Orthotown April 2021 - 30

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Broken Bracket Emergencies
Townies share how their teams help set expectations for patients with broken brackets

Ortho965
Member Since: 08/29/17
Post: 1 of 15

How do you handle broken bracket emergencies where you can't put the bracket back on during
the appointment, but the patient/parent insists you put it back on at the emergency appointment?
We explain at bonding that a broken bracket without discomfort is not an emergency, but
patients still come in and expect the bracket to be placed back on during the emergency appointment.
How do you explain you won't be putting the bracket back on again to the patient/parent without
them throwing a fit and complaining? If you cannot replace the bracket at the emergency visit,
and the parent or patient is upset by this, what do you say? ■

1/30/2020

justinudm
Member Since: 09/29/14
Post: 2 of 15

I can't speak to how anyone else deals with this, but my front desk worked with me clinically
for 4.5 years before going up front. (You want a front desk with clinical expertise for scheduling,
in my opinion.) Because of her experience, she knows when something needs to be seen and when
it's not a true emergency.
For instance, if it's O-ties with a broken posterior bracket and the patient has an appointment
in less than a week. She tells the parent we will fi x it at the next appointment. If it's a broken front
bracket with power chain that could cause a tooth to rotate, she tells them to bring the patient
over the next morning.
I think what you need to do is type up a flow chart of questions your front desk needs to ask
to determine what needs to be done.
Worst case, I tell the parent to take a picture and text it to me so I can tell them what I think
needs to be done. I hope this helps in some way. ■
1/30/2020

fesdds
Member Since: 05/22/08
Post: 3 of 15

1. I agree with Justin: Make sure your staff knows how to distinguish the need to get them
in ASAP versus the ability to wait for a convenient time.
2. 99.99% when a patient comes in due to a loose bracket, we fi x then, whether it is 1 or 5. It
does not benefit the office to just take the bracket off and fi x at another time. It just takes longer
that way. The exception is when someone comes in when I am out of the office. The staff will
tell them we will remove brace and get them comfortable, but they will need to return for me to
be there when placing bracket again. ■
1/30/2020

ucla98
Member Since: 09/28/07
Post: 4 of 15

Instead of wasting time to explain things and to argue with the parents, I repair all loose
brackets the same day. To maintain a smooth clinic flow, I make the patient who has loose brackets,
wait for 20-30 minutes so the staff can quickly treat the ones who don't have anything loose
first. It only takes 5-10 minutes to treat people without loose brackets. From having to wait for
the brackets to be repaired, the patients should learn to be more careful with their appliances.
To minimize the problem, I band all the molars. ■
1/31/2020

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