Orthodontic Therapists Research Articles

My week as an orthodontic therapist

My week as an orthodontic therapist

A day in the life

Rachael Hartley walks us through a day in the life of an orthodontic therapist.

Enjoying the journey

Rajani Byanjankar details her journey from dental nurse to thriving orthodontic therapist.

NHS orthodontic services in Wales: orthodontic workforce distribution and primary care commissioned activity in 2021.

Objectives 1) To ascertain the volume of primary care orthodontic activity commissioned within Wales and compare this to the 12-year-old population; and 2) To ascertain the orthodontic workforce undertaking NHS orthodontic provision within Wales and their distribution.Methods Information was gathered between September and November 2021 from multiple sources within Wales, including: Freedom of Information requests; Welsh Government statistics; orthodontic professional networks; orthodontic provider websites; health boards (HBs); and directors of primary care/contracting/commissioning.Results The HBs had varying levels of orthodontic need and commissioned activity with a significant amount of cross border activity in South Wales. Overall, it indicated that Wales was only commissioning orthodontic activity to meet 76% of the annual orthodontic need. Overall, 97.9% of commissioned primary care orthodontic activity was being used to provide treatment for 9,500 patients per year. Furthermore, 112 GDC-registered clinicians provide NHS orthodontic care within Wales - 52 orthodontic specialists; 32 orthodontic therapists; 24 DwSIs; and 4 orthodontic trainees (StR 1-3). NHS orthodontic care is provided at 47 sites within Wales - 32 sites in the GDS/Specialist Practice, 6 sites within the CDS and 9 secondary care settings.Conclusions NHS commissioned primary care orthodontic activity within Wales is 76% of the potential orthodontic annual need. Primary care orthodontic services are efficient with 97.9% of commissioned activity being used to provide treatment. In total, 112 GDC-registered clinicians provide NHS orthodontic care across 47 sites within Wales, with 29.5% of clinicians working at multiple sites. The distribution of the orthodontic providers is predominately in areas of high population density, resulting in some rural communities being a significant distance from any orthodontic provider.

Health and Wellbeing of Clinical Dental Care Professionals: A Systematic Review.

There has been much research relating to stressors in the dental environment and concerns over dentists' health and wellbeing. The determinants of dentists' health and wellbeing within the UK include macro-factors, such as healthcare systems and regulation; meso-factors, such as job specification and workplace characteristics; and micro-factors, such as personal aspects, professional career level, and personal and professional relationships. Given the challenges in dentistry, research is needed to investigate the key determinants relating to the health and wellbeing of clinical dental care professionals (DCPs) nationally. To review the literature on the key determinants of health and wellbeing among dental hygienists, dental therapists, clinical dental technicians, and orthodontic therapists in the UK. A systematic review of the literature was conducted across seven databases. The records were screened by title, abstract and full text based on the study inclusion criteria. Extraction of data and a qualitative synthesis of the included studies was performed. A mixed methods appraisal tool was used to quality assess for risk of bias. Twelve studies were included in this review, eleven of which were medium to high quality (5*, 4*) and one low quality (2*). Ten studies focused on dental therapists, and/or hygienists, with only one each on orthodontic therapists and clinical dental technicians. Job satisfaction and professional careers were the primary factors explored in the included studies and clearly identified as determinants of health and wellbeing. However, there was evidence of these being associated and linked with a range of determinants at macro-, meso-, and micro-levels, with a general lack of evidence on the overall health and wellbeing. There is currently very limited evidence on the key determinants of health and wellbeing of clinical DCPs within the UK, but the available evidence maps to the same domains as dentists. Further well conducted research examining the overall health and wellbeing is required, with consideration of the full matrix of possible factors.

Orthodontic-related nerve injuries: a review and case series.

Trigeminal neuropathy secondary to orthodontic tooth movement is reported as a rare occurrence. Risk assessment is possible to prevent or immediately treat these injuries and clinicians should be aware of the risk factors. Increasingly, orthodontics is provided by non-specialists and orthodontic therapists. This paper presents cases and a review of orthodontic-related nerve injuries, where early diagnosis of orthodontic nerve injuries was misdiagnosed, preventing early or immediate treatment that would have likely optimised neural recovery and prevented permanent sensory neuropathic pain in these patients. We present two cases of trigeminal neuropathy following orthodontic tooth movement that highlight some key issues relating to improving pre-orthodontic risk assessment during treatment planning and early identification of developing neuropathy requiring urgent cessation/reversal of orthodontic treatment. The cases presented demonstrate the importance of thorough pre-orthodontic assessment before treatment planning. Traditionally, two-dimensional imaging such as panoramic and periapical radiographs have been the gold standard for predicting the relationship of the dentition to the mandibular canal. However, cone beam computed tomography imaging is now accepted as providing a more accurate image of the position of the teeth in relation to vital structures, such as neurovascular supply.

Giving patients back their smile

Nimota Olabisi Owolabi talks about the orthodontic therapist apprenticeship – a dental nurse career pathway

Life on the other side of the chair

Fiona Ellwood investigates dental nursing career opportunities, with a look at how passion and hard work paid off for one of the students at Warwick University, orthodontic therapist Lilly-Rose Cairns

How Orthodontic Therapists have Changed the Provision of Orthodontic Treatment

The last decade has seen the orthodontic workforce transformed by the introduction of orthodontic therapists. This article aims to highlight how they have changed the provision of orthodontic treatment and how the orthodontic profession has caught up with general dentistry where task delegation to dental therapists and hygienists has been commonplace for many years. CPD/Clinical Relevance: This article will enable readers to see just what roles OTs undertake, increase their awareness of who may be undertaking the treatment on the patients they refer on and highlight the guidelines on appropriate supervision that their referring orthodontists should be following.

Training and scope of practice for orthodontic auxiliaries: where does the uk sit within europe?

Abstract: This article aims to outline the role and training of orthodontic auxiliaries in the UK, including the development of orthodontic therapists (OTs). The limitations and findings from a survey taken to understand the training and scope of orthodontic auxiliaries across Europe are provided and we reflect on the desirability and feasibility of standardized training for OTs, particularly in light of Brexit. CPD/Clinical Relevance: Orthodontic auxiliaries are important members of the dental team. It is important that the training, role and scope of practice of all team members are understood to allow safe delegation and supervision.

‘I find working as an orthodontic therapist so satisfying’

Amanda Stephens, 38, is an orthodontic therapist at Plymouth Hospitals NHS Trust. She is married to Ian, a photographer, and they have two daughters.

Scope of practice: orthodontic therapists

Scope of practice: orthodontic therapists

High job satisfaction among orthodontic therapists

O. Onabolu,1 F. McDonald2 and J. E. Gallagher3 present a UK workforce survey.

High job satisfaction among orthodontic therapists: a UK workforce survey.

High job satisfaction among orthodontic therapists: a UK workforce survey.

Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 2: a national cross-sectional survey of orthodontic therapists

Orthodontic therapists (OTs) are the most recent addition to the orthodontic clinical team. The General Dental Council (GDC) and the British Orthodontic Society have formulated guidance and guidelines relating to their scope of practice and level of supervision, however there has been no contemporary UK-based research investigating practice and supervision of OTs. The aim of this study was to investigate the scope of practice and level of supervision of OTs working in the UK. Ethical approval was received from the University of Manchester Research Ethics Committee. An anonymous postal questionnaire was dispatched using postal details acquired through the British Orthodontic Societies mailing list. Three mailings of the questionnaire were conducted. A 74% response rate was achieved. OTs routinely conducted 16 of the 20 procedures from their scope of practice. Uncommon procedures included fitting headgear (24%), lingual appliances (27%), inserting or removing temporary anchorage devices (20%), and taking facebow record (18%). A total of 62% of OTs took patient consent for treatment. 59% were supervised through a written prescription with no direct supervision. OTs were directly supervised for only a quarter of their clinical practice. Orthodontists viewing frequency for OTs varied significantly, and was found to be the following: every 2-4 visits (36%), every other visit (35%), and every visit (26%). OTs mostly carried out the scope of practice as permitted by the GDC. Procedures uncommon to routine orthodontic practice were also uncommon to Orthodontic therapist clinical practice. OTs work mostly through written prescription with no direct supervision.

Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 1: a national cross-sectional survey of orthodontists.

Since the introduction of orthodontic therapists (OTs), there has been little research on the scope of practice and the level of supervision they receive. This study investigates how OTs are being utilised and supervised, and how this compares with current recommendations. A postal cross-sectional survey was mailed to all UK General Dental Council (GDC) registered specialist orthodontists. A 59.7% response rate (747) was achieved. 52% of the respondents reported they worked with/employed an OT. The majority of orthodontists worked with an OT in primary care (67%) seeing predominantly NHS (56%) patients and performed a wide range of duties. Orthodontists reported a perceived increase in clinical output (74%) and time available for treatment planning (61%). The majority (85%) of orthodontists indicated they provide a written prescription for the OT. Forty-two per cent reported the prescription did not contain the required information as stipulated by the GDC. OTs are valued members of the orthodontic team, improving productivity and allowing orthodontists more time for treatment planning. The majority of orthodontists appeared to be working to the BOS and GDC recommendations, with greater awareness needed regarding the provision of a written treatment prescription.

The knowledge and attitudes of orthodontic trainees towards orthodontic therapists: a national survey.

To assess the knowledge and attitudes of orthodontic trainees towards orthodontic therapists (OTs) in the UK. Cross-sectional survey. UK-based orthodontic trainees. An electronic survey was sent to all members of the Training Grades Group of the British Orthodontic Society assessing exposure to OTs and their knowledge regarding current supervision guidelines and scope of practice. Attitudes towards OTs were also explored. Seventy-six responses (response rate 57%) were returned. Nearly 90% of trainees had no formal training regarding OTs. A total of 15.5% were aware of the correct current supervision guidelines and there was large variation in the knowledge of OTs' scope of practice. The majority of trainees were happy to supervise OTs, but only 22.4% felt prepared for this during training. In total, 63% of trainees felt that OTs could impact their own future job prospects. Currently, there is minimal formal training provided to trainees regarding the role of OTs. This is reflected in the lack of knowledge regarding supervision guidelines and scope of practice. Overall, trainees felt OTs were positive for the workforce but were concerned regarding the impact of their own future employment.

BOS updates its guidance on supervision of orthodontic therapists

BOS updates its guidance on supervision of orthodontic therapists

Patient Feedback on Orthodontic Therapist Student Outreach Training.

The introduction of orthodontic therapists as a new group of dental care professionals (DCPs) requires that their training in specialist orthodontic practices has provision for monitoring the level of supervision and clinical care provided by the students. The University of Warwick Diploma in Orthodontic Therapy programme has developed a patient questionnaire with the aim of assessing the patient's perception of the student. The observational questionnaire was designed to cover the four General Dental Council (GDC) domains and learning outcomes for orthodontic therapists, such that patient response could potentially provide valuable feedback to support the training programme. Each of the 10 students had 30 questionnaires to complete. The questionnaire was anonymous and it was designed to be suitable for both young patients and their carers to complete in less than five minutes. The response rate was very high, with 291 of the 300 questionnaires being completed. The level of co-operation may have been partly due to the ease of completion of the questionnaire, but might suggest the willingness to provide supportive feedback for the students. This study provided formative feedback to students' educational and clinical development without impacting on a student's clinical activity and will be used to develop further assessment tools.

The Role of Extended-duties Orthodontic Nurses and Therapists in Delivering Oral Hygiene Instruction and Impression-taking Clinics in a Specialist Orthodontic Practice.

Provision of orthodontic care is increasingly the remit of a highly skilled and qualified team, led by a specialist orthodontist. Often separate patient clinics are held in specialist practice for oral hygiene instruction and for impression taking. These tasks are increasingly delivered, under prescription from the specialist orthodontist, by orthodontic nurses (ON) with appropriate post-registration training and/or orthodontic therapists (OT). Nurse or therapist-led clinics can be beneficial in stimulating patient co-operation, enhance both practice efficiency and staff involvement and maximise the patient experience.