What does Doc do?

[JillD]

When I go in for adjustment, my doctor always looks at my teeth and tells the assistant what to do and moves on to the next patient. And she doesn't check if the assistant did everything right.

Yesterday when I went in for adjustment, she did the usual thing. But it seemed that the assistant didn't quite know how to do what she asked her to do. When the assistant was ready to do the work, I told her that I would prefer that the doctor do it. The doctor did the part the assistant didn't have experiences with and told her to change the wire (which is easy for the assistant) and let her know when she was done so that she could do the rest. When the assistant finished, the doctor was putting brackets on another patient's teeth. I assume that the doctor couldn't stop because of the glue. So the assistant asked me if I would mind if another assistant does the last part because she has a lot more experiences than she does and the doctor wasn't available at the moment. So I said yes. I guess everything was done properly and I left the office. But back on my mind I thought it would have been nice at least the doctor had checked if everything was done properly.

No patients at the office seem to have any issues about the fact that the doctors don't check them after the assistants were finished. And I don't want to be a difficult patient. While I was shopping for an ortho, this office seemed to be most thorough. That was why I chose them. Also I get feeling that my doctor knows what she is doing. In general I am happy. But I wish my doctor at least checked me before I leave.

[nikkibabie19]

This happens to me too....

But the assistance at my office seems pretty capable they. And I have actually had the doctor more times than the assistant so im not too worried.......

But ur right, the docotr should check afterwards just to ensure everything was done correctly.

[BetsyBug]

At my orthos office, the assistant will take off all the ligs and leave the wires in, will call the ortho over to check everything out. At this point if something needs to be changed, then he will tell her what to do. If there is any question however when she is carrying out his orders she always calls him over. I don't know how your orthos office is set up but mine has about 7 chairs, all in the same long room they face a long window with flowerbeds and trees...(kinda peaceful) each chair has an assistant and the ortho rotates between them (sometimes there will be two orthos working at once) It always seem efficent. I have had to wait for 10 min or so for an ortho once or twice but usually there isn't much waiting. there was a couple of times that the assistant couldn't get a wire tie on or something similar and she said she would just let the ortho do it and would call him over.

[nikkibabie19]

My office is like that as well.

Except its about seven chairs arranged in an "L" shape around the room.

The practice I go two is 2 brothers and a father. I think the father retired so its just the two brothers.

But there is about 4 assistants and 2 orthos.
Its quite efficient.

The assistant takes off the ligs ask me which new color I want. Then puts it out 4 the ortho.
He comes out and check the progress. If the assistant is wid another client the ortho will put on the new wire n ligs. Usually he does. But if he's needed elsewhere he'll leave instructions wid the assistant. This only happen once to me. Usually my ortho handles the wire change and stuff. He has some weird iigs configurations ℓσℓ


But while putting on the ligs the assistant was repeating to the ortho the configurations and he assured her so um confident she got it right.

[vincent168]

Orthos in the US seem a lot more productive/allowed to be. Here in Australia the ortho does all the work. I am not sure how I would feel it the assistant did most the work. I don't think the orthos are allowed to do that here nor are they that booked either

[jem]

I am in the UK. My ortho has a separate room for patients and is involved throughout each appointment doing all the work herself. She works as a team with her nurse, but the nurse is very much in a secondary role,for example holding the light to cure bracket adhesive,getting out the size wire the ortho requests, cutting a powerchain to the required number of cells. I very much appreciate both the privacy and the individual attention I receive. My ortho seem to give me plenty of time to carry out my treatment and answer my questions and I am surprised after each appointment to note that it has in fact lasted ten minutes at most( apart from when my brace was first fitted, and even that took only fifteen minutes plus time with the nurse for advice re hygiene) .

From arriving very early for appointments on occasion, I have noted the large number of patients my ortho must see per day and how hard she must work. Even with the number of staff she employs and the high cost of running the practice, I reckon from the level of fees she must make a pretty decent income ( which she fully deserves). It would be interesting to know how much the NHS pays her per treatment compared with what she charges her private clients.

So how much money must US orthodontists make running their practices on the lines described above? I think if I were in the US, I would encourage my son or daughter to train to be an orthodontist.

Jem

[Ashybear]

I'm in Australia, and the assistant generally does most of the work. However, my teeth apparently require a lot of "fiddling around with" so at my last adjustment, the ortho came in and did a lot of it. Normally, my ortho just looks at my teeth and tells the assistant what to do.

I think I'd prefer if the actual ortho did most of the work though..

[smilehope]

Ortho does all my work. As with Jem, the assistant is just that - she passes stuff to the ortho, does the UV light trick, etc. Maybe that's more common in the UK. I like having the privacy to ask my daft questions - I think I'd feel inhibited if there was a row of other people there!

[Metal Mickey]

Wow, I couldn't imagine being in a room with a row of other patients My ortho is the one 'in charge', he does all the hands on work whilst the assistant gets equipment ready/passes things to him. She does do the light curing bit but he never leaves my side whilst that is happening. Don't think I'd feel very comfortable with the assistant - as good as they are - being left to get on with it so to speak.

I am in the UK so maybe things are different here, but saying that I still think your ortho should check the assistants 'handiwork' before you leave, after all you are paying a lot of money to have this work done!

[Marigold]

My office is much like BetsyBug's, with the chairs all facing windows overlooking a wooded area. I don't mind being in the room with others (and I'm usually the oldest by far.) There's always soft rock music playing, everyone is happy and joking around, and it makes me feel happy to be there. The assistants remove the wires and get the next ones ready. The ortho comes by to check my bite and tells the assistant if he wants to do a power chain, which bands to use, and when he wants to see me back. He moves on and the assistant puts the wires/power chain/bands on, then I'm done. When I had a bracket come loose, the assistant did all the prep work with the adhesive and everything, then she called the ortho over to place it and cure it, then she put the wires back in and I left. So while it may seem like the ortho does very little, he's doing all the decision making and placement. The assistants carry out the orders. The ones in my office are all capable and friendly and I feel very comfortable with them.

[BetsyBug]

Jem, I couldn't tell you how much money they make but I'm sure its quite a bit.... especially if you judge from the cars they drive and the pictures from exotic vactions and such. I think the ortho would be a cool job I just am not ready to commit the amount of years it takes to get to that position.

[Angel269]

I'm in the UK.

Doc's assistant/nurse just passes ligs, cuts powerchain etc. I am grateful that all the work is done by doc-I dont think I'd feel comfortable about paying for what I'm having done if the person who devised my treatment plan wasn't doing the work.

I'm so glad the treatment is in a room in private-I couldnt bear the thought of being in a big room whilst others were receiving their treatment

[Sita]

My orthodontist only did my second adjustment not the first or the third. He comes over and has a look, gives instructions and moves on. I don't have a problem with it. I actually think that I would have less faith in the therapists if they needed to be checked up on all the time.

I'm in Australia and the office I go to is small. They have two dental chairs in the same room and the ortho moves back and forth between the two.

[DrJasonKTam]

Always interesting to hear the other side.

The most important role for the doctor is to plan your treatment and figure out what needs to be done rather than actually physically do the work. We are the ones who envision what the final result will look like and then make sure steps are taken to get there.

In our jurisdiction, we have to use dental hygienists. There are certain things I have to do such as IPR or any equilibration of the teeth. My staff put the braces on, but then I check them before they are cured. I have also checked any brackets that go on as indirect bonding, but patients may not know this, and think that the hygienist has done this.

During training of my staff, they have everything checked at multiple times during a single appointment. After hundreds and thousands of procedures, they are more than capable to perform most procedures without requiring a check afterwards. This is a function of their training and my judgement that they are ready for this independence. I will still check on certain procedures if they are slightly different from our routine to ensure that things were done properly.

The truth is, after this many years in practice, my staff have done most procedures MORE than I have. I think that the experienced ones actually do many of the procedures better than I do because of this amount of repetition. For instance, the average dental hygienist probably cleans teeth better than most dentists.

Remember that the orthodontist's job is to figure out what to do and make sure it gets done properly and on time. This is where a highly-skilled and trained staff comes into play. I feel 100% confident in my delegation of the tasks required, and our experience is that parents and patients who are concerned with me not doing all of the work for them are quickly less apprehensive after our staff have gained their confidence.

[oimysizex]

I'm also from the UK. My ortho calls me into a 'private' room and does all the treatment herself.
The assistant does help, e.g. using the UV light, passing the ligs to the ortho.

Maybe this is just a UK thing