British Orthodontic Conference 2022 – Most.Smile.Debate

Registration is now open for the 2022 British Orthodontic Conference – do not miss the largest event in the UK dedicated to dental professionals with an interest in orthodontics. This year’s theme is Most.Smile.Debate – inspired by the What.3.Words address of the ICC Birmingham. Indeed the inventor of what.3.words, Jack Waley-Cohen, will be addressing the conference about how the App came about.

At the ICC, between the 15th – 17th September, there will be a line-up of hugely respected speakers from the UK and around the world including Dr Michael Mosley, Sandra Tai, Lars Christensen, Björn Ludwig, Ewa Czochrowska and Pawel Placwicz.

David Spary will be delivering the prestigious Northcroft memorial lecture and on a wide-ranging programme there are also parallel sessions on Driving Private Practice and for those considering a career in orthodontics. There is also a well devised programme for both orthodontic therapists and nurses.

The BOC social programme always proves popular and the 2022 Gala is being held at the Birmingham Library – a venue with a difference. The beautiful Town Hall will be hosting the exclusive banquet and there will be plenty of opportunity for those wishing to see the sights and heritage of Britain’s second city. Indeed, if you haven’t been to the centre of Birmingham for some years, you may not recognise it. There has been significant investment ahead of hosting the Commonwealth Games in July.

Trevor Hodge, Chair of the British Orthodontic Conference Committee added, “I am delighted to welcome everyone to the city where I did my postgraduate training and of which I have a lot of fond memories. We have a pre-conference course on Autotransplantation, two parallel sessions, a fantastic programme for therapists and nurses as well as excellent social events for which the BOC has become famous. As in 2021, the conference will be hybrid so there is an option for those who cannot attend in person to still benefit from the excellent education on offer. I look forward to seeing you all.”

To book, please visit https://boc-birmingham-2022.reg.buzz/

An early bird discount is available for all bookings made before 30th June and a combined team rate is on offer too so that the whole team can come along, learn a lot and have fun.

BOS releases teledentistry guidance

The British Orthodontic Society (BOS) has released its guidance on teledentistry and remote interactions in orthodontic care. Further to statements from both the GDC and the CQC in 2021, the BOS have produced this guidance to help orthodontic providers and their teams better understand the scope of teledentistry services and technologies as part of orthodontic care, as well as the associated issues. In addition, it will direct teams to the current regulatory frameworks, resources and highlight best operational practice.

Teledentistry is a term which covers a range of technologies and operational practices. These include various communications via interactive, two-way audio or video as well as indirect, synchronous communications, in which a patient’s information (such as questions, requests, photographs, videos) is exchanged with a dental professional for review. This may be via messaging platforms or dedicated hardware and applications.

Teledentistry can enhance patient care, assist in achieving agreed treatment outcomes, and strengthen the relationship between clinician and patient. Potential benefits of integrating teledentistry technologies and procedures into orthodontic care include greater accessibility, better patient engagement and experience, reduced physical appointments – ideal from a COVID-19 perspective as well as reduced carbon footprint, and above all, increased treatment efficiency.

In accordance with the GDC Scope of Practice, all diagnostic and prescriptive decisions must be made by the treating orthodontist/dentist who have adequate training and skills. The direct involvement of an appropriately trained and registered orthodontist/dentist is essential for the monitoring of orthodontic care. Patients undergoing treatment must be made aware of the name of the clinician responsible for their care and be able to make direct contact with this clinician as well as be able to arrange appropriate face-to-face appointments when required. Patients should be informed that clear aligner treatment, even for cosmetic purposes, is not a simple process but is a medical procedure using a medical device. Treatment should only be undertaken with the direct guidance and ongoing supervision of a named orthodontist or suitably trained dentist.

The BOS still has significant concerns surrounding the appropriate examination, diagnosis and consent process for ‘DIY orthodontic’ systems as well as ongoing supervision and the nature of the relationship between patient and treating clinician.

BOS Director of External Relations, Anjli Patel commented, “If used responsibly, digital technologies and associated tools or applications have potential to improve professional care and enhance both patient outcomes and convenience, adding a potentially convenient way for clinicians to engage with current or prospective patients. It can enhance patient care, assist in achieving agreed treatment outcomes, and strengthen the relationship between clinician and patient. However, it should never be used to alter clinical practice in such a way that patient safety, valid consent or treatment planning and outcomes are compromised.”

View the guidance here.

BOS joins European consensus: ‘DIY Orthodontics’ is hazardous for patients

The British Orthodontic Society is delighted to join a Europe wide consensus that sees 31 professional dental and orthodontic societies, associations, and institutions from 25 countries come together to endorse and fully support a Joint Declaration regarding the unacceptable and potentially unsafe remote treatment of malocclusions. This Declaration by EFOSA (European Federation of Orthodontic Specialists Associations) clearly states the basic requirements that must be met for any orthodontic treatment.

Dentists and Orthodontists all over Europe are witnessing the increasing activities of start-up companies promoting and selling orthodontic treatment using aligners by post with great concern. This type of remote treatment is provided without either proper initial diagnosis or any form of regular clinical monitoring. These companies often present their services as affordable, fast, and safe, although they clearly do not meet required professional dental standards. Orthodontic treatment without proper initial diagnosis and regular clinical monitoring can cause severe risks to patients’ health.

“The unanimity shown by European orthodontists on this subject makes it clear that orthodontics is more than just aligning the front teeth. It is about a holistic approach to care where the patient’s best interests are at the heart of our treatments,” says Prof. Dr. Christian Scherer, who coordinated the project for EFOSA. Every patient should make sure that the basic requirements formulated in the Joint Declaration are also observed in his or her treatment so that their treatment is practised safely.”

Anjli Patel, Director of External Relations for the British Orthodontic Society added, “Orthodontic treatment without thorough clinical face-to-face examination of the patient, x-ray imaging and regular clinical monitoring, is potentially hazardous to the patient’s health. Any self-administered and remote treatment cannot be justified from a professional medical perspective and thus represents a serious violation of ethical, medical and dental standards.”

The Joint Declaration on the remote treatment of malocclusions is available in twelve languages. It reads:

 

On the remote treatment of malocclusions
Various companies offer self- and remote treatment of malocclusions without direct contact between patient and a regular dentist by means of tele-media by transmitting image or video files. Treatment planning is based on impressions taken by the patient themselves, followed by consecutive manufacturing and deployment of treatment devices – particularly aligners – to the patient via mail. Treatment progress monitoring happens entirely without patient contact.

In this respect we declare:

  1. Any treatment of malocclusions represents a medical intervention in the stomatognathic system and should therefore be exclusively performed by a fully qualified dentist.
  2. Any treatment of a malocclusion must be preceded by a thorough clinical examination of the patient. Moreover, imaging findings must be evaluated for adequate treatment planning in order to identify contraindications or special risks.
  3. Any treatment of malocclusion requires regular clinical monitoring. It is essential to assess the treatment progress, but also to detect possible complications such as undesirable tooth movement or other intraoral pathologies at an early stage.
  4. Patient self-treatment and exclusive patient remote treatment must therefore be rejected as potentially hazardous to the patient’s health. Exclusive self- and remote treatment cannot be justified from a professional dental perspective. Exclusive self- and remote treatment represents a serious violation of the dental standard.

We have endorsed this joint declaration

BOS supports GIRFT report into Hospital Dentistry

The Consultant Orthodontist Group (COG) of the British Orthodontic Society are delighted to support the publication of the GIRFT report into Hospital Dentistry.  Recommendations in this new report aim to improve access and standards of care for patients, and knowledge of activity to the secondary care trusts and wider NHS.

Liz Jones, National Lead for the report, engaged with specialties as data collection revealed variations, coding of activity being a standout issue especially in Orthodontics.

The COG working group, chaired by Helen Travess, developed two booklets to clarify the guidance on coding for hospital dentistry, published by BOS, RCS and GIRFT.  Developed for clinicians, clinical coders and other health professionals within secondary care trusts, it aims to improve the quality of data and reduce unwarranted variation. It has been widely published through the society, with open access to clinicians. Orthodontics has been an exemplar to the field, with other specialties also now developing guidance to coding.

Jonathan Sandler, President of BOS, said: “We welcome this new report into hospital dentistry.  It couldn’t be more timely in this post pandemic phase of healthcare delivery.  Interdisciplinary working is key to hospital dentistry.  This report supports these aims with recommendations on workforce and access to such care. It also highlights the role of oral heath advice and multi government agency action.” 

Safe Smiles: new campaign set to champion the benefits of safe dentistry

The British Orthodontic Society and The Oral Health Foundation are launching a new campaign to help patients make safer choices when it comes to their dental treatment

The public awareness campaign, named Safe Smiles, will highlight the benefits of safe dentistry and treatment when carried out in dental practices by trained and registered professionals.

Safe Smiles is a dental sector response to concerns about the growth of direct-to-consumer alternatives, with the campaign’s two organisers worried about patients performing treatments at home – potentially putting themselves in danger.

The campaign was announced at this year’s British Orthodontic Society’s annual conference (16 September) in Manchester, in a joint press conference between the Oral Health Foundation and the British Orthodontic Society.

Recent research by the Oral Health Foundation reveals one-in-four (25%) UK households have opted for some form of DIY dentistry during lockdown.

The nationwide study also shows over half (55%) of adults feel they have neglected their teeth during lockdown. Around one-in-seven (15%) admit to not brushing their teeth as much as before the pandemic.  One-in-five (20%) are eating unhealthier foods, and more than one-in-ten (11%) have been drinking more alcohol. 1

Dr Nigel Carter, Chief Executive of the Oral Health Foundation is worried the potential decline in oral health status may lead to poor consumer choices, with many favouring shortcuts and attracted by direct-to-consumer alternatives.

Dr Carter says: “We are really concerned by evidence suggesting the UK’s oral health habits have declined during the pandemic. Symptoms associated with dental disease – mainly pain and changes in visual appearance – are leading patients to seek quick and cheap home cosmetic treatments advertised online. This is a great cause for concern and one of the key driving forces behind Safe Smiles.

“Dental treatment of any kind must involve face-to-face contact with a trained clinical professional inside the dental practice. This is to ensure patient safety and the most effective treatment.  It is important that the profession continues to champion safe dentistry and advise patients against direct-to-consumer treatments and alternatives shared on social media.

“When carried out correctly, cosmetic dental treatment can give patients the white, straight and confident smile they have always dreamed about. Safe Smiles will make sure patients are given the very best advice about the safest and most effective way to have dental treatment.”

Further findings from The British Orthodontic Society suggest that adults have become more conscious of their smile during lockdown. Over half of orthodontists (60%) say they have seen a larger than expected demand for treatment during the pandemic. It is suspected those affected could be looking for solutions to treat dental problems and improve the appearance of their smile.  

Speaking at the launch of the campaign, Anshu Sood, Director of Clinical Practice at the British Orthodontic Society, says: “We’re delighted to be extending our long-standing campaign with the Oral Health Foundation. It’s heartening to see overwhelming endorsement from the dental sector. This couldn’t be more timely. Our recent stats revealed the pandemic has seen a rise in the number of people seeking orthodontic treatment. With this demand comes a growth in online companies offering treatments.

“Embarking on treatment without seeing a suitably trained clinician could result in serious conditions being missed or dangerous treatment carried out. We want to ensure patients have the very best advice about the safest and most effective way to have treatment. We know that, when carried out correctly, orthodontic treatment can have a positive and life-changing impact.”  

Data shows that more than four-in-five (84%) UK adults want to change something about their smile. Over the next year, more than one-in-three (35%) are thinking about having their teeth whitened while around one-in-six (16%) are considering orthodontic treatment. 1

Safe Smiles will be asking all patients considering treatments to visit dental practices in the UK and have treatment carried out by clinicians registered with the GDC.

The campaign will tackle the dangers associated with dental tourism, inappropriately fitting mouthguards bought online, as well as harmful aesthetic changes to the mouth like lip tattoos, oral piercings, tooth jewellery, modifications and grillz.

The new campaign is being supported by Align Technology and has gathered support from across the dental world. The campaign has already received endorsement from the British Dental Industry Association, British Academy of Cosmetic Dentistry, British Dental Bleaching Society, British Society of Dental Hygiene and Therapy, British Association of Dental Nurses, and British Association of Dental Therapists.

Edmund Proffitt, BDIA Chief Executive, says: “The British Dental Industry Association is delighted to be supporting Safe Smiles. With ever growing interest in cosmetic dental work, the dental industry feels that it is very important that patients can achieve a healthy smile in a safe environment. Be it orthodontic work, tooth whitening or any other aesthetic dental treatment, working with trained dental professionals within a dental practice is a great way to get safe and effective treatment.

“With some unsafe and unregulated online and ‘do-it-yourself’ treatments available, and unfortunately, a number of unregulated practitioners offering treatments, we thoroughly recommend that patients engage directly with dental professionals to get the best, safest healthy smile.”

Jacqui Elsden, BADN President: “We’re thrilled to be supporting safe smiles. With the rise in popularity of unsafe do it yourself treatments and unregulated providers, we hope that this campaign will help patients become more aware of these dangers and think twice before they purchase them. We recommend that patients engage in this initiative and take steps to safely pursue treatment options.”

Zaki Kanaan, Chairman of the British Dental Bleaching Society: “There is no doubt that one of the most common cosmetic dental procedures that is carried out routinely in dental practices is tooth whitening. Done properly, by a dental care professional, tooth whitening is one of the least invasive ways to improve one’s smile. This popularity has led to the growth of direct-to-consumer options that often get around the legality by using non-peroxide based products that not only have little to no efficacy in whitening one’s teeth but many OTC products are in fact harmful to teeth and their surrounding structures. Members of the public seeking OTC products are leaving themselves open to harm with virtually no recourse when things go wrong.  Over many years at The British Dental Bleaching Society we have been striving to highlight to the public this exact issue and we therefore fully support The Safe Smiles Campaign.”

A special toolkit has been created to help dental professionals support the campaign and share the importance of safe dentistry.

The toolkit is available on the campaign website at www.dentalhealth.org/safesmiles.

Reference:

  1. ORAL HEALTH FOUNDATION (2020) ‘National Dental Survey’ Atomik Research. UK. Sample 2,004.

BOS: CQC statement on DIY Orthodontics “provides clarity”

The British Orthodontic Society (BOS) is delighted that the CQC have provided further clarity on the position of Direct to Consumer Orthodontic providers and the fact that they must be CQC registered.

In their statement, the CQC are very clear:

“We consider orthodontic treatments provided to patients following an intra oral scan or when a patient has taken impressions themselves to be regulated activity. This is in the same way that treatment planning and diagnosis associated with aligners is also regulated activity. Regulated activities are listed in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. In this case, they come under the regulated activities of Treatment of disease, disorder or injury and Diagnostic and screening procedures.”

The statement goes on to say: “We can use our regulatory powers to prosecute such offences.”

In a recent BOS members’ survey (April 2021), 82% of members were ‘concerned about more patients seeking DIY orthodontics during and following the pandemic’. In fact, it has been a concern for BOS members for a number of years.

BOS Director of External Relations, Anjli Patel said, “This news from the CQC is very welcome. This is something that BOS have been calling for, for a long time. As we have highlighted before, this is a patient safety issue and we hope that this action will provide more certainty for those seeking orthodontic treatment. One of our primary concerns about DIY orthodontics is that many patients were said to be unaware of the identity of their supervising dentists. Today’s announcement will mean this is rectified.”

The BOS first duty of care is to patients – the charity’s ultimate beneficiaries are patients, and benefits to patients are provided through the advancement of knowledge, practice and standards. The Society advises that anyone seeking orthodontic treatment should speak to a dentist or orthodontist first.

British Orthodontic Conference 2021 – Registration now Open

Registration is now open for the 2021 British Orthodontic Conference – the largest event for UK dental professionals with an interest in orthodontics and this year’s theme is Don’t Look Back in Anger. This year’s conference is being held at the Midland Hotel and Conference Centre in Manchester between the 16-18 September.

As everyone is aware, it has been an unpredictable 18 months or so, full of trepidation and the unknown. With this in mind, we are delighted to be delivering the first ever British Orthodontic Conference in both a physical and virtual format.

In the main programme, delegates will benefit from:

  • Phil Hammond (Private Eye’s M.D., physician, broadcaster, comedian and commentator on health issues)
  • Professor Jonathan Sandler presenting the Northcroft Lecture
  • Padhraig Fleming and Pratik Sharma delivering the Chapman Prize 2020 – ‘Prescription of full or part-time Twin Block wear: A randomised controlled trial and qualitative evaluation’
  • Simon Littlewood – ‘Retention – science, clinical tips and comedy disasters’
  • Sarah Good – ‘Things I have learnt from hanging out with the kids’
  • Paul Redmond – ‘Managing, motivating and engaging multi-generational teams’

‘Driving your Private Practice’ sees a series of engaging and pertinent presentations with the aim of helping attendees move their private practice forward.

‘So you want to know about orthodontics’ is aimed at those that are considering a move into orthodontics or have just begun their journey. There is also a full two-day programme for Dental Care Professionals.

David Waring, Chair of the British Orthodontic Conference Committee added, “We were so disappointed not to have a conference in 2020 and we have worked extremely hard to deliver a conference in 2021 that is doubly good! Every precaution will be taken to ensure a Covid safe

conference and everyone can book with confidence – if we have to make any changes or hold a purely virtual event, you will be able to transfer to the online event and get the appropriate refund. We recognise the importance of flexibility when it comes to plans and hope this provides the reassurance colleagues need.

We feel that we have something for all the team at this year’s conference and look forward to welcoming everyone.”

Of course, there will be fabulous social events and a chance to see Manchester’s finest bars, restaurants and venues. To book, please visit https://www.bos.org.uk/BOC2021 An early bird discount is available for all bookings made before 23rd July and a combined team rate is on offer too so that the whole team can come along, learn a lot and have fun.

GDC publishes statement on direct-to-consumer orthodontics and supporting information for dental professionals

The General Dental Council (GDC) has today published an updated statement in relation to direct-to-consumer orthodontics which highlights issues dental professionals – particularly those working in the remote provision of orthodontics – need to consider.

The statement is based on three main requirements:

  1. In line with current authoritative clinical guidance, and orthodontic training, clinical judgements about the suitability of a proposed course of orthodontic treatment must be based on a full assessment of the patient’s oral health. At present, there is no effective substitute for a physical, clinical examination as the foundation for that assessment. Should a dentist rely upon information from another source to inform their own clinical judgement, the responsibility for that judgement rests wholly with the prescribing dentist.
  2. Direct interaction between patient and practitioner – whether in person or remotely – is essential for providing patients with the opportunity to ask questions, provide valid and informed consent, and be satisfied that the course of treatment proposed is likely to meet their needs and expectations.
  3. Patients must know the full name of the dental professional responsible for their treatment and be able to make direct contact with that person if they need to.

GDC Executive Director, Strategy, Stefan Czerniawski, said: “Traditionally, healthcare is delivered in person – patient and clinician sitting in the same room discussing treatment options and agreeing on a way forward. New technology is challenging that norm and we support innovation wherever it safely brings benefits to the patient. But safety is absolutely key and new ways of doing things must not compromise well-established safety measures which are designed to protect patients.

“Our statement highlights a number of issues that dental professionals working in remote models of treatment will need to consider. One of the main things to remember though, as is the case in any other setting, it remains the treating dentist who is responsible for ensuring they have met all of the Standards for the Dental Team.”

In addition to the statement, the GDC has also published information to support dental professionals in exercising professional judgement.

Should professionals have any questions or concerns in relation to their practice, they should seek further advice from their indemnifier or professional association. The GDC says it will continue to monitor developments in this area.

The GDC has also developed a social media toolkit to help dental practices communicate with their patients about these important issues. 

BOS Response

In response, the British Orthodontic Society (BOS) has wholeheartedly welcomed the GDC statement and accompanying guidance for both patients and professionals regarding direct-to-consumer orthodontic treatment.

BOS members have long warned of concerns about direct-to-consumer orthodontics. The most recent members’ survey from last month (April 2021) showed that 82% of members were concerned about more patients seeking DIY orthodontics during the pandemic, and 98.92% wanted to see the GDC take action.

Anjli Patel, Director of External Relations at BOS, said, “Today’s announcement is about the most fundamental element of healthcare – patient safety. We are delighted that our concerns have been heard by the GDC and acted upon. However, as the voice of orthodontics in the UK, we still have reservations about how any wrongdoing by DIY orthodontic companies could be picked up by authorities and we don’t want patients falling through regulatory cracks. Patients don’t know what they don’t know – we will endeavour to give them all the facts.”

British Orthodontic Conference 2021 to go ahead in September

The British Orthodontic Society are delighted to announce that this year’s British Orthodontic Conference, to be held in the iconic Midland Hotel in Manchester on the 16th-18th September 2021, will be the event’s first ever hybrid offering.

Following such an unusual year, the BOS would like to invite everyone with an interest in orthodontics – consultants, specialists, training grades, GDPs, therapists and nurses – to come along, listen to a fantastic programme live, visit Manchester, socialise and meet friends and colleagues again.

The hybrid element event will allow those delegates who, for whatever reason, can’t travel, or overseas delegates, to be able to register and access the BOC lecture programme virtually, as well as attend a virtual trade exhibition and network with colleagues online.

The conference features a tremendous programme that includes Phil Hammond (Private Eye’s M.D., physician, broadcaster, comedian and commentator on health issues), and the prestigious Northcroft Lecture will be presented by BOS President, Professor Jonathan Sandler. There will also be parallel sessions: ‘Driving Private Practice’, ‘So you want to know about Orthodontics’ for aspiring Orthodontists, and a 2-day DCP programme.

David Waring, Chair of the British Orthodontic Conference Committee added, “We were so disappointed not to have a conference in 2020 and we have worked extremely hard to deliver a conference in 2021 that is doubly good! Everyone can book with confidence – if we have to make any changes or hold a purely virtual event, you will always be able to transfer to the online event and get the appropriate refund. We recognise the importance of flexibility when it comes to plans and hope this provides the reassurance colleagues need.

We feel that we have something for all the team at this year’s conference and look forward to welcoming everyone.”

Registration will open at the start of May for the 2021 British Orthodontic Conference – please follow us on Facebook (@BritishOrthodonticSociety) or Instagram (@bosbraces) for updates or visit www.bos.org.uk/News-and-Events/Events-Meetings to find out more and to book.

An early bird discount will be available for all bookings made before 23rd July and a combined team rate is on offer too so that the whole team can come along, learn, and have fun.

Your Jaw Surgery – online resource celebrates 5 years

Your Jaw Surgery – a valuable information resource for patients (and clinicians) from the British Orthodontic Society has celebrated its 5th birthday. Created to help patients better understand jaw surgery, it includes videos detailing what patients can expect at every stage of the jaw surgery journey, animated films, downloadable advice sheets as well as patients sharing their experiences and stories.

The most recent statistics show that since upload of the videos in 2016, there have been more than 1 million impressions and over 200,000 video views. These views have been across the whole of the UK and indeed further afield. The lack of reliable, high quality information not just in the UK but worldwide is further illustrated by more than 10% of total views being from overseas.

Caroline McCarthy, Consultant Orthodontist and Chair of the organising committee of Your Jaw Surgery commented, “Your Jaw Surgery was inspired by the success of the BOS Jaw Surgery DVD but with a desire to update the information and to enable online access for patients considering surgical options. It has now been going for 5 years and the statistics speak for themselves.

“We are all really proud of this piece of work and are glad that it is staying current and relevant to more than 3000 people who undergo orthognathic treatment in the UK every year. It also helps those people with a dentofacial condition to accept this and decide that treatment is not for them. We know, as hospital consultants, that hospital departments are recommending the website to the patients who are seeking orthognathic treatment.

“We would also like to encourage our general and specialist colleagues to access the information too so that their patients can be directed to it and benefit from all the information available. It will help GDPs gain greater insight into this complex multi-disciplinary treatment and would also help specialist orthodontists with the many adult patients seeking orthodontic treatment. Many of these wish to accept the skeletal aspect of their problem and the information on this website can really help patient understanding for the informed consent process.” This valuable resource can be found at: https://www.bos.org.uk/Your-Jaw-Surgery