W DENTISTRY L GREAT BRITAIN BY RICHARD GIBSON Richard Gibson, Principal of Wallasey Orthodontics and Consultant to Liverpool University Dental Hospital talks to us about dentistry. Out and about in the car the other day, my 4-year-old was humming a tune to himself. “What song are you humming?” I asked, “the National Anthem!” came the reply. I was a little shocked – usually the reply would be Paw Patrol or some little ditty he’d made up about his big brother. He went on to tell me that they were having a special day at school to celebrate Great Britain and had been learning about some important British people, their achievements, our foods, culture and traditions. This led me to think about the National Health Service – once the envy of the World, but all we hear about in the press are its trials and tribulations. I probably have as much to do with the NHS as anyone – my mum and mother-in-law are nurses, my sister, father-in-law and sister- in law are doctors and I’m married to a dentist all of whom have worked and most of whom still work within the NHS. On top of that I have 2 boys and so have tested the emergency departments on the odd occasion! My job gives me the ability to work within a large NHS Trust and provide a specialist local service to the community from my practice in Wallasey. Is the NHS perfect?... No, I’m not naïve, but it does deliver a fantastic service in the face of significant adversity. Take dentistry for example, albeit a fairly blunt tool, but the NHS friends and family questionnaire, is the biggest feedback mechanism the NHS has ever seen – 97% of responses said they would be likely or extremely likely to recommend their dentist. In Orthodontics, the majority of treatment provided in the UK is carried out in Specialist Practice by Specialist Orthodontists and their teams but there is also some provision within certain hospitals. This allows for training future generations and providing multidisciplinary care, along with other departments, for people with more complex problems for example mismatches of the jaws, people born without all their teeth, the rehabilitation of cancer patients, patients with cleft lip and palate, those born with syndromes 70 wirrallife.com affecting the face and teeth and those with needs requiring hospital team working. There are strict guidelines in place for the provision of NHS orthodontic treatment that are benchmarked with 2 national scales; the Index of Orthodontic Treatment Need (IOTN) and the Index of Functional Treatment Need (IOFTN) (see the British Orthodontic Society’s page www.bos.org.uk for more information). As implied in the title, the IOTN attempts to measure an individual’s need for treatment and identify those who will benefit the most. It looks at specific dental features and the overall appearance to generate a dental and aesthetic score. A line in the sand is drawn at a specific point on the scale and people who score above it qualify for treatment on the NHS, as long as; they are motivated for care, have no active dental disease, excellent oral hygiene and haven’t had full treatment in the past. This line in the sand means that some people, who may have their own concerns about their teeth, will fall beneath the threshold. This does not rule out treatment but any orthodontics provided would need to be done on a private basis. Sometimes the balance of risk and benefit is tipped in favour of no treatment being the best solution. The other consideration is age. The pot of money is only so big and it certainly isn’t growing and so age restrictions do apply when accessing NHS orthodontic treatment. In most of the World, orthodontics is exclusively a private treatment option and this means that when most of the World look at Great Britain – I suspect that they still do look with an envious eye at the service our taxes help to fund. We can sleep safe with the knowledge that we no longer need to be known as a country of bad teeth and horrendous smiles – with NHS and private treatment we have all the bases covered! For more information on the types of treatment we offer or the results we can achieve, please visit www.wallaseyorthodontics.co.uk or the British Orthodontic Society’s page www.bos.org.uk which has great sections for adults and children alike.