Case selection key to success – Ten Dental

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  Posted by: Dental Design      3rd January 2019

As you know, interest from adults in improving the appearance of their smiles has rocketed over the last decade, with more patients than ever before seeking out aesthetic treatments from general dental practitioners and specialists alike.

Orthodontics in particular has grown in popularity with image and oral health conscious patients, and unsurprisingly is still on the upward climb according to the British Orthodontic Society (BOS).[i]


Indeed, a recent survey found that a staggering 80% of orthodontists reported a rise in adult private treatments, which is an increase of 5% in just two years. Of the respondents, over 75% revealed that they offer fixed braces with clear aesthetic brackets, while 35% provide lingual braces. Furthermore, over 75% are qualified to offer clear aligners to their patients.iSo what happened to make Brits more interested in rectifying their misaligned, crowded and protruding teeth? And why are so many adults seeking orthodontic treatment despite the fact that it is widely offered on the NHS during adolescence?


In some cases, patients might have fallen through the gap and didn’t receive necessary orthodontic treatment; or perhaps they simply didn’t need it at the time. However, it is becoming an increasingly common occurrence to have patients present that have had previous childhood comprehensive orthodontic treatment, who, because of poor retainer compliance and retention, have relapsed results. It is for that reason that post-treatment reviews and patient education are critical to ensuring long-lasting quality outcomes.

There’s also a greater acceptance of orthodontic treatments now than there used to be. We can, of course, only guess at the reasons why, but it certainly helps that there are a number of celebrities that have been open about their orthodontic experiences in recent years. After all, if high profile names like Kendall Jenner, Brooklyn Beckham, Dakota Fanning and Emma Watson are proud to show off their braces, then why shouldn’t the average Joe? Plus, patients are far more conscious about their appearance and how other people perceive them. It is well documented that a person’s smile can have a huge impact on self-esteem and well-being,[ii]so it is no surprise really that more and more adults are making the decision to have their teeth corrected.

Of course, with this increased interest comes increased expectations about treatment outcomes, which, as you know, are sometimes above and beyond what can be achieved with orthodontic appliances. This is especially true with short-term orthodontics, as there are limitations to these appliances. The main restrictions are that they can only align anterior teeth, and are only suitable for mild to moderate cases of misalignment, crowding or protrusion. As such, there are certain appliances and orthodontic treatments that are not viable in some cases – and that can sometimes come as a surprise to patients.

To ensure that patients have a realistic expectation of what can be achieved with various appliances, it is crucial that you take the time to discuss every facet of every possible treatment. Likewise, if there is a treatment that they have their heart set on but is not viable, then be sure to explain why it’s not appropriate – the last thing you need is a negligence claim made against you. Like it or not, patients will not be eligible for all orthodontic treatment, and it’s up to you to identify what’s within the realms of possibility. It’s also down to you to recognise when a case is beyond your scope of practice, and when to refer to a specialist orthodontist.   

In most cases, there will be guidelines in place from the manufacturer of the appliance(s) you are trained to use to help you with this, and you can usually rely on the laboratory to assist with case selection. Still, if you are unsure or the orthodontic assessment reveals severe crowding, an increased overjet, increased overbite, crossbite with displacements and/or mild hypodontia, then it’s always worth seeking the advice of a specialist orthodontist. For ultimate peace of mind, contact Ten Dental, winner of Best Referral Practice at the Private Dentistry Awards 2017. With their help and expertise you can rest assured that your patients will achieve the best possible treatment from a highly skilled specialist.

As the number of adults seeking orthodontic treatment continues to rise, practitioners will need to pay close attention to patient expectations and case selection. Together with an appreciation of your scope of practice and knowledge of when to refer to a specialist, you can help ensure that patients receive safe, ethical and effective orthodontic treatment that is right for them.



For more information visit www.tendental.comor email: office@tendental.comor call on 020 33932623


[i]British Orthodontic Society: New BOS survey released for National Smile Month reveals the number of adults seeking orthodontic treatment in the UK continues to rise. Published 8 May 2018. Accessed online June 2018 at

[ii]de Couto Nascimento V, de Castro Ferreira Conti AC, de Almeida Cardosci M, Valarelli DP, de Almeida-Pedrin RR. Impact of orthodontic treatment on self-esteem and quality of life of adult patients requiring oral rehabilitation. Angle Orthodontist. 2016; 86 (5): 839-845. Accessed online June 2018 at

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