Evaluating the co-delivery of orthodontic treatment by dentists and orthodontic therapists

Introduction: The first orthodontic therapists (OTs) registered with the General Dental Council in 2007. There has been limited research around the role of OTs in the last five years, and the barriers and enablers to effective working practices between OTs and supervising clinicians (SCs) have not previously been investigated.
Aim: To establish how orthodontics is currently co-delivered by OTs and SCs, and to explore clinicians’ perceptions of these working arrangements.
Objectives: To establish:
- The working arrangements of OTs with SCs.
- Clinician perceptions of their contribution to patient care.
- Clinician perceptions of the barriers and enablers to co-delivery of treatment by orthodontists and OTs.
Study design: Cross-sectional survey using an online questionnaire.
Method: A link to the online questionnaire was emailed to all members of the British Orthodontic Society and Orthodontic National Group and was posted in two Facebook groups. Reminder emails and Facebook posts were sent.
Results: A total of 161 responses were received from 89 SCs and 72 OTs. Most worked in primary care as their main clinical role. Most OTs in primary care provided a mix of NHS and private care. Appointments with OTs were most likely to be supervised every other visit, with more frequent supervision reported by SCs, and by clinicians in secondary care. A total of 63% of OTs reported being supervised remotely at times. OTs and SCs disagreed about the barriers and enablers to effective working practices: whilst OTs reported improved patient satisfaction as the main consequence of their utilisation in the orthodontic workforce, SCs described improved clinical efficiency.
Conclusion: OTs are generally working within their scope of practice, although some respondents indicated a desire for this to expand. Remote supervision has been reported for the first time. More research is needed to explore the working relationships between OTs and SCs.