Category Archives: Risk Management

Noncompliant patients

From: Utley3 <>
Subject: noncompliant patients
Date: Monday, February 28, 2011, 8:02 AM


I just finished reading an article in The Bulletin about treating noncompliant patients.  The authors suggested that the orthodontist was too agreeable with the parents in allowing treatment to continue despite his poor oral hygiene.  They note that if the orthodontist would have terminated treatment after “a few months”, the parents would have been more accepting of his decision to terminate treatment.  It seems to me that we are required to be clairvoyant in situations like this.  I have fought the oral hygiene battle for many years.  Most of the time, I win, but not always.  If I were to have terminated treatment after just a few months on every poor brusher, many patients would not have their malocclusion corrected today.  Besides, in the vast majority of cases I have treated with poor oral hygiene, the worst “damage” can be repaired with conservative measures (enamel microabrasion, composite restorations…etc)  I think that is better than leaving someone with a 10 mm overjet with no decalcifications.  It is obvious in hindsight what the orthodontist in the article should have done, but we have to make judgements in the present.  Clearly, in a small percentage of patients, treatment should be terminated, but the guidelines in this article would apply to a significant percentage of my patients.
Kevin C. Utley