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.

Can you ask to be referred to a dentist who specialises in children with SEN? It might be a long journey but probably quicker than another five year wait!

Gillick Competency relies on the child being able to FULLY understand the questions and scenario that is being out to them. If the OP is correct, that sounds unlikely to be the case with her son, hence her advocating for him is correct.

You can report him to the practice manager. There is a mediation service, the dental complaints service (DCS) for formal complaints, or if you want to take it further you can complain to the General Dental Council (GDC), who regulate dentists.

While the whole appt sounds awful, if there is an indication your son will not engage with the treatment - retainer, bands, taking photos, they will stop treating him. They need to make sure the teenagers are willing and able to care for the braces themselves.

This is absolutely understandable and if DS had said he wont have them etc etc then I would most likely have decided hes not ready and possibly looked into waiting another couple of years, saving up and going private (not ideal but id never force him). He really was ready to have them but the dentist didn't give either of us the chance to properly explain.

This is absolutely outrageous.
The only answer from a 13 year old on if they would "like braces?" is no, who the hell would relish the idea.
Had he asked would he agree/consent to having braces fitted to correct his teeth I'm sure he would have said yes.

My son didn’t start betting braces until he was 16 it’s not a big deal if he has to have them later. Lots of responsibility when they have the retainer so better to wait tbh.

You need to complain to the practice manager and ask how to take this further. The solution should be education for the dentist who misunderstands the situation and your son of course needs to be seen again immediately, not to have to wait again

Ask to be referred to the Community Dentist service. It's a specialist NHS service. They may be a better option than a regular dentist.

And the dentist assessed the OP's son's Gillick competency how exactly?

Retired Dentist here . He isn’t

My dentist reported us to social services once.... took my daughter in with a bad tooth, they said it needs to come out as a matter of urgency we will send you an appointment.... 18 months later I miss the appointment as they sent the letter for it with 3 days notice and we were away on holiday for a fortnight so didn't get the letter or get to the appointment. No calls, no texts, just a letter from social services asking me to call them as they had had a referral for neglect. I was spitting feathers as you can imagine. Social services spent 30 seconds on the phone and told me they had no concerns and they wouldn't be following up the complaint!

Was he using the refusal as a way to reduce his list? The rates paid for NHS dentistry are shockingly low.

He isnt what sorry?

Surely there are barely any children who are enthusiastic about having braces, or who actively don’t want them but need them medically. What child or adult really wants to have any dental work done? I’d definitely complain, it sounds like this guy is trying to shorten his own waiting list if he’s asking everyone whether they’d like to have invasive work done

Well, funny you say that because someone my DP works with used to work with him as a dental nurse and hes evidently known for it. He's made alot of money from private treatments and isnt a fan of the NHS stuff. She ended up refusing to work with him and moved to a different surgery. This is hearsay though so I have no real way if verifying this info.

I think that 'he isn't' is in reply to the suggestion that your dentist is following the correct consent protocol, @Shmee1988.

You need to go to pediatric hospital dentistry , they are usually trained and have seen it all, especially kids with SEN

Yes, I think youre right

"He also was not refusing treatment he was expressing his dislike at the idea of having braces. He was fully prepared to have them."

The dentist isn't a mind reader. He asked your son if he wanted braces and the answer was "No".

The rule is that the practitioner has to have "informed consent" Had he gone ahead and fitted them when your son had said "No" it could be grounds for a claim of assault.

The dentist was erring on the side of caution.

When my DS left the room, I said that exact same thing to him and he told me that I was 100% wrong and he very often has teenagers in his office very upset because they've been told they dont need or dont qualify for braces because braces are 'cool now'. I was a doubtful about this but couldn't really tell him thats bs

The rule is also that the healthcare professional seeking informed consent also has to adjust their communication style to suit the patient's needs, not expect the patient to adjust to theirs.

Only if you fail to explore what the child is responding too. If someone said to me would you like surgery I’d say no. If they said you need this treatment to get better, not to have x issues, does that sound like a good idea? I’d say yes. Children have capacity of course but they also need good communication as do all patients. The question asked was a closed not open question as the child’s mother, his advocate, OP tried to share

All health professionals including dentists have to complete mandatory Oliver McGowan training. Oliver was a young autistic man who died because of a lack of understanding about SEND and autism among the health care professionals treating him. The dentist asked the wrong question and got a literal answer. The dentist did not facilitate an informed choice. Most people do not want braces but understand they need them. Ask the practice if the dentist has completed their training and inform the CQC if they haven’t (as well as complaining).

He didn't ask my DS if he wanted braces. He asked him if he would like braces. The word 'like' to a child who interprets everything literally and at face value is very different to 'will you have braces' or 'woukd you allow me to fit braces' etc. I explained all of this to him whilst ds was out of the room in the hope that the dentist would bring him back in an rephrase the question. He didn't.