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Leaving NHS orthodontist before end of treatment?

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We are not happy with teenage child's orthodontist. I know our only other option is to go private elsewhere. If we ask the orthodontist to remove the braces can he refuse? Will we have to pay a penalty? 
Teen is 18 in a few months but has been told treatment has to continue for another 18 months as brace has broken number of times and that each break adds 3 months to treatment.  Teen has severe anxiety and the stress of seeing orthodontist is adding to this. We had persevered, believing that the end was in sight but the extra 18 month news is the final straw. 
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  • silvercarsilvercar Forumite, Board Guide
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    Before you make a final decision, why not see a private orthodontist for a second opinion?
    I suppose your current orthodontist could refuse, on the grounds that it is not dentally correct, but any orthodontist (or probably dentist) could remove a brace, you don't need to go to the person that fitted it.
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  • GrumpysallyGrumpysally Forumite
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    Yes, I was thinking about making an appointment at our regular dentist to see what advice they could give. Im not sure if they are taking routine appointments at the moment. This all came to a head yesterday so I'm still getting my head around it all.  I also need to find some recommendations for a local-ish orthodontist.


  • edited 15 September at 10:04AM
    UndervaluedUndervalued Forumite
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    edited 15 September at 10:04AM
    We are not happy with teenage child's orthodontist. I know our only other option is to go private elsewhere. If we ask the orthodontist to remove the braces can he refuse? Will we have to pay a penalty? 
    Teen is 18 in a few months but has been told treatment has to continue for another 18 months as brace has broken number of times and that each break adds 3 months to treatment.  Teen has severe anxiety and the stress of seeing orthodontist is adding to this. We had persevered, believing that the end was in sight but the extra 18 month news is the final straw. 
    Whether the orthodontist's advice is good or bad I couldn't say (and I doubt if either of the helpful dentist's that post here will venture an opinion either).

    However with the anxiety issues you describe I wouldn't have thought that compelling this orthodontist to do something he doesn't want to and/or admit he is wrong will be an easy situation for your teen.

    If the decision is to end treatment (which of course the teen will be able to decide for themselves in a "few months" time) then I would have thought you ask another dentist to remove the braces.

    There is surely only any point in seeing another specialist if you (for now) and the teen him / herself in a few months is likely to be prepared to continue, should that be the advice.
  • VegastareVegastare Forumite
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    I can only say that I myself many years ago had seen an orthodontist and had a brace which had a tweak to adjust it now and again.  It started to become really uncomfortable .  All my Mum and I  got was will see what things look like in six months....and so on.  I saw my dentist for a check up and he removed it after we explained the discomfort etc.  Am not sure how that would be viewed these days....
  • ToothsmithToothsmith Forumite
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    Your choices here are to stop treatment or to carry on.
    If you stop - no-one is going to die, but the teeth almost certainly won't be in a stable position, so they will drift around until they find a stable position which may or may not be better than the position you started off from in the first place. It's unlikely to cause anything more than an aesthetic problem though, but you need advice from dentist/orthodontist on what things would probably look like if you did abandon.

    If you carry on, then it will either be with this orthodontist or a new one. Finding a new one with capacity to treat Teen may be a problem, as orthodontists are struggling to cope with patients they have under treatment at the moment anyway.

    If you find an orthodontist who will see him privately, I think it's highly unlikely that treatment will be completed any quicker than the first one has said. The big flashing red lights here to me are the anxiety issues and the fact Teen has broken braces several times. My question would be how much did Teen want the treatment in the first place, and how much commitment to further treatment there is now? If treatment is successfully completed - how much commitment would there be to wearing retainers? If retainers aren't worn - there will be some relapse anyway. 
    Paying money to get the orthodontics finished won't solve the issues Teen has towards treatment, and breakages may well continue and frustration increase.
    I think you need big chat with Teen as to what is wanted from them. Do they want to continue, or just stop?
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
  • UndervaluedUndervalued Forumite
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    Your choices here are to stop treatment or to carry on.
    If you stop - no-one is going to die, but the teeth almost certainly won't be in a stable position, so they will drift around until they find a stable position which may or may not be better than the position you started off from in the first place. It's unlikely to cause anything more than an aesthetic problem though, but you need advice from dentist/orthodontist on what things would probably look like if you did abandon.

    If you carry on, then it will either be with this orthodontist or a new one. Finding a new one with capacity to treat Teen may be a problem, as orthodontists are struggling to cope with patients they have under treatment at the moment anyway.

    If you find an orthodontist who will see him privately, I think it's highly unlikely that treatment will be completed any quicker than the first one has said. The big flashing red lights here to me are the anxiety issues and the fact Teen has broken braces several times. My question would be how much did Teen want the treatment in the first place, and how much commitment to further treatment there is now? If treatment is successfully completed - how much commitment would there be to wearing retainers? If retainers aren't worn - there will be some relapse anyway. 
    Paying money to get the orthodontics finished won't solve the issues Teen has towards treatment, and breakages may well continue and frustration increase.
    I think you need big chat with Teen as to what is wanted from them. Do they want to continue, or just stop?
    Yes. The OP has not really said why they (and / or the teen) are not happy with this OD. If they are concerned s/he is not doing a decent job, the the only real answer is a second opinion. If however it is personality / attitude (which may well contribute the the anxiety issues) then as you say the only options are somebody else or discontinue treatment.

    The problems are of course getting one "professional" to openly criticise another (if indeed that is justified) or being happy to accept their assurance that OD 1 is doing a good job (if that is the case).

    If it is personality / attitude than that is not realistically going to change and any complaint will make it worse. The vast majority of medical professionals are decent / kind / well meaning people but that doesn't mean that they get on with everybody. Equally, as in all walks of life, there are some right obnoxious idiots too!
  • GrumpysallyGrumpysally Forumite
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    Its partly personality / attitude issue. The OD talks at my teen rather than to them. Teen then gets all tongue tied and even more anxious. I think OD just wants to get on to next patient and get through his work load and doesn't have time for small talk or putting teen at ease. Teen just wants to get out of the surgery ASAP.
     Teen has had problems with the brace when this OD has adjusted it which haven't occurred on the occasional appointments when we've seen a different member of staff. Sharp ends on the brace wire, wires cutting badly into the cheeks. I know some discomfort  is to be expected.  I have two older, grown up children, both had braces but never problems like this.


  • GrumpysallyGrumpysally Forumite
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    Your choices here are to stop treatment or to carry on.
    If you stop - no-one is going to die, but the teeth almost certainly won't be in a stable position, so they will drift around until they find a stable position which may or may not be better than the position you started off from in the first place. It's unlikely to cause anything more than an aesthetic problem though, but you need advice from dentist/orthodontist on what things would probably look like if you did abandon.

    If you carry on, then it will either be with this orthodontist or a new one. Finding a new one with capacity to treat Teen may be a problem, as orthodontists are struggling to cope with patients they have under treatment at the moment anyway.

    If you find an orthodontist who will see him privately, I think it's highly unlikely that treatment will be completed any quicker than the first one has said. The big flashing red lights here to me are the anxiety issues and the fact Teen has broken braces several times. My question would be how much did Teen want the treatment in the first place, and how much commitment to further treatment there is now? If treatment is successfully completed - how much commitment would there be to wearing retainers? If retainers aren't worn - there will be some relapse anyway. 
    Paying money to get the orthodontics finished won't solve the issues Teen has towards treatment, and breakages may well continue and frustration increase.
    I think you need big chat with Teen as to what is wanted from them. Do they want to continue, or just stop?
    You are right. No one is going to die. 
    I do think realistically it is a choice between  continuing or stopping. I suspect compliance with private treatment may be just as difficult for my child. I can think of plenty of other ways to spend a  couple of grand at the moment. University costs for a start.
    They did want the treatment at the beginning but has had so much pain from the braces that its all gone sour.
    I didn't go to the last appointment, it was my OH. I've had two conflicting  versions of what went on. OH says orthodontist gave teen the option of continuing or stopping. Though he does admit he couldn't hear him properly through the mask and the radio playing. Teen says they weren't given that option and the choice given was something along the lines of,"18 months or if you keep breaking it you can carry on for years, I'll still be here". I think the truth is somewhere in the middle.
    Tried talking to teen about it today but must have picked wrong moment because I hit a brick wall. Lots of other issues going on in their life at the moment.
    Next appointment is in two months. I'll find out by then what they want to do and will make sure I go to the appointment.
    I can't remember what was on the contract we signed at the start of treatment. Am I likely to be liable for any charges for not teen not completing  treatment?
  • brook2jack2brook2jack2 Forumite
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    The thing that rings alarm bells is that the brace has repeatedly broken. 
    How keen is the teen at having a brace , continuing brace work? As you know braces require a great amount of Co operation , you have to avoid certain foods, you have to be meticulous about oral hygiene and you have to avoid certain habits that make breakages more likely. 

    The orthodontist is quite right that a breakage will keep on putting the end result back. 

    Could you not just ring the practice up and ask if another member of staff can take over the treatment? It may be that the orthodontist can just supervise and the "day to day" adjustments be done by an orthodontic therapist or that another orthodontist at the practice can take over. 

    Going to a completely different practice is by far a much less satisfactory solution as taking over someone else's half way completed treatment has a lot of inherent problems. You will also be looking at anything from £1500 to £3000+ for treatment. 
  • GrumpysallyGrumpysally Forumite
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    I don't have any doubts that breakages put the treatment  back, though 18 month would suggest being broken six times which I don't think it has. There's also of course the six months of lockdown to take in to account.
    I'm not sure how the appointment system works, it seems to be pretty random. Apart from the main orthodontist I don't think we've seen any one person more than once. Its a mystery how the system works. No one is particularly approachable.
    The orthodontist we see owns the practice so I do feel more reluctant to raise concerns  than if they were a regular member of staff.
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