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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
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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.