#125 Kieferorthopädie: Beratungsgespräche mit Eltern – Orthodontics: Consultations with Parents

00:00:03: Sabine Nemec: Herzlich willkommen zu Dental English to go. Ich bin Sabine Nemec und lade Euch ein, mit diesem Podcast Euer Englisch aufzufrischen. Ich möchte Euch zeigen, dass es ganz leicht ist, sich im Praxisalltag auf Englisch zu verständigen. Jede Woche schauen wir uns eine bestimmte Situation in der Zahnarztpraxis an und trainieren/üben die passenden Vokabeln und die richtige Aussprache. So here is your weekly dose of language refresher.

00:00:33: In today’s lesson, we will talk about orthodontics and how to consult parents on braces for their children. So, let’s start! In a pediatric orthodontic consultation, there are typically three people in the room: the orthodontist, the parent or guardian, and the child. Each has different needs. Bei einer kieferorthopädischen Beratung für Kinder befinden sich in der Regel drei Personen im Raum: der oder die Behandelnde, ein Elternteil oder eine erziehungsberechtigte Person sowie das Kind. Jede dieser Personen bringt unterschiedliche Bedürfnisse mit. The parent wants to understand what the problem is, whether treatment is truly necessary, what it involves, how long it takes, and how much it costs. The child wants to know whether it will hurt, whether it will look obvious, and whether their friends will notice. The orthodontist’s job is to address all of these concerns — thoughtfully and in the right order.

00:02:00: Opening the Consultation: A good orthodontic consultation starts with a warm, unhurried welcome and an open question that invites the parent to share what has brought them in today. "Thank you for coming in today. Before I share my findings, could I ask — is there anything specific that has been concerning you about your child's teeth or bite? Sometimes parents notice things that are really important for us to know." Parent’s answer: "Well, I've noticed that her front teeth are quite crooked, and her dentist mentioned something about an overbite. I wasn't sure if she needed braces yet or whether we should wait." Answer: "Those are both really valid observations and exactly the kind of things we'll be looking at today. Let me take you through what I've found, and then we can talk about the options together."

00:03:20: Explaining the Clinical Findings: When presenting clinical findings to parents, the challenge is to be accurate without being overly technical: "Looking at your daughter's teeth and jaw, I can see a few things worth discussing." "Firstly, the upper front teeth are quite crowded — there isn't quite enough space in the jaw for all the teeth to sit in a neat row. This is very common and very correctable." "Secondly, I can see that the upper jaw is sitting slightly forward relative to the lower jaw — we call this an overbite. At her age, this is actually an ideal time to address it because her jaw is still growing, which gives us a real opportunity to correct it without surgery." "Thirdly — and this is the good news — her oral health is excellent, her permanent teeth are coming through in the right order, and there are no missing or extra teeth. We have a really solid foundation to work with."

00:04:48: Timing: One of the most common questions parents ask is: does my child need treatment now, or can we wait? The answer depends entirely on the type and severity of the orthodontic problem. Here are some useful phrases for discussing timing: "The timing of orthodontic treatment is really important. Some problems are best addressed early — during the growth phase — because we can use the jaw's natural growth to our advantage. Other problems are better treated once all the permanent teeth have come through, typically around twelve to thirteen years of age." "In your son's case, I'd recommend we start treatment now, at age ten, with a removable functional appliance. His lower jaw is still growing, and this appliance will help encourage it to grow forward into a better position. If we wait until he has stopped growing, correcting this jaw discrepancy would require much more complex treatment — and potentially jaw surgery in the future." "For your daughter, I'm going to recommend a watchful waiting approach for now. Her crowding is mild, her bite is good, and her last few permanent teeth haven't come through yet. I'd like to review her in six months — at that point, we'll have a much clearer picture of how things are developing and whether braces are needed." "Not every child needs orthodontic treatment, and not every crooked tooth needs to be corrected. We only recommend treatment when there is a genuine clinical benefit — or when the child themselves is bothered by their smile and wants to make a change."

00:07:40: Explaining Options: The next step is to explain the treatment options: "For your son, I'm recommending a two-phase approach. In the first phase — which we would start now — he would wear a removable appliance called a Twin Block. It fits a bit like a gum shield and works by holding the lower jaw slightly forward, encouraging it to grow into the right position. He'd wear it full-time — day and night — except when eating and cleaning his teeth." "Once that phase is complete — usually after nine to twelve months — we'll have a review and assess whether fixed braces are needed to fine-tune the alignment of the individual teeth. Many children in phase one need a shorter and simpler course of fixed braces in phase two as a result of the early treatment." Parent’s question: "Could she have the invisible ones — the clear aligners — instead of metal braces?" Answer: "That's a question we get a lot! Clear aligners can work very well for some patients, but for children and teenagers, fixed braces are generally more reliable and give us more control over complex tooth movements. That said, there is a teen version of clear aligners that works well for older teenagers with good compliance. Let me explain both options so you can weigh them up together."

00:09:38: Addressing Common Parent Concerns: Parents will often have a range of concerns that may or may not be directly related to the clinical recommendation. Question: "Will it hurt?" Answer: "Most children experience some tenderness for a day or two after each adjustment appointment — the teeth can feel a little achy as they're being moved. This settles down quickly, and over-the-counter painkillers and soft foods help. The brace itself shouldn't cause pain — though it may take a week or two for the cheeks and lips to adjust to the feeling of having something new in the mouth." Question: "How long will it take?" Answer: "Treatment time varies depending on the case. For a straightforward case of crowding, we're usually looking at twelve to eighteen months of fixed braces. For more complex cases involving the jaw as well as the teeth, total treatment time including both phases can be two to three years. I'll give you a more precise estimate once we've confirmed the treatment plan." Question: "Will the braces affect her school life or her sport?" Answer: "Not significantly. She'll be able to continue all her activities as normal. If she plays a contact sport, we'd recommend a mouth guard to protect both the teeth and the brace." Question: "What happens if she doesn't have treatment?" Answer: "That's a really important question and I appreciate you asking it. If we leave the jaw discrepancy untreated now, the window for using growth to correct it will close as she finishes growing. At that point, correcting the bite would require either very complex orthodontic treatment combined with compensations, or jaw surgery as an adult. Neither of those outcomes is inevitable, but they become more likely. That's why I'm recommending we act now while we have the best opportunity."

00:12:28: Involving the Child in the Decision: Orthodontic treatment only works if the patient is motivated and cooperative — and that motivation must come from the child as well as the parent. Here is how to bring the child into the conversation: "Now — I've been talking to your mum a lot, but I'd really like to hear from you. What do you think about your teeth? Is there anything you'd like to change about your smile?" Child: "I don't like how my front teeth stick out. Some kids at school have said things about it." Answer: "Thank you for telling me that — that's really important. The good news is that's exactly what we can fix. And I promise you — lots of children your age wear braces, and most of them say it's worth it when they see the result at the end. Would you like to see some photos of patients who have had similar treatment?"

00:13:45: Here is your overview of the vocabulary of this week’s lesson: to vary – differieren; to wear – etwas tragen; inevitable – unvermeidbar; straightforward – einfach, unkompliziert; achy – schmerzhaft; tenderness – Druck- oder Schmerzempfindlichkeit; braces – Zahnspangen; opportunity – Gelegenheit; full-time – ganztägig, rund um die Uhr; neat row – schöne Reihe.

00:14:45: Das war unsere Lesson für diese Woche. Nächste Woche gehen wir zurück an den Empfang und befassen uns mit den unterschiedlichen Patientengruppen, die in eine Praxis kommen. Wenn Ihr noch mehr Dental Englisch trainieren wollt, empfehle ich Euch mein Buch „Dental English“, erschienen im Quintessenz Verlag, oder auch die Fachzeitschrift „Team Journal“ – hier findet Ihr in jeder Ausgabe eine Übung. Vielen Dank fürs Zuhören. Wenn es Euch gefallen hat, dann abonniert diesen Podcast. Es gibt jeden Montag eine neue Folge – überall, wo es Podcasts gibt. Wenn Ihr Fragen habt, dann schreibt auf Instagram oder an podcast@quintessenz.de. Alle Links und Adressen findet ihr auch in den Shownotes. Ich sage: Goodbye and see you next time! Das war Dental English to go mit Sabine Nemec: der Englisch-Podcast für den Praxisalltag – ein Quintessence Podcast.