Switching ortho?

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Switching ortho?

#1 Post by tartanhabit »

I'm 3 and a half months into treatment. Only top braces are on so far, bottom to follow at next appointment.

I'm feeling some regret about my decision to go with this ortho. I consulted with several and thought that this was the one - staff very friendly, very good reviews, nice office with individual consultation rooms (rare in US?) and what I was told was a relatively low volume of patients so they could give each more individual attention. It was a partnership with 2 orthos. One left shortly after I started treatment. It feels rushed with the ortho each visit, exactly the opposite of what I wanted.

I'm not sure if it's a personality clash that has led me to feel lacking in confidence. The main problem:

* questions feel like an intrusion. The techs start the treatment before I see the ortho, placing the new wire. Then the ortho comes in the room to 'check' and that's literally what it feels like, a quick peek in my mouth, fast in and out. When I ask questions, they are answered minimally, all the while with tools hovering over as if she'd just like to get on with whatever it was she came in the room to do.

There's never 'hi, how's it going, any questions coming up?'

She is highly trained from good schools. Many of the good reviews reference her partner who is no longer with the practice.

*is it normal for the techs to do all the work and the ortho to be super quick in and out?

*anyone ever changed ortho during treatment? Please share details!

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Re: Switching ortho?

#2 Post by EWUgal15 »

tartanhabit wrote:The main problem:

* questions feel like an intrusion. The techs start the treatment before I see the ortho, placing the new wire. Then the ortho comes in the room to 'check' and that's literally what it feels like, a quick peek in my mouth, fast in and out. When I ask questions, they are answered minimally, all the while with tools hovering over as if she'd just like to get on with whatever it was she came in the room to do.

There's never 'hi, how's it going, any questions coming up?'

She is highly trained from good schools. Many of the good reviews reference her partner who is no longer with the practice.

*is it normal for the techs to do all the work and the ortho to be super quick in and out?
I'm sorry this has been your experience. While I've not had the pleasure of switching practices, I have had experiences similar to these. So I thought I would share.

Typically speaking, my appointments tend to follow suit to what you describe. Usually a tech will ask me how things are going and try to get a feel for if I have any questions, remove my ligatures (actually power chains right now), then some kind of magic happens and one of the two doctors comes over. At this point, the doctor comes over and asks how we're doing, asks the tech what they've done so far in the appointment, if I had any questions or concerns and what was done at the last appointment, pokes and prods my teeth, has me open and close my mouth (I'm a surgery case), and then gives the tech instructions for ligation, wire changes (if needed), any elastics, and when my next appointment should be. The tech then does whatever the doctor said to do, puts on new ligatures (or power chains), and schedules my next visit. My adjustments are usually about 15-20 minutes and the majority of time is spent with the tech. For me, it's pretty normal to only see the doctor for about 5 minutes. So I would say that it is pretty normal for the tech to do most of the work, but they shouldn't be making treatment decisions (increasing wire size, prescribing elastics, etc).
My most recent appointment didn't go this way. I had my power chains and wires removed, progress molds taken for surgery purposes, then my wires were put back in and I was re-ligated. Only when I asked to see the doctor did the tech signal for her to come over. I found out that they had no plans to bring the doctor over that day and I got the feeling they weren't going to schedule me for another appointment. I left with an appointment, but I was pretty depressed. You see, the day before that, I had a follow up with my surgeon where I was told that he felt I was ready for surgery. I kind of knew going in to my appointment with the orthodontist that I would probably be in a stasis phase before surgery. But there was also a chance that I could be entering into a phase of arch correction for some minor tweaks before surgery. You can imagine how upsetting it was to me to not have any changes made to my elastics or anything. Not even a peep about being ready for surgery or not.

The following Monday, after I had a chance to calm down and organize my thoughts, I called my treatment coordinator. She's my bulldog. If I need something done or questions answered, I put her on it and it gets done. She doesn't take crap from anybody. Needless to say, she was appalled by what I told her about my appointment. She listened to everything I had to say and gave me reassurance that what I experienced never should have happened. She then told me she would find out where my molds were and get my questions answered by the end of the week, the biggest one being whether or not we're ready for surgery. I got a call from her the same day telling me to start coordinating my schedule for surgery because it was time. She didn't say if there were going to be any changes at my next appointment, other than getting new power chains, but I instantly felt better knowing that I should have gotten more than what I did. This is the first time something like this has happened, so I hope it doesn't happen again.

My suggestion would be to make your frustrations known to the office staff. Call them. You're the one paying them, you should feel happy to do so and it doesn't sound like you are. At the same time, know that switching practices will likely cost you more money as you might not get much of a refund (if anything) from your current orthodontist. Maybe you could track down the doctor than left the practice and chat with him about the situation you're in now.

Best of luck to you.

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Re: Switching ortho?

#3 Post by metalliKa »

The honest truth is that I believe it's pretty routine for the tech to do more work although under the ortho's direction in the first few months of treatment. My first few monthly adjustments, my ortho sat in the chair no more than 5 minutes to just look over my bite and for space opening up. The tech did all the ligs and wires change after the ortho's quick assessment. It was only in the last couple of adjustments that my ortho and I actually had conversations because he was in the chair longer. For my 7th adjustment today, he was in the chair a good 20 minutes. He was telling me stories while ipr-ing away at my teeth.

However, if you have questions or want to know something, it's safer to ask than not ask. You are never a bother even though you may think you are. I know it's frustrating not knowing what is next to be done and quite frankly, I don't think the ortho knows that himself/herself until the next adjustment.
Offenses: Skeletal and Dental Class 2 malocclusion
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Re: Switching ortho?

#4 Post by ItsFreyja »

I agree with EWUgal15 and metalliKa -- your experience sounds a lot like mine, except that if I ask questions the ortho will happily stay and talk with me. This is pretty much what I expected; I am fine with it since it is clear to me that the orthodontist is ultimately directing my treatment. I have two thoughts for you. First, if you want to command the ortho's extended attention, sit upright in the chair and look her in the eye while you talk to her. I feel like the horizontal posture in the reclined chair can take away our power sometimes. Second, keep in mind that you (by definition, since you're here at ArchWired) are not a typical ortho patient. The vast majority of patients (including, obviously, nearly all children and teenagers) could not care less about the particulars of their treatment, so orthodontists are generally not accustomed to answering super-specific questions or explaining what they're doing. Good luck to you.

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Re: Switching ortho?

#5 Post by tartanhabit »

Wow, I'm really heartened to hear these stories from others. EWUGal15, I'm sorry you've had a disappointment too but sounds great that you have a treatment coordinator. It's nice that you have that person between you and the ortho. Good luck with your process. This practice I'm in is pretty small.

So I guess it doesn't seem that unusual at all that the techs are doing most of the interaction, judging from what ItsFreyha and MetalliKa said. But it's the ortho's attitude to my questions. As if it's a nuisance. ItsFreyja, really interesting point about sitting right up and get eye contact. I agree! Lying back reclined is not the way to have a good conversation in my opinion. I was thinking about that today as my ortho literally has her tools poised in her hand, ready to do whatever it is she's there to do and get back out of the room again. It's as if I am interrupting and delaying her getting on with her job.

EWUGal15, I wish I could track down the former ortho partner but I know he's moved across country. I actually went with this ortho because of him, I'd met him before and I had a good impression. It was at my consultation that I found out that he was leaving the practice. I think I convinced myself that my experience with him would be my experience with his partner and they are clearly turning out to be pretty different in style.

Thanks for letting me vent a bit and I'm grateful for the feedback. Makes me feel like this is not far off the norm and I need to get my questions answered whether my ortho likes it or not. Realistically though, she's just not going to be the one starting that kind of conversation.

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Re: Switching ortho?

#6 Post by oldfart »

Both orthos (I also had to switch due to moving) has their assistants do most of the work. But also will go out of the way to answer any and all questions I have. But I also make sure I schedule my questions to when I know I they aren't super busy. Or if my appointment is during a time that I know they will be super busy, I will type them up and email them into the office a few days before treatment. That way they have time to look at them and prepare them selves with answers when they work on you.
Braces on: 2/25/2013. Braces Off: 12/23/2015
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Re: Switching ortho?

#7 Post by Featheryy1221 »

Assistants doing the majority of the work is pretty standard. Sometimes my ortho would ask me how I was, but sometimes he wouldn't. I only asked him a few questions during my time with braces and when I did I made sure it was before he left my station. You have to remember they have a TON of patients/cases (usually 100's), and only so many hours in a day to spare. Your ortho more than likely won't be able to answer during your alloted spot all of your questions. What questions i couldn't get answered i saw others on here going through some of the same things I was wondering or I just figured he knew what he was doing (dude's been in practice for 30 years in my case).

You're still in the 'new to braces' stage, so you may find as you go along with treatment that you have less questions as you go along. Mainly because braces get way less exciting and more of just your routine (sorry, hate to say it).

I definitely don't think you should switch orthos. You'll find the same situation elsewhere. I'd only switch if you were unhappy with your results and they weren't working with you to fix that, or you move, or something like that.

Estimated treatment time: 18 months. (6 months- expander, 1 year- braces)
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Re: Switching ortho?

#8 Post by gabriella36 »

Chiming in here just to say that my experience lines up with the stories others have shared. My ortho, while incredibly kind and skilled, spends less than 5 minutes with me each appointment, except when she did my first round of IPR. I agree with making eye contact and speaking up to say "I have a few questions, when might be a good time to talk?" I think the whole experience is set up to funnel patients in and out with a minimal of fuss, so feeling like you're interrupting is kind of part of the whole setup.

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Re: Switching ortho?

#9 Post by stephcsun »

I also felt like the ortho didn't do much at first, and I wasn't sure if that was just the office I went to...but now that I am almost done or so they say (2-3 months left) the ortho does most of the work even changing ligatures and wires .The assistant just places the instruments needed in the room.
However, I can see how you would feel concerned given that one of the 2 orthos left and it changed the atmosphere at your office(and if you wanted to switch you'd have a valid reason). I can only hope that its just temporary and things will get better for you. It is important to feel comfortable given that you might be there for a while.

Best of luck!

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Re: Switching ortho?

#10 Post by Catpotat »

Yes! I had the same experience which surprised me when I started treatment. I thought I would be mainly interacting with the ortho but the techs do most of the work and this made me feel somewhat neglected as a patient. My ortho seems too busy to properly explain things or answer my questions. When I have a concern, I don't feel like they take me seriously or empathise.

I'm worried that she's not even really looking at what's going on in my mouth. She didn't check my elastic configuration so I've been wearing them incorrectly for the past few months. I'm positive that I followed her instructions and maybe she forgot to communicate a new configuration to me. The only way she knew was because I brought up undesirable changes in my midlines. Now I have to reverse the mistake which means extra time. Does anyone know if you have to pay extra if your treatment takes longer than the estimated time frame?

Sorry for the rant; overall I'm quite upset and angry about the lack of care and communication. I think being more assertive, double checking everything with the ortho, and bringing up concerns as soon as you have them (instead of waiting for the next appointment) would save you from the situation I was in.


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Re: Switching ortho?

#11 Post by tartanhabit »

Meowmei, sorry you find yourself in that situation.

I started this thread a long time ago and just saw a recent posting. Well, the update is that my feelings about my ortho did not change and I went quite a way into treatment. I was both not happy with how it was going nor the communication style of the ortho. It's as if we were just not seeing the same things. I took the plunge and went to see a number of other orthodontists as a consult to change. It was a big deal even just to do that but I found several who were generous enough to give me their opinion. They confirmed the things I was seeing were off. I brought it all up with my ortho - had a meeting with her. Ultimately, although she claimed to be interested in resolving everything to my satisfaction, I'd already lost confidence in her treatment and certainly our communication styles were totally incompatible.

Several orthos I went to see mid treatment confirmed that the choice of braces I was in were not what they would have used for my particular case and were part of the problem in not achieving the results I wanted. I took the plunge and changed ortho about 2/3rds of the way into treatment. It was a HUGE decision with financial implications and meant another year and a half in braces. I have absolutely zero regrets. This second round was amazing - gave very personal treatment, not just to me, to every single patient. His office runs like clockwork, I never once felt he didn't want to answer questions and he was an excellent communicator. RELIEF!! I had a very difficult case with some limitations and I think I got the best results I could have with him.

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Re: Switching ortho?

#12 Post by joicetti »

Yes as everyone is saying, the techs spend more time with you than the orthodontist during the course of your treatment. When you do your consultation you meet with the ortho and make a lot of your decision based on him/her and what you're told, but the truth is that you end up working more with their teams than you do with that initial person. I wish more folks had the opportunity to know that ahead of time.

You do need to be your own advocate. You look at your teeth daily. Your ortho spends 5 minutes a month with you. If you have questions and especially if you see something wrong, let the tech know as they will tell the ortho and then you can get your concerns addressed. In my case I'm pretty sure my ortho misdirected the tech on my elastics at one point, which caused reversal of some good progress I had made, and it was only when I pushed and questioned that she reviewed her prior instructions and had me change the way I was wearing my elastics. She never admitted an error but she had me change them from a class II configuration to a class III, which makes sense for an underbite case like me. I'm 2 months behind in my treatment as a result, but it could have been more I suppose.

I also find that the ortho adapts to your style. In my case I ask questions when I hear them speaking in their shorthand, but I think they're used to working with kids so they tend to not offer information upfront. They may be busy but you're investing time and money and they should make each person feel comfortable and heard.

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