Policies
Introduction
Achieving the best results requires teamwork between patients, parents, orthodontist and office staff. Sax Dearing and his staff enjoy building high performance teams with patients and their parents to achieve the best possible result for each patient. To assist us we would appreciate your taking a few moments to review our office policies and procedures outlined below. We hope that your assistance now will help to avoid any misunderstandings in the future. This page covers appointments, office hours, telephone, fax and e-mail, sterilization, new patients, punctuality, extraction of teeth & associated issues, fees, methods of payment, languages spoken and how to complain if you feel we haven’t lived up to your expectations.
Dr Dearing and his staff are committed to providing you with the best service and orthodontic experience possible. The goal of our practice is to treat every patient as we would wish to be treated ourselves. We do everything in our power to provide each patient with the most pleasing smile possible, cost-effectively, comfortably, and on time. Furthermore, we use every possible means to ensure that our patients receive the best orthodontic care available world-wide.
Typically, the first consultation takes approximately 20 minutes at a fee of $60.00 (not including X-Rays). This is usually followed by a 20 minute appointment to get any other X-Rays that are required, photos and impressions (“records”) prior to final treatment planning at a cost of $240.00.
The appointment when braces are fitted usually lasts 60 to 90 minutes. Most of the following appointments, for adjustments and arch wire changes, will last 10 to 20 minutes each, and will be scheduled from 4 to 6 weeks apart depending on the movement we are trying to obtain, observed tissue reponse and the level of patient collaboration experienced. Most patients are school-aged children or working adults, so late afternoon appointments are the most popular. We therefore need to reserve afternoon appointments for monthly adjustments because these appointments are shorter and occur more frequently. Longer appointments to fit appliances are scheduled in the mornings to allow as many patients as possible the more desirable appointments after school.
Office Hours
Sax Dearing Orthodontics Limited has comfortable air-conditioned offices in Hastings, Napier and Masterton. Dr Dearing attends the Hastings office on Monday and Tuesday and the Napier office on Wednesday, Thursday and Friday. The office hours are 8.30 am to 5.00 pm each day at both locations. Appointments may be scheduled between 8.30 am and 4.40 pm each day. Each office is staffed by a senior nurse who can attend to administrative tasks or look after minor emergencies in Dr Dearing’s absence.
Dr Dearing also attends clinics in Masterton every second Friday. Once a month he stays over and has a Saturday morning clinic in Masterton as well.
Punctuality
Sax Dearing and his Staff pride themselves in running to time. This involves not spending more than the scheduled time with each patient, thus avoiding penalising the next. Late arrival erodes the time available to examine and or treat patient�s to acceptable standards. Please ensure you arrive slightly ahead of your scheduled appointment. We find refusing to see patients who arrive late embarrassing, and patients and parents find it frustrating. This is a situation beyond our control and we ask for your help in avoiding such incidents.
Telephone, Facsimile and E-mail
A receptionist is on duty from 8.30 am to 5.00 pm each day to answer your calls. The facsimile and telephone numbers are:-
Napier Tele/Fax: (06) 835 4998, Hastings Tele/Fax: (06) 878 7130,
Masterton Tele/Fax: (06) 377 7182
A 24-hour facsimile service is available at all offices. An answer-phone service is provided for any after hours calls which will be faithfully returned.
A/H: [64] (06) 878 3800, Fax:(06) 878 3830, Mobile:[64] 027 276 4725
E-mail: mirriam@saxdearing.co.nz
Sterilization
Today, we are all very safety conscious. With this in mind we want to advise you about our infection control and sterilization procedures. These are not new to our office and we have continuously upgraded our methods as new practice techniques and better equipment have become available. Our goal is to provide the highest level of safety and for you to feel comfortable knowing that these procedures are being routinely performed as recommended by the Dental Council of New Zealand. They include:
- Barrier controls including use of protective eye wear and new gloves for each patient.
- Steam sterilization of all heat stable tools and instruments after each patient, killing all organisms with pressurised steam.
- Disposable items are used whenever possible and are always discarded once used or exposed to the treatment environment.
- Disinfectants are applied to chairs, counter tops and other surface areas in all treatment rooms between patients.
We are committed to staying up to date with the best infection control, sterilization guidelines and equipment. When you visit our office, you can feel confident that you and the health of your family are protected.
New patients
An adult must accompany new patients under the age of 18 years for obvious medico-legal reasons
Extraction of teeth
One of the most disliked aspects of orthodontic treatment is that it very often involves the extraction of teeth to relieve crowding, increase anchorage and improve stability of the treatment result. The decision to extract teeth is a highly specialised judgment made on individual case analysis and is only recommended when it improves the prospect of successful treatment.
If the patient and/or parents refuse extractions, arch expansion may be used to reduce the crowding. However, the patient parent and orthodontist must accept a higher risk of relapse when expansion is resorted to. Nevertheless, to some this choice is preferable to extractions. It is simply a matter of informed consent that provides the patient and parents with choices and the responsibility of their decisions. If you are interested in the effects of arch expansion on the stability of treatment results please ask for a copy of a recently published article by Drs. Blake and Bibby in the American Journal of Orthodontics and Dentofacial Orthopaedics that reviews over 100 scientific papers about this fascinating subject.
Recently, TV programmes promoting the concept that extraction of premolar teeth �ruin faces� have been promoted. However under scientific conditions panels of lay people, dentists and orthodontists shown photographs of patients who have completed treatment could not differentiate between patients who had extractions and those who did not. This investigation has been replicated several times by different researchers producing similar results. The concept that extraction of premolar teeth �ruins faces� has thus been disproved.
You may ask why it is that the New Zealand Dental Association and Dental Council of New Zealand have not acted against dentists spreading such misleading information. That is a question that interests Sax Dearing also.
A little thought will lead you to the conclusion that there are just too many variables affecting profile such as late growth of the nose and chin, tonicity of lip musculature, and changing levels of tissue-fat to be able to reduce the issue to a question of simply extraction versus non-extraction treatment.
There are other issues. In patients who have all their third molars present (the “wisdom teeth”), the extraction of four premolars as part of orthodontic treatment increases the chance of the third molars erupting into functional occlusion without further assisstance to about 80%.
The reverse is also true. If premolar extractions to relieve significant crowding are not done, any patient developing a full complement of third molars has a very high chance of having to have these teeth surgically removed later in life. Anyone who has experienced that operation knows what an unpleasant experience that is. Third molar excision carries significant risks – possible jaw fracture, damage to the Inferior Alveolar Nerve causing numbness of the lower lip which can be permanent, and localised chronic osteomyelitis sometimes taking months to heal.
The slavish avoidance of orthodontic extractions carries significant long term risk and is most certainly not the panacea it is sometimes made out to be!
If interested, you can research this topic yourself by asking for copies of the following aticles from your local library.
“Smile esthetics after orthodontic treatment with and without the extraction of four first premolars”. Johnson, D.K. & Smith, R.J. American Journal of Orthodontics and Dentofacial Orthopaedics 1995; 108 (August): 162-167.
“A comparative study of facial profiles in extraction and non-extraction treatment”. American Journal of Orthodontics and Dentofacial Orthopaedics 1998; 114 (September): 265-276.
“Changes in soft tissue profile after orthodontic treatment with and without extractions”. Kocadereli, I. American Journal of Orthodontics and Dentofacial Orthopaedics 2002; 12 (July): 67-72.
“The decision to extract: Part 1 – Interclinician agreement”. American Journal of Orthodontics and Dentofacial Orthopaedics 1996; 109 (March): 297-309.
This is by no means and exhaustive list – but the reference sections at the end of each of these articles will identify many other references you can get if interested.
Sax Dearing believes that treatment planning should be based on the best available scientific information. At the end of the day it is the patient’s and/or parent’s choice to accept or decline the treatment advised. He can only hope and trust that his colleagues, patients and/or parents base their decisions on science rather than emotion.
Fees
Some practitioners offer free initial consultations in an effort to attract clients. However, I am confident that you will value my advice. Typically, the first consultation takes approximately 20 minutes at a fee of $65.00 (not including X-Rays). This is usually followed by a 20 minute appointment to get any other X-Rays that are required, photos and impressions (“records”) prior to final treatment planning at a cost of $195.00.
Treatment fees are estimated and cover the cost of the appliance, treatment to completion and any procedure that is carried out at this office during treatment. It does not include the initial consultation and radiographs, any general dentistry or oral surgery carried out by another practitioner which is needed during or related to the orthodontic treatment. The fee also covers one set of retaining appliances after the completion of treatment. The only reason for a change in the fee would be if we found that progress was being delayed by indifferent cooperation (missed appointments, poor oral hygiene, and undue damage to appliances).
To give you some idea of possible costs the fee range for Fixed Appliance treatment for space-maintenance or to counter finger-sucking and/or tongue posture habits range from $300 to $1000. Removable Appliance (plates) treatment to achieve simple tooth movements range between $500 and $1000. It is very difficult to quote for fees for comprehensive treatments with Fixed Appliances (braces) without seeing the patient first but these can range from between $3,700 for a single arch (one jaw), between $5,500 and $6,800 for two-arches and up to $7,000 for treatment that includes jaw surgery.
Payment
It is not essential that the total fee be paid prior to the braces being fitted. Below is an example of how we usually charge our fees. This method can be varied by negotiation provided the matter is discussed prior to appliances being fitted.
EXAMPLE (with average fee)
Total fee (including GST) $5,900.00
Initial payment due when braces are fitted $2,300.00
The balance of $3,600.00 is arranged in nine payments of $400.00 at intervals of two months. This extends the payments out over an 18 month period which is an average period for treatment. Amounts can be varied by negotiation before treatment starts.
For your convenience we have facilities to receive payments made by Eftpos, major credit cards, automatic bank payments, personal cheques, or cash.
If you cannot afford to pay the deposit in a lump sum, automatic payments as little as $65.00 per week are acceptable. In this case, the start of treatment is delayed until a credit equal to the deposit has been accumulated.
Fees for treatment in Masterton are set slightly higher than elsewhere to balance travel and accommodation costs.
Languages
Day to day conversations in our practice are conducted in English. One of our staff members is Thai and is immediately available to act as an interpreter. Interpreters for Maori, most other South East Asian, and some European languages can usually be arranged by appointment.
Complaints
If you have any complaints about your treatment please inform us immediately. We believe that our responding positively to your concerns results in an improved service and in turn, a more successful practice. Experience has taught us that most problems result from misunderstanding on both sides and are easily corrected by discussion. We welcome your contacting us about any problems that may arise. You can contact us using the feed back form in the “Contact-Us” page if you wish. If you need help communicating with us contact the Health and Disability Commissioner’s Office PO Box 1791, Auckland.
Tele: 0800 11 22 33;
Web-site: http://www.knowledge-basket.co.nz/hdc
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