The Council has been receiving an increasing number of expressions of concern and complaints from patients, general dentists and orthodontic specialists concerning the quality and appropriateness of orthodontic treatment provided by general dentists practising orthodontics.
The concerns expressed have primarily related to both inappropriate treatment and poor quality of treatment provided to patients; complex treatment undertaken beyond the practitioner’s competence; further orthodontic education and training marketed to dentists who do not hold an orthodontic dental specialist post-graduate qualification; and the potential for irreversible harm being suffered by patients, particularly children and young people.
We have established an orthodontic working group to advise on the provision of orthodontic treatment by general dentists. In particular:
(i) To what extent may general dentists provide orthodontic treatment to patients within their scope of practice?
(ii) Is the scope of practice for general dentistry defined sufficiently that, when considered in concert with the curriculum for the Bachelor of Dental Surgery, University of Otago, the extent of orthodontic treatment that may be provided by a general dentist is readily identifiable?
(iii) To what extent do further education and training post-graduation, not dental specialist post-graduate training, advance practitioner skills and competencies to undertake orthodontic treatment?
(iv) How do practitioners ensure patients, in particular, where children and young people are to be treated, have an appropriate level of understanding:
- to provide informed consent and ongoing assent to a treatment plan that may involve treatment over several years;
- that such treatment is being provided by a general dentist as opposed to a specialist orthodontist; and
- of the differences between a general dentist, or a general dentist practising orthodontics, and a specialist orthodontist?
(v) How do practitioners ensure patient safety when outsourcing the diagnosis and treatment planning, in particular, to overseas-based specialists?
The working group composition and appointees are:
- Dental Council member (working group Chair): Dr Robin Whyman
- registered dentist – performing orthodontic treatments: Dr Brett Hawkins
- registered orthodontist specialist: Dr Winifred Harding
- “Independent” specialist (not orthodontics): Dr Chris Waalkens
- dentist with no particular practice interest in orthodontics: Dr James Talbot
- senior dental academic: Prof Paul Brunton
- children’s advocate – Ms Andrea Jamison
- external lay member: Ms Sue Ineson.
