needs and that it wasn’t taken into consideration. Do make it clear that you will complain for being dismissed as his primary carer. Use about everything that you can to jump the queue and get back what you should. I am sure they can fit you in in between as it was their mistake.

Of course a 13years old can’t be forced to have braces. Your son will have to state that he doesn’t like it but will have them as he needs them.

It is not the dentist’s job to fit braces on a patient who doesn’t want them.

In fact, he would be in danger of losing his licence to practise if he did so.

I work in Orthodontics. It seems he is implying that you are trying to coerce ypur son. I work in a hospital setting, and we see the more complex of cases. We do ask our patients young and old what they think about wearing braces. This gives an indication of the compliance level. The respinses can often vary widely from a definate no way, no response, a shrug of shoulders or a don't mind.
Occassionaly the odd would LIKE to have braces. With neurodiverse patients its often a negative response to braces due sensory or orher difficulties and can often involve a lot of acclimatisation. As rhe aunty of autistic/adhd children. I totally get the litrral thing. The way it was phrased to your son would have been interpreted as a "like" and not a "want" or need. So yes, if erre you. I would complain about him.

Wow! What a twat! @Shmee1988 my son is also 13 with adhd and autism spectrum. He had his braces fitted last week. He told the dentist he doesn't want them but agreed to having them. What an absolute idiot. Kick up a fuss! He needs them in before he reached adulthood.

I have no advice beyond what's already been posted but just wanted to sympathise..
Yesterday in a meeting with a HCP my autistic DC was asked "would you want xxx"
The answer was no because "want" was not correct. DC understood the reasons behind xxx but did not "want" that

I'd see if you can get a referral to community dental services/ special needs dentistry to see if they can work with him better / can refer him to a better dentist for braces.

It's unclear if he's going to cope with the implications of having braces (no hard sweets, permanent retainer afterwards, very frequent appointments, the dentist fiddling in his mouth, toothbrushing requirements, his mouth hurting after the braces have been adjusted etc).

Even if he isn't in law capable of withholding consent to the treatment, this isn't something where treating him against his wishes is reasonable if the issue is simply that he has wonky teeth / an overbite/ overjet etc.

You could do with advice from your usual dentist about whether the issue is cosmetic or one that poses risks to him - not where he falls on the IOTN but what the actual risks are of him not having fixed straighter teeth. If there's some sort of bigger problem then you have a better arguement for referral and treatment.

He just couldn't be arsed with the work. I bet if you paid him private price, he wouldnt be turning you away with such haste.

It not the dentist's job to make assumptions based on their own unclear language and refuse necessary treatment either but it doesn't seem to be stopping them.

It does feel a lot like ‘well this will cut the waiting list down a bit’ doesn’t it?

Surely most teenagers if asked if they’d like braces would say no! But that isn’t what informed consent is! Informed consent is discussing the pros and cons and allowing a young person to take time to consider their decision. Not saying ‘well you’ve said no once so you’re off the list’ ffs!

If a patient isn’t super keen and motivated braces can be a total disaster - I’ve seen cases where the patient hasn’t been motivated with cleaning and ends up stopping half way with holes in every tooth!

the orthodontist has been super sensible!

Hi @Shmee1988 was this a high street dentist with an NHS contract or an NHS only CDS community dental service dentist? That is referral only. Sounds with his needs that your son should be with CDS for this care, it also sounds like your DS dentist is trying to bounce him. You can and should complain with the GDC, that dentist has NOT shown he’s aware of the Oliver McGowan training as a minimum and has breached the standards required of him. You should also complain and ask for a different dentist if competent of the practice partner owners, and you should absolutely complain to your ICB and NHSE commissioners who manage this contract. Other dentists would be happy to be paid to deliver this care, sounds like their contract should be revoked to me. Your MP may also be interested

Your son would pass the gillick competency tests as having adhd and autism doesn’t stop him from knowing his own mind and being able to make informed decisions. I work in a dental surgery and can tell you the dentist is following the rules. You can ask to be referred to a different practice

I could very easily be you in a few years with Autistic DS...

Is there any mileage in, maybe with GP support (that's probably insane but there might be someone helpful) helping your DS to write to the dentist/practice manager?

If he said words to the effect, "I am autistic and I don't want to be denied treatment due to my communication differences. I want to have this treatment but you asked me if I would like it not if I wanted to have it. Liking something means .... to me so I said no but I do want to have the treatment. "

Just thinking perhaps there's a slightly more ameliorative way to approach the situation

Obviously ignore me completely if this isn't helpful. Good luck (from the midst of an EHCP nightmare)🍀

That sounds like an a**hole of a dentist and totally unreasonable on his part. I would certainly be complaining about his lack of professionalism and understanding around your son. He has nothing to report you for unless you were aggressive or rude ( which it doesn't sound like you were!) .

If OP want to make a disability discrimination claim, she’ll need to show DS's impairment meets the Equality Act’s definition of disability.

However, she wants to go down that route, that's her choice

That is rediculous, he asked the wrong question. Nobody “wants” to have braces. Don’t be scared about being reported - let him report you. But you should take this further as it will be too late in 5 years. I think you have been unlucky with this dentist, obviously he needs to get consent but he hasn’t asked in the right way and a different dentist would probably deal with the situation in a different way.

I get that. But he needs them. Would he 'like' them? Of course not, why would anyone. They would rather just have been born with straight teeth.

For dentist to threaten OP in this manner is bang out of order.

Shocked!! I'm so sorry that you are going through this,it's ridiculous!!! You have to politely take it further,I'm sure online will have the chain of people to contact...after you explaining, he should have took a few minutes to chat with your son. My daughter had braces five years ago,she was never asked.And even if it's now protocol, there has to be some common sense around surely. You explained, another chat should have took place if he didn't want to take your word for it...there surely must be some protocol to for patients with extra needs...my son has autism, luckily his current dentist is good with him,and explains everything she's going to do...Please do search for where to talk about the situation to take it further. Good luck

Do you have any experience of neurodiversity? Because you don't sound like you do.

Some people take questions very very literally. They literally don't understand what you mean if you don't phrase it exactly right. That means, in this circumstance, that the son was not able to consent/withhold consent.

The dentist has discriminated against him because of his disability - he knew about the boy's needs but failed to make reasonable adjustments. I suspect the dentist thought the boy would be 'difficult' because of his communication needs and just didn't want the hassle. It is appalling.

The dentist has discriminated against him because of his disability - he knew about the boy's needs but failed to make reasonable adjustments. I suspect the dentist thought the boy would be 'difficult' because of his communication needs and just didn't want the hassle. It is appalling.

Then the OP needs to stop posting here and raise a concern about this. Time is of the essence.

I understand your frustration but braces and asd can be a horrendous combination.
One of my sons got them and quite frankly he thought he was being tortured. It was a distressing experience for all involved.

My other son needs them but i am waiting until he really wants them and really understands that it is painful from time to time and uuncomfortable most of the time and that he needs to be rigorous in his oral hygiene.
13 yo with asd may be too young.