Please introduce yourself
Hello, I’m Iain Hoeltschi, specialist orthodontist and owner of Splash Orthodontics in Brighton & Hove.
How would you describe the patient experience at Splash Orthodontics?
We’re a small friendly team, and we want our patients to feel comfortable and supported at every visit. Everyone is provided with a personalised experience, from their choice of brace to their music selection.
We enjoy going the extra mile for our patients. We’ve even been known to remove braces mid-treatment for special occasions such as weddings.
What should adult patients consider when thinking about orthodontic treatment?
Adults are very unlikely to qualify for NHS treatment, so an important consideration will be the cost of braces. Most orthodontists offer monthly payments and interest-free finance.
The orthodontist’s experience is another crucial factor. What training have they had, how many cases have they treated, do they offer a choice of braces? Appointments are typically every 6–8 weeks and the average treatment time is 12–18 months, so a convenient location will be beneficial.
After braces, retainers need to be worn for life to keep teeth straight. Orthodontic treatment should always include aftercare.
What are the advantages and disadvantages of orthodontic treatment as an adult?
There are some misconceptions surrounding orthodontic treatment for adults. While it’s often easier to treat individuals that are still growing, adults can absolutely benefit from braces and achieve exceptional results.
Older patients are more likely to have restorations such as crowns and implants, but usually, we can work around these. Sometimes adults’ teeth move slightly slower, but the difference is often negligible.
For many adult patients, orthodontics provides a less invasive alternative to treatments such as veneers and crowns.
How would you reassure a nervous patient?
I’d start by finding out why the patient feels nervous. It’s not always obvious, and they might be concerned about one specific aspect of their treatment. Once we know the cause of their anxiety, we can offer advice, slow things down and alter their treatment plan to help.
Some patients worry about their braces hurting, so we use very light wires to begin with. Others are apprehensive about extractions, so we find ways to avoid them. It’s always rewarding to see nervous patients become more confident during their visits.
What advice would you give to someone thinking about using aligners to straighten their teeth?
Aligners should be worn for at least 20 hours a day, so they’re a big commitment for some patients. They can be used to treat a wide range of concerns, but they still have a few limitations. For example, they can’t treat deep bites as effectively as fixed braces. However, some cases are better suited to aligners, for example, open bites.
Most patients will need interproximal reduction (IPR) before or during their aligner treatment. IPR involves carefully removing minimal amounts of enamel from between specific teeth. It has been carried out for decades and providing it’s done correctly, it’s very safe.
Aligners can be removed for brushing and flossing, making them an excellent choice for anyone with oral hygiene concerns.
What makes a great patient?
The best patients are committed to their treatment and aware of their responsibilities. Especially if they’re wearing aligners, where compliance is the most significant indicator of success.
The same qualities apply at the end of treatment. Retainers should be worn indefinitely to maintain the results of orthodontic treatment.
What happens at a typical adjustment?
We’ll check in with the patient to see if they have any questions or concerns. Then we’ll review their progress relative to our plan and see if any milestones are approaching.
During the appointment, we’ll make any necessary adjustments to the patient’s teeth and braces. We’ll explain everything we’ve done and provide any instructions that need to be followed at home. There’s always time for more questions at the end of the appointment.
What are the developments in orthodontics that you are most excited about?
Patient Monitoring is an exciting area that will allow us to keep in touch with patients between appointments through an app. Another development that benefits both orthodontists and patients is 3D printing. It’s now possible to print removable retainers in-house!
What advice would you give to someone thinking about ‘direct to patient’ orthodontics?
When you’re dealing with biological systems, there’s a large amount of variation. It’s essential to provide a comprehensive examination and physically monitor cases closely. It’s my understanding that this doesn’t always happen when treatment is provided online.
What meal would you cook for a patient who has just had their braces fitted?
Fondue! In recognition of my Swiss roots. With some soft foods for dipping.
Thank you Iain for this interview, it’s been great learning more about the patient experience at Splash Orthodontics.
If you would like to contribute an interview to my blog, I would be delighted to hear from you.