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. Contact the practice manager and say your son’s additional needs were not taken into account during this appointment.

Theres not a single person alive who “wants” braces! Everyone would rather not need them, but they're a means to an end! The dentist is a first class twit…

Its a standard question in my experience.

Get back onto the practise, and ask to speak to the practise manager. Explain of course dc doesnt like to have braces when the orthodontist asked however he failed to let dc explain that knows he needs them to have healthy teeth.

Not at all.
It was a conversation between the OP and her son that took place in the waiting room

Today 19.17

A previous poster asked - "You must have been sitting in the surgery with your son, couldn't you have talked to him when he said he didn't want the braces?"

The OP replied " Yes, I tried and he interrupted me and told me that I couldn't force him. I wasn't trying to force him, I was reminding him of the conversations wed have and why it is important."

My view, and precis of the situation

Dentist asked son, known to be neurodiverse, if he would like braces.

(FFS no-one LIKES having braces)

Son gave a textbook ND response, answering the question as asked.

You explained this to dentist.

Dentist refused to listen, and refused to make ANY disability accommodations.

It is this last, bolded, statement which gives you clear grounds for a complaint against this dentist. I bet the bastard asked the question this way deliberately.

Unleash the hounds of hell on him!

Yup, massive conflict of interest. I would be so angry about this treatment OP. Make a massive massive fuss. Rubbish behaviour from the dentist.

Use some context cues and realise the first “he” is the dentist

It's not. The Orthodontist has a contract with a set amount of funding from the NHS. They will do a set amount of work and get paid a set amount by the NHS. there's no benefit to chosing one patient or another within that quota. No Orthodontist needs to create extra private work for 5 yrs down the line

A PP said that it sounds as if your son really needs them, and I agree. I hope you can find some way to sort this out! The length of waiting time on the NHS is crazy. If this dentist isn't comfortable going ahead after hearing the no, could he send you to someone else? And then maybe you wouldn't lose your place in the queue. Another idea - maybe your son could write a letter to the dentist giving his consent and explaining that he took the dentist literally. That he doesn't want braces in the sense that no one does, but wants to have better teeth, and he consents to the treatment and would like it. Maybe the dentist would feel better if he has written consent from your son.

I wondered this...

No dentist is going to risk being reported to the GDC for not obtaining informed consent.
Don't forget there is a DSA (Dental Surgery Assistant) in the same room who will be noting all this down, keeping records and making sure correct procedures were followed. They also act as chaperones.

This!! Im so angry for you.... barstard!

Good. There will be an accurate record of the dentist being an absolute arsewipe then

What part of the country are you in OP? I work in this field and I am shocked that the ortho said this to you! Could you get your GDP to refer you to a different practice or your nearest dental hospital/community care which has an ortho department?

Because a medically necessary jab is completely different to braces. Braces require long term engagement from the child. You are altering that child's appearance. No child should be undergoing that unless they want to.

OP needs to prove that her child wants braces. I agree that she should contact the practice manager, but I wouldnt advise going down the route of he's not gillick competent or comparing it to something like jab

Although your son has crowded teeth, him getting braces is completely optional. Having crowded teeth is not a functional problem, only an aesthetic one. And getting braces increases the risk of decay because there are many more nooks and crannies for plaque to collect.
For this reason, the child needs to be absolutely on board with getting braces because otherwise they will lack the motivation to keep their teeth clean which is quite tricky with braces.

If your child lacks capacity to consent then he probably lacks capacity to keep his teeth clean with braces.
If your child has capacity but is not keen on the braces then he probably lacks the motivation to keep his teeth clean.
If you pressure your child regardless to get the braces he will (again) lack the motivation to keep his teeth clean.

He will then be left with tooth decay for having gone through with what is a completely optional and purely aesthetic treatment.

These are your orthodontist's concerns. Complaining about him is ridiculous: he is withholding an optional treatment which the patient does not expressly want, because it carries an actual risk.
I'm sorry but it sounds like your son is not ready for braces yet.

Not at all, all the "hes" refer to the son.

Well he clearly didn’t as the mother explained and the child with SEN has walked out without braces.

Will be interesting to see how any assistant can put a spin on the mother explaining her son’s SEN and ND. 2 members of staff ignorant as to the needs of ND patients.

Op complain ASAP.

Not life, a year or so, which the mother would have helped out with - if she hadn't been stopped in her ways...

As is so often the case here, the first post has nailed it.

Life is correct. Retainers must be worn for life or the crowding will come back. An unmotivated child is not suited for braces.

Not at all.

There will be a record of what happened and this would be produced if the OP were to take it further. The GDC would then decide if there was a case to answer.

Oh don’t be ridiculous. The son did not expressly not want them as the op explained. My autistic daughter said similar. We all laughed and I explained her meaning. Our orthodontist was better trained as regards ND and listened .

All my children are ND and all had braces. They are entitled to them as much as NT children even though they need more support and time at home and at the dentist as regards going through care etc. None of my dc “wanted” braces, they say it as it is, but knew they needed to have them. Not one has a single cavity.

I am a dentist in the uk (not an orthodontist however we are an orthodontic practice so have them working closely with us).

Firstly, I’m not sure what he was saying with regards to reporting you. A social services report wouldn't go very far in this case! If he was saying he would report you to the PM, perhaps he felt like you were being aggressive. I’m not saying you were but often patients (or family members) frustration, can come across as aggression, and every practice I know has a no tolerance policy when it comes to this.

I do know that it is policy for an orthodontist to ask every patient if they want braces and for a patient to decline, is an automatic no. I understand in your case there are other things to consider which is perhaps why he’s saying come back later, rather than just rejecting the referral. Braces cost the NHS approx £3000 which is why this rule is now in place. It’s a relatively new thing.

With regards to gillick competency, I agree that he your son most likely isn’t. However we still cannot force teens into doing treatment they don’t want. I appreciate, however, you saying it’s perhaps the language the orthodontist used. And in this case, I agree he could have changed his language or approach. I have seen many SEN patients and always take into account their literal thinking.

On the other side of the argument, for someone with SEN, braces can be really difficult. They’re painful, they irritate the mouth and tongue, they’re different and new, and many can’t tolerate them.

I don’t agree with how your interaction went, he should not be saying he will report you for being a concerned mother. And as I mentioned already, it would not go anywhere if he tried. So please be reassured in that respect. I just wanted to put across the perspective as a dental professional. Please feel free to DM me should you have any further questions