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.

This. my teen who is much older at 17 is currently in the process of getting braces fitted on the NHS after a long 5 year wait. She still says she doesn't wants braces but is willingly going ahead because she knows she needs them and wants lovely straight teeth. like you say nobody really wants to have the hassle of braces in their mouth. Im another that also thought maybe its a way he can reduce his NHS patient list.

@Shmee1988 He really was ready to have them but the dentist didn't give either of us the chance to properly explain.

But he wasn't was he? You said "he interrupted me and told me that I couldn't force him."

That sounds like a "no" to me.

There's a weird irony here in someone asking a figurative question and then being bizarrely literal-minded in their insistence that the response must be figurative, and being unable to accept that it was a literal one...

My son has additional needs, quite similar to yours I suspect. When my dentist referred him, he had to wait quite a long time but that was because they referred him to an orthodontist who specialises in children with SEN. I'm not sure on the protocol to get referred, but that is what you should request. Sadly it means you will have to wait a while, but you shouldn't get these issues next time. He had a lot of extra appointments to go through what would happen, extra help to ensure good hygiene, etc. You've been treated very badly so I'd consider finding another dentist, if that's possible in your area, to request that. Very best of luck.

Wrong! It was the dentist who interrupted and said that - not the son 🙄

Do you mean the dentist is not following the correct consent protocol?

Our dentist was great. When I phoned to cancel and said I didn't think my daughter would cope with braces, she has DS, they said to bring her in anyway and they'd explain everything to her with my help and we'd go from there. She's had braces now for 4 months and has coped really well. I really should not have underestimated her.

I would argue that child with ADHD and ASD probably isn’t gillick competant.

Yes .Exactly that .My reply was far too brief

If my kids had their way they wouldn’t have brushed their teeth for 18 years!

Complain to the practice manager.

It’s the GDC. General Dental Council

I can see exactly what you're saying OP and agree with you

I’m afraid this is utter bollocks.

the dentist knew of the additional needs. He asked if the son WOULD LIKE braces. I was recently offered surgery and I was asked if I “would like it”. I answered “probably not, but if it’s medically necessary I’ll go ahead”. But I’m not ND and not a child.

the dentist should have realised that OP’s son hasn’t got capacity to make that decision and asked OP, as his parent.

It's in the dentist's financial interest to postpone fitting braces until your ds doesn't qualify for them on the NHS.

If the dentist wants ok to assume gillick competency or even assume a child does not have this he should have the skills to conduct a simple mental capacity assessment and see if your son knows the risks around each decision. He should not be basing his decision on one answer, like you say if someone says would you like to have this that an the other done, my answer would be no reframe the question my answer would be very different.

It's not the same question though

If a child doesn't want braces, isn't engaged in their treatment, motivated to maintain their braces and wear a retainer for life they shouldn't have braces. A child cajoled into braces by their parents is not a suitable patient.

Braces are slightly different to a medical or surgical procedure that is necessary. Braces are never completely medically necessary, they will need longterm engagement with the treatment from the child.

The Orthodontist probably should have asked follow up questions. But it's not just about the child withdrawing consent, it's assessing a child's motivation to undergo a long often uncomfortable treatment, that requires additional daily effort and maintenance for life

Can you explain how he did not follow protocol

but the question wasn’t about that. It was about whether he would LIKE them.

Report them to the general dental council they should open an investigation if you Google GDC it will come up x

Your dentist is mental and wrong.
Children with autism need their parents to speak up for them.
I'd be firing off emails left right and centre about this. Hope you get it sorted quickly.

Personally, I'd contact the practice manager, explain that there was a misunderstanding, and that you really would like a meeting to discuss.

Purely from a practical stance, yes the orthodontist was wrong, but at the same time, getting an orthodontist on the NHS is really difficult.

Maybe use the analogy of inoculations where teenagers are definitely not asked if they want the injection - just whether they consent.

Please put in a formal complaint to PALS. NHS expect clinicians to complete and apply Oliver McGowan training. This dentist is ignoring the principals of this training.

NHS Oliver McGowan Training

Can you get a referral to a special dentist. In my area there is a special clinic with dentists who can communicate better and had more training.

He is welcome to refer you. I had a dentist refer me to safeguarding once and I got a call and they put us in touch with the special needs dentist so it worked out fine.

Gosh, things have changed since I was a child 40-odd years ago. Back then, if you needed braces, you got them. Not much say in the matter! Your parents made you do it. There was no question of the child having to give their consent. The only way of getting out of it would be to scream the surgery down! 🤣

I think the dentist was probably covering himself. Maybe he'd heard some horror stories or had previously experienced issues.

I think its good the dentist was considering your son's opinion.However it would have been better if after he said 'no' this was explored with him by the dentist as to why, chat about the procedure to check he is sure etc, rather than just being so black and white about it, as it does sound like your son really needs them!