The British Orthodontic Society Clinical Effectiveness Bulletin No.33 November 2014 Clinical Governance Directorate of the British Orthodontic Society Director’s Remarks Moving House! lthough this is the autumn edition of the 1st Prize Clinical Effectiveness Bulletin, I think there An audit of compliance in Orthodontics with has been something of a spring clean within Department of Health 2007 “Smokefree and A Smiling” guidance. the editorial ranks. This edition has been jointly produced by Kate House, the outgoing editor, and A.McMullin and S. Caldwell (University Dental Jadbinder Seehra, our new incoming editor. The Hospital Manchester). team have worked hard to produce an excellent Bulletin with an interesting range of articles. There 2nd Prize are some familiar themes again, patient satisfaction Use of the PAR index to assess outcomes of and multidisciplinary care, but some more varied orthognathic surgery in cleft lip and palate patients. projects looking at the periodontal health of our C. Rolland (VT dentist), C. Chambers (Bristol patients and their dietary habits, reflecting the wider Dental Hospital) and S. Deacon (Frenchay Hospital scope of our practice. and Bristol Dental Hospital). Knowing that audit is strong within our specialty, 3rd Prize I was interested to read that the Healthcare Quality Orthodontic treatment and orthognathic surgery – Improvement Partnership (HQIP), the organisation do we predict the length of treatment accurately? tasked with promoting quality in healthcare, in C. Dunbar, G. McIntyre (Dundee Dental Hospital) particular increasing the impact that clinical audit and S. Laverick (Ninewells Hospital, Dundee). has on healthcare quality in England and Wales, recently promoted its second ‘Audit Awareness Many congratulations to all the winning authors. I Week’. This initiative is aimed at encouraging know it is a difficult task selecting winners with the engagement of staff at all levels in clinical audit number of high quality reports that are submitted within the workplace. Although this is aimed and published. I would like to thank all the authors principally at the medical field, it is an idea that for continuing to support this publication and the we could embrace within our specialty. I think we editorial board and referees for all their hard work in are ahead of our colleagues in this area and I am its production. pleased to see articles both from practitioners based in primary and secondary care. Within the Society I’ll finish by wishing Jadbinder every success in his the Audit committee is always thinking of ways to term as Editor and thanking Kate for all her hard increase audit’s relevance and impact. We would work over the past three years. I know that Kate has welcome ideas from members of how this could be left the Bulletin in safe hands. enhanced. Nikki Atack The BOS Clinical Audit Prizes were announced at Director, Clinical Governance the BOC in Edinburgh. The winners were chosen from the last two issues of the CEB and were awarded to: Editor’s Cut This is my first editorial as the new Editor of the BOS Clinical What does the future hold for the Bulletin? First and foremost I hope Effectiveness Bulletin. I would like to begin by thanking my very much to continue the success of this publication and continue predecessor, Kate House, for her tremendous hard work and effort. I the great work of my predecessors. I am aware of the responsibility am sure we would all agree under Kate’s stewardship the Bulletin has that comes with this role and I hope that I do not disappoint. I will be gone from strength to strength resulting in a high quality publication exploring options to further improve the submission process, overall reflecting the excellent clinical standards practised by orthodontic format and content of the Bulletin. If any member of the Society has clinicians within the United Kingdom. On a personal note, I would any thoughts and ideas, please feel free to contact me. also like to thank Kate for showing me the ropes and ensuring a BOS Clinical Effectiveness Bulletin Editorial Board smooth handover and transition. Celtic Regions I would also like to thank both Gavin Mack (South-East) and Amreen Liz Turbill ([email protected]) Ahmad (Northern) for their hard work and contribution to the success of the Bulletin. Both Gavin and Amreen, who will be leaving their Northern England positions on the editorial board, have excelled within their roles Amreen Ahmad ([email protected]) as regional sub-editors. New sub-editors for these regions will be South West and Midlands appointed in due course. I look forward to working with the existing Christian Day ([email protected]) and new editorial board members who I am sure will further enhance South East the reputation of the Bulletin. Gavin Mack ([email protected]) The success of the Bulletin is also dependent on the numerous Post- TGG representative CCST trainees across the country who undertake peer-review of Rachel Stephens ([email protected]) articles. I have found these reviews to be conducted in a careful and diligent manner and I would like to thank you all for your continued Ann Wright ([email protected]) support and excellent reviews!! This is greatly appreciated. Lastly, Jadbinder Seehra the Bulletin would not be in circulation without the numerous high Editor BOS Clinical Effectiveness Bulletin quality articles submitted for publication by members of our Society. The effort made by clinicians to report standards of clinical practice Department of Orthodontics and improve clinical effectiveness is impressive. I would strongly Kings College Hospital NHS Foundation Trust encourage all members of the orthodontic team in both primary and Denmark Hill, London secondary care to consider submitting their articles to the Bulletin. [email protected] In this issue…. 1. An audit of functional appliance treatment. C. Dunbar, 10. Documentation of the Basic Periodontal Examination scores as K. Mouton-Manhem, C. Harper. Royal Berkshire Hospital, part of the orthodontic examination for new patients: Reading A two-cycle audit. A. Hindocha , N. Patel, J. Turner, S. Visram. Birmingham Dental Hospital 2. New patient satisfaction. S. Nandhra, S. Power, E. Thickett. Royal Bournemouth Hospital 11. An audit on patient experience following orthognathic surgery. M.W Tang and A. Dibiase. William Harvey Hospital, Ashford, Kent 3. Patient satisfaction with Croydon MDT dento-alveolar clinics. L. Khamashta-Ledezma, Z. Kordi, J. Radecki, L. Davenport- 12. A regional audit of orthognathic service provision and Jones, M. Chia. Croydon University Hospital treatment duration. A.Tsichlaki1, S. Ward2. University Dental Hospital Manchester1, Royal Blackburn Hospital2 4. Retainers - What retainers? Patients understanding of orthodontic retention: A multicenter audit. J. Flanagan, 13. Audit of patient dietary habits. S. L. Stephens, R.M. Stephens, S. Kotecha, J. Panesar. Birmingham Dental Hospital S.J. Cunningham and F.S. Ryan. Eastman Dental Hospital UCLH Foundation Trust and UCL Eastman Dental Institute 5. An audit to assess the number of inappropriate referrals to a primary care specialist orthodontic practice. P. Raval. Peace 14. Clinical audit of patient oral hygiene measures. R.M. Stephens, Children’s Centre, Watford S.L. Stephens, S.J. Cunningham, F.S. Ryan. Eastman Dental Hospital UCLH Foundation Trust and UCL Eastman Dental 6. Occlusal outcomes for patients undergoing orthognathic Institute surgery in Devon and Cornwall. M.Moore, K. Drage, A. Jerreat, K. Postlethwaite, R. Robinson, A. Smith, N. Wenger. 15. Re-Audit of Orthodontic Model Boxes. F. Ahmed, H. Mazey. South West Regional Orthodontic Audit Group (Southern University Dental Hospital Manchester Section) 16. An audit of instrument decontamination standards and barcode 7. Orthognathic surgery precision - A retrospective audit of sticker usage in a London teaching hospital orthodontic planned and actual movements during maxillary surgery. department. L. Tabrett, H. Ling, P. Acharya. Eastman Dental 1 2 2 1 H. Barry , P. Shah , H. Popat and A. Cronin . University Hospital, London Dental Hospital, Cardiff & Vale University Health Board1 and School of Dentistry, Cardiff University2 17. A re-audit of the use of fluoride mouthwash in orthodontic patients. M. Storey, L. Mitchell. St Luke’s Hospital, Bradford 8. Orthodontic mini-screw effectiveness in Leeds. S.K. Barber, D.O. Morris. Leeds Dental Institute, Leeds, UK 18. A General Practice Based Audit of Orthodontic Extraction Letters. J. McGarry. McGarry’s Dental Practice, Lisnaskea, 9. A regional audit to assess the surgical re-exposure rates of Co.Fermanagh, N.Ireland ectopic palatal maxillary canines. A. Gill1, R. Valiji Bharmal1, T. McSwiney1, M. Palarajah 2, B. Bagdadi3, C. Campbell1. John 19. An audit of patient satisfaction among lingual orthodontic Radcliffe Hospital, Oxford1, Heatherwood and Wexham Hospital, patients. R. Paul Cheruvathur, H. Patel. The Liverpool Brace Slough2 and Stoke Mandeville Hospital, Buckinghamshire3 Place, Liverpool 2 1 AN AUDIT OF FUNCTIONAL APPLIANCE TREATMENT C. Dunbar, K.Mouton-Manhem, C. Harper. Royal Berkshire Hospital, Reading INTRODUCTION Overbite. Functional appliances are frequently used in the United Centreline. Kingdom for treatment of Class II malocclusions1,2. A successful outcome is strongly dependant on patient METHODS compliance, appropriate case selection and subsequent timing This was a retrospective audit completed at one district general of treatment2.