NHS Orthodontic Care: views and experiences of parents, carers, children and young people

Healthwatch Hertfordshire undertook research for the local ICB on people's experiences of NHS Orthodontist services. They ran a survey, interviewed parents and carers, children and young people.  They heard from 70 people in total.

It was clear that many people felt the level of communication and information provided by their orthodontic practice was lacking. Patients were often left feeling uninformed about their treatment, or unaware of how long they would be waiting to start treatment. Therefore, ensuring patients and their parents or carers are informed ahead of their first orthodontist appointment and allowing for time at the end of appointments to ask questions or discuss concerns is vital. 

For the majority of participants, waiting times was a significant barrier to accessing orthodontic treatment. The lack of communication and information provided compounded this, as many were left not knowing whether they had been referred by their dentist. As a result, providing information and general updates ahead of the initial appointment would prevent parents and carers from needing to take on the responsibility of chasing for updates. Moreover, some parents and carers expressed greater willingness to wait for their child to start treatment if they were kept informed.

Some felt that the continuity of care was lacking, due to a disconnect between their dentist and orthodontist. Some people were sent to appointments without having had extractions, which created further delays to treatment. Setting up greater communication between service providers would ensure that individuals are referred appropriately and are prepared to start their treatment. 

Many had difficulty with appointment availability, as most appointments were only available during school and working hours. As most people travelled to their appointments by car, this resulted in inconveniences due to scheduling. Moreover, missing school was a primary concern for parents and carers, as the majority of orthodontic patients are at the age where they are sitting GCSE and A-Level exams. Providing equal access to flexible appointment times outside of school hours for both NHS and private patients would reduce the pressure on children and their parents and carers to attend their orthodontic appointments at difficult times.

Several participants also raised concerns around accessibility and reasonable adjustments for those with additional needs. For some, it was difficult to attend appointments due to a lack of functional disability accommodations, such as for wheelchair users. For others, inadequate communication for those with autism or learning disabilities caused a lack of clarity in terms of treatment progression. Ensuring clearer communication for those with additional needs is crucial to ensuring the level of care is equal for all patients. Also, offering alternative treatment options to people with sensory processing difficulties and other differences would enable everyone to have equal access to orthodontic treatment and care that is personalised to their needs.