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NHS Patient/Orthodontist Partnership Contract

This is a Birmingham Black Country Area Team standard Patient/Orthodontist Partnership Contract given to all patients undertaking orthodontic treatment at Ortho Exclusively Specialist  Dental Practice. Patient compliance is vital to enable us to achieve the best possible orthodontic treatment outcome. This document provides useful information to ensure that treatment progresses smoothly and that our patients obtain the best possible results.

The Patients Commitment:

I............................................... Wish to undertake orthodontic treatment at Ortho Exclusively Specialist  Dental Practice.. My treatment has been discussed with me by my Orthodontist and/or Treatment Co-ordinator. I have read and understood the enclosed British Orthodontic Society leaflet entitled “What are the risks of Orthodontic Treatment?” I understand that I will be given a separate written NHS orthodontic treatment plan. This outlines details of the braces and retainers that I will be given, I addition to other important facts about my proposed treatment.

Active Orthodontic Treatment

Once the braces have been fitted I understand that I will need to attend on a regular basis for adjustments – normally every 12 weeks. I have been informed by my orthodontist and/or treatment Co-ordinator how long my active treatment is likely to take.

I will need to maintain a good standard of oral hygiene, keeping my teeth and braces clean and follow the advice of the Orthodontist and his staff. If my cleaning does not reach the acceptable standard I understand that my teeth might be permanently marked and that the Orthodontist may suggest that my braces removed early and my treatment “discontinued”. I am aware that I have to avoid sticky/hard food and fizzy drinks. If my fixed braces are broken repeatedly, I understand that the Orthodontist may be forced to terminate my treatment and that I will not be able to access this treatment elsewhere on the NHS.

I understand that I will need to attend the appointments on time and on the correct day. If I am late, the Orthodontist/Orthodontic Therapist may be unable to see me since his/her treatment session might subsequently run late and thus inconvenience all the other patients scheduled to attend after my appointment. If I miss my appointment or cancel without giving 24 hours’ notice, I will be offered the next available appointment (usually six – eight weeks after the date of my failed / late cancelled appointment). Should this happen on two occasions, - in conjunction with the Local Office of England – my treatment may be terminated prematurely and I will not be able to access this treatment elsewhere on the NHS.

The Retention Period and Retainers

At the end of active treatment the Orthodontist/Orthodontic Therapist will remove my braces and fit retainers. The Orthodontist and/or Treatment Co-ordinator will explain what retainers are and why they must be worn. The retention period commences the day that braces are removed.

Removable & fixed retainers

  • I understand that, if retainers are removable, they need to be worn in accordance with the instructions given to me.
  • I understand that, once the braces are removed, the responsibility for the future position of my teeth depends on my wearing the retainer’s long term.
  • I understand that the Practice will supervise retention for a period of one year ONLY (the cost of this supervision is included in the NHS contract) and that I will be discharged back to my General Dental Practitioner after this period. Following this year period, replacement retainers will be charged for on a private basis regardless of age or exemption status. This condition also applies to the provision of retainers by the General Dental Practitioner.
  • I understand that, if removable or fixed retainers are broken or lost during the initial one year period, there will be a charge. If a fixed retainer is used, it usually remains in position for at least 5 years. If I return after being discharged to have this (or any other type of retainer) repaired or removed, there will be a charge.
  • I understand that, at the end of this initial year of retention, my treatment at Ortho Exclusively Specialist Dental Practice.  will be officially complete. There will be a charge for any further appointments, the 
repair or replacement of removable retainers and the repair or replacement of bonded retainers.
  • I understand that teeth may try to move throughout life due to continued growth development or 
other biological changes and that I am strongly recommended to continue with part time wear of the retainers on a permanent basis (ie for life). My Orthodontist cannot be responsible for any movement of my teeth if I chose to stop wearing the retainers.
  • If I contact the Practice, or any other Orthodontist, subsequent to ceasing the wear of my retainers with a problem that my teeth are moving out of alignment, I realise that any further treatment may involve the use of fixed appliances. There will be a charge for a review appointment (to access the problem), and for any subsequent treatment. Such subsequent treatment is very unlikely to be available on the NHS unless there are very exceptional circumstances that can be evidenced. 
The Orthodontist’s Commitment 
The Orthodontist will explain the treatment as fully as possible and make sure you understand the treatment options, you will also be given a printed treatment plan. The outlines details of the braces and retainers that will be used, in addition to other important facts about the proposed treatment. The Orthodontist/Orthodontic Therapist will endeavour to see you on time for each appointment. If a clinic is running late, this is probably due to circumstances beyond the control of the Orthodontist. For an emergency appointment, the orthodontist may remove any discomfort only and a full repair may have to wait until your normal booked appointment.

During a course of active treatment and your retention period:

  • It is usual to provide a maximum of 2 repairs to a fixed appliance.
  • Excessive numbers of breakages means that treatment will be ineffective and prolonged, and the 
Orthodontist may be forced to terminate it prematurely.
  • There may be occasion where you will be required to complete your treatment under the care of an alternative orthodontist. 
Please be informed that you might be able to claim a refund for payments made for lost/broken appliance if the change causes undue financial hardship. Form FP17R11 can be downloaded from the Business Services Authority website (www.nhs.uk/DentalServices.aspx). Your receipt should be sent with the completed form to the Dental Services Division of the BSA.

Out of Hours Emergencies

If you have any discomfort in relation to your brace outside normal surgery hours please ring '111 for emergencies' which will give you advice on what to do. Please not emergency appointments are reserved for severe discomfort related to your brace which you cannot rectify yourself by ceasing the wear of the brace or removing the offending part yourself as a temporary measure.

I ....................................., the patient/parent/guardian of .............................................., hereby consent to the above named patient undergoing the proposed orthodontic treatment. Signed:................................................. Patient/Parent/Guardian.
Date:....................................................

If you have any further queries, please contact the surgery on 0121 708 2994 during working hours or email reception@orthoexclusively.co.uk