Orthotown November 2017 - 16
message board
justinudm
Member Since: 09/29/14
Post: 10 of 16
I'm sorry I disagree with this. I will never put a chance to make money above the truth. My
job as a specialist is to educate the public in my town or city. Said another way, my job is to tell
the patient and parents what they need to hear, not what they want to hear ... different strokes
for different folks. ■
9/4/2017
emac
Member Since: 11/21/11
Post: 12 of 16
I look at every patient as if they were my child. I know that sounds corny, but that is really
what I do. I think it takes the bias out of the equation.
In these cases, I tell them braces alone do not correct skeletal issues, and skeletal issues are
corrected with surgery, after growth (18-21) is completed. Most, if not all, insurance will not
cover surgery. That is my reality, yours may vary. Knowing this, we will correct the teeth as much
as possible at this time. If we aren't happy, then we will consider surgery or other options later in
life. I tell them if we do the surgery, I will set the case up for little to no cost. I think surgery is
worth mentioning, but it can't be done for many years. What do you do in meantime? You have
a growing motivated patient. Put some braces on. If surgery is 100 percent off the table, then we
discuss other options. ■
9/5/2017
justinudm
Member Since: 09/29/14
Post: 13 of 16
I line up the upper and lower arches, give the patient a pleasant smile for now and then do
surgery later. But a Herbst, Mara, whatever is not gonna fi x this child. So, tell them the truth.
As for surgery not being covered, that's not always true. The surgeon I use always writes this
up from a functional standpoint, not an aesthetic standpoint. We have a high success rate of
getting approval. We tell patients in advance we may have to file several appeals but we will likely
get it, so don't let medical insurance determine what should be said to the patient.
Again, these are my thoughts, your opinions may vary and that's all right. ■
9/5/2017
davidharnick
Member Since: 08/28/02
Post: 14 of 16
We all have to make these decisions. Here is a case I just finished this morning. It was a surgery
case and still is. However, this family cannot possibly do the surgery and this child desperately
wanted a better smile. I can get kids like this to wear headgear so that is what I did. I just got a
hug from the dad and the kid is beaming. Maybe not so bad?
I choose to do nonextraction on these cases to leave all options on the table. ■
9/5/2017
Have a similar case?
Search: "Nonsurgical"
Discussing surgery with young patients and their parents can be daunting. Have you dealt
with a similar case? To share your cases and advice, head to orthotown.com and search
"nonsurgical"-this message board will be the top result.
16
NOVEMBER 2017 // orthotown.com
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