We all strive to make the end of treatment both fun and celebratory. But that’s not always the case. Arguably, the hardest thing about being an orthodontist is having to rely on patients to do what they need to do so we can properly finish treatment. But that sounds a lot easier than it really is. Many kids don’t where their elastics and many don’t brush their teeth the way they should. So, when should an orthodontist “throw in the towel” and end treatment?

We’ve all had those endless conversations with parents, who stare at the beleaguered 11 year old and wag their finger at them, promising swift justice for poor brushing reports, all to no avail. Papers get signed, photos taken, more warnings issued.

But we find ourselves in a difficult position. When do we stop treatment in the middle because of poor home care or poor elastic compliance (and face the wrath of a parent who doesn’t understand that their child isn’t up to the task) and when do we continue and risk decay?

Of course, we are always advocates for the child whose frontal lobe development doesn’t let them clearly understand the consequences of their actions (or inaction). It’s often the parent who makes things difficult, getting angry at the child or us, making the advocacy for the child’s dental health a challenge. But, we are up to the task. However, it’s not easy.

It’s certainly a tough position and no matter how many forms are signed, or discussions had with parents, the “stopping point” is different for everyone.

What are your guidelines for discontinuing care? What discussions or paperwork do you give to your patients’ parents? How do you handle the financial side of the problem? These are legitimate questions that affect every practice, and nobody said it’s easy.

If only they’d simply brush and wear their elastics…think of how much easier our practice lives would be. 🙂

Wishing you all the best!!!

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GLENN KRIEGER IS AN ORTHODONTIST WITH 20 YEARS OF RESTORATIVE AND COSMETIC DENTISTRY EXPERIENCE BEFORE HE RETURNED TO ORTHODONTIC RESIDENCY. DR. KRIEGER LEARNED ABOUT THE IMPORTANCE OF WELL-DESIGNED PRACTICE POLICIES AND SYSTEMS DURING A YEAR AT THE SCHUSTER CENTER FOR PROFESSIONAL DEVELOPMENT IN SCOTTSDALE ARIZONA, AND AN UNDERSTANDING OF GENERAL ACCOUNTING PRACTICES AND INDUSTRIAL PSYCHOLOGY AT THE UNIVERSITY OF WASHINGTON GRADUATE BUSINESS SCHOOL’S “DENTIST AS CEO” PROGRAM. HE IS THE HOST OF “THE ORTHOPRENEURS PODCAST”, MANAGES THE ORTHOPRENEURS FACEBOOK GROUP AND RUNS THE ANNUAL ORTHOPRENEURS SUMMIT.

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