Scope of Practice and Supervision of Orthodontic Therapists in the United Kingdom: Part 2: A National Cross-sectional Survey of Orthodontic Therapists

Abstract

Background

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.

Method

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.

Results

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%).

Conclusions

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.

Keywords

Orthodontics orthodontic therapists supervision scope of practice

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References

Banks

, Elton

, Jones

, Rice

, Derwent

, Odondi

2010. The use of fixed appliances in the UK: a survey of specialist orthodontists. J Orthod. 37:43–55.

Blau

. 1973. Expanded use of auxiliary personnel in orthodontic practice. Am J Orthod. 64:137–146.

The British Orthodontic Society. 2017. Guidelines on supervision of orthodontic therapists. London.

The British Orthodontic Society and the Orthodontic National-Group 2012. Guidelines on supervision of qualified orthodontic therapists. London.

The British Orthodontic Society Archive and Museum Committee. 2011. A history of the events which lead to the establishment orthodontic therapists in the UK. In: Bos , editor. London.

Choi

, Pak

. 2005. A catalog of biases in questionnaires. Prev Chronic Dis. 2:A13.

Coughlin

. 1990. Recall bias in epidemiologic studies. J Clin Epidemiol. 43:87–91.

Dugdale

, Ahmed

, Waring

, Malik

. 2017. Scope of practice and supervision of orthodontic therapists in the United Kingdom: Part 2: a national cross-sectional survey of orthodontists. J Orthod.

Gardner

, Jones

. 2002. An audit of the current consent practices of consultant orthodontists in the UK. J Orthod. 29:330–334.

10.

General Dental Council. 2009. Scope of practice. London.

11.

Hobson

, Clark

. 1998. How UK orthodontists advise patients on oral hygiene. Br J Orthod. 25:64–66.

12.

Hodge

2010. Orthodontic therapists – a challenge for the 21st century. J Orthod. 37:297–301.

13.

Ide

, Scanlan

. 2003. The role of professionals complementary to dentistry in orthodontic practice as seen by United Kingdom orthodontists. Br Dent J. 194:677–681;Discussion 673.

14.

Kalange

. 2004. Indirect bonding: a comprehensive review of the advantages. World J Orthod. 5:301–307.

15.

Kincaid

, Fishburne

Jr , Rogers

, Chissom

. 1975. Derivation of new readability formulas (Automated readability index, fog count and flesch reading ease formula) for navy enlisted personnel. No. Rbr-8-75. Naval Technical Training Command Millington TN Research Branch.

16.

Lawshe

. 1975. A quantitative approach to content validity. Personnel Psychol. 28:563–575.

17.

Moss

. 1993. Orthodontics in Europe 1992. Eur J Orthod. 15:393–401.

18.

Nuffield Foundation 1980. Inquiry into dental education. London.

19.

Samuels

, Willner

, Knox

, Jones

. 1996. A national survey of orthodontic facebow injuries in the UK and Eire. Br J Orthod. 23:11–20.

20.

Shih

, Fan

. 2009. Comparing response rates in e-mail and paper surveys: a meta-analysis. Educ Res Rev. 4:26–40.

21.

Shirck

, Firestone

, Beck

, Vig

, Huja

. 2011. Temporary anchorage device utilization: comparison of usage in orthodontic programs and private practice. Orthodontics (Chic.). 12:222–231.

22.

Stephens

, Cook

2002. Attitudes of UK consultants to teledentistry as a means of providing orthodontic advice to dental practitioners and their patients. J Orthod.29:137–142.

23.

, Banks

, Conwell

. 2009. Disparities in emergency department wait times for acute gastrointestinal illnesses: results From the national hospital ambulatory medical care survey, 1997–2006. Am J Gastroenterol. 104:1668–1673.