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.

You must feel so upset

Definitely complain. It sounds as though he didn't even try to ascertain if your DS fully understood the importance of having braces. Most kids are going to say no but when an explanation is given they will accept that's it's a good thing. The dentist sounds impatient and dismissive.
Complain to the practice and tell them that you want your DS to be referred to the local orthodontist for a consultation.

Hi
You are def not being unreasonable.
omg what is going on with healthcare. This happened to us. My 7 year old needed little surgical procedure on skin. The consultant asked her if she wanted it and she said no so they wouldn’t give me a date for op. As if a 7 year old is going to say yes!! You don’t ask a child if they want to go to bed/clean teeth! So why ask this question? They said I had to go home talk to her and call back when she is sure! By this point we missed the next months slots. I had to talk very carefully to receptionist to get them to book it. I meant to write a complaint afterwards. Still need to do this!!
Good luck!

I wouldn’t jump straight to reporting him to the GDC. I would ask the practice about their complaints procedure and start there. Your other option is to ask the dentist who referred you if they can refer somewhere else. State a breakdown in trust and communication as your reason for wanting a re referral. In Cheshire (where I work) we can’t refer direct to practice for NHS orthodontics. We have to refer online to a central referral system. From there they triage and forward to the appropriate place for orthodontics. I’ve never had to do it but there may well be a way for the referral to be transferred to a new place meaning you won’t go to the bottom of the list again. Call the practice that referred your DS and ask for help.

There is no need for a discussion in this case because braces are not medically necessary.

The patient said he didn’t want them and the dentist took the pragmatic decision not to take it any further.

Don't be a dick. If you know, then just don't.

I wouldn't let this go, my DD had her braces fitted when she was 17, she's now 18 and was very reluctant to have them.

The orthodontist said she couldn't force her, but then put the photos of her teeth on the screen. She explained again why she needed them and my DD agreed.

He needs to get them on asap as my daughter had to wait due to COVID and she hates having them on at 18!

The patient did not say he didn’t want them! He was asked if he’d LIKE them. He said no. The question was worded badly eliciting the response the patient gave.

This is awful. The dentist clearly has no knowledge of autism and/or teenagers! No one would actually like braces-what a ridiculously strange thing to ask! I have no idea what you should do- but you cannot let this go! I'd be complaining to any and all relevant people.

I don’t agree her child responded to a very leading loaded question. I think this process is being mis used to reduce workload!

The dentist is a prick. Find another dentist.

If he'd have said 'do you want braces' you'd be saying who the hell would WANT braces. It all amounts to the same thing. The child is not keen on the intervention but might go through with it for the long term benefits. Fine if this was a vaccine or something which actually benefits his health in some way. It does not, so what the orthodontist is looking for is someone completely sure and keen for braces.
To you, thinking of how long term it'd be great to have had the braces and have straight teeth, this might seem very pedantic. From the orthodontist's perspective it's introducing a completely unnecessary risk and he just won't do it if the person doesn't really really want it.

Or you could call the referral centre.
0113 493 1920
Ask your dental practice for you DS’s unique referral reference number. Call the number above and ask if they can help. I call them frequently and they’re very helpful. They’d be able to advise if you can go to a different ortho practice (if that’s what you decide to do)

I’d presume safeguarding

@Shmee1988 I'm feeling you should have sent the dentist to a dentist, with a punch on the mouth.

Even if you could stretch this to say the dentist is being cautious, he was very quick to jump to ‘no consent’. I’d expect as a minimum some questions to clarify understanding. Ie ‘do you realise this will mean you won’t have treatment and will have misaligned teeth’ or ‘I am taking your comment to mean you are not happy to proceed, is that correct?’

I don’t think you could possibly take that one line response to a singular question from a child with SEN as having fully explored their understanding of the situation and whether they were prepared to accept treatment.

I am currently involved in the care of an adult relative under section. The medical staff are fully explaining implications of procedures even though this individual lacks capacity. They are also being very persuasive in explaining why specific treatment is in their best interest. The dentist does appear to have come to a ‘non consent’ view rather quickly.

^ This

I see your point but the dentist didn’t lead the conversation as nicely as that. He bullied the parent into not being able to respond and have a proper conversation.

Bloody hell the dentist is an idiot. Definitely complain.

By OP’s description of his teeth, braces now will prevent surgery etc in the future

Was it the orthodontist who said this?
If a healthcare professional feels a child is “at risk” they have a safe guarding duty to report.
In this case, your son doesn’t sound “at risk” at all though.
You can’t really force a teenager to have orthodontic treatment. It’s an involved and long drawn out process. If oral hygiene isnt up to scratch, or the patient refuses to go to appointments ( I’ve seen this with SEN patients, I’ve seen it in patients without SEN) they can end up in a worse place than where they started with the fixed braces causing tooth decay and gum disease. He should be aware of this.
Can’t the orthodontist recall you in a month or so for a review after you’ve had chance to chat to your son? Rather than discharge you? This is what normally happens in the area I work. By that time your son may be more comfortable with the idea. The orthodontist doesn’t sound like they handled the situation well and I’d be upset too, poor you. Does potentially sound like they were maybe being a little quick to shorten their waiting list too
If you want to complain, DO NOT go straight to the GDC, that is for the most serious issues and is very heavy handed (if someone has suggested that in earlier posts).
You need to complain directly to the practice and they should address this with you. If you are still unsatisfied - you could speak to NHS England.

Where on earth have you got that from? Seriously. No.

No- the patient said “you can’t make me”, which seems quite a clear refusal of consent.

I think the dentist was right. By your own admission your kid was clear he didn't want braces and only after a lot of 'conversation' got his agreement. This could be seen ss coercive control, wearing him down to mske him agree yo your wishes.
You say he is not Gillick competent. Is he recognised as being cognitively delayed?

Yeah I guess if it happened the way op described he didn't handle the people side of it very well which isn't very nice. But I'm trying to point out how very low his threshold is for 'no' and why it is that way.
I'd imagine by asking him to come back he's hoping in a couple of years the child is a bit more mature and also motivated. The parent being enthusiastic for the braces doesn't count for much.