In my clinical experience I have realized that we put a lot of extra effort resolving repair issues of orthodontic appliances. If you see 30 patients a day and have 3 emergencies (patients needing repairs), it means for every 10 days you work, you are putting in an additional day to take care of such patients. When we look at the lost production that repair appointments cost, it is worth your time to determine what can be done to avoid them.
Physically checking and double-checking the ends of arch wires at the end of every appointment (even emergency visits) saves unnecessary visits to the office. Turning the distal ends of arch wires during space closure will allow the patient to go longer between appointments. Using bumper tubing where there is a long inter-bracket distance and orthodontic wax can make the patient more comfortable and can also save a call or return visit. Banding and bonding upper arch initially and waiting for the lower arch after a month allows patients to adapt to orthodontic fixed appliances more easily.
These are just few suggestions that can be considered for orthodontic practice and are learnt through experience, only if a regular clinical audit is carried out and repair appointments are highlighted, critically analyzed and protocol devised to reduce them as every practice has its own dynamics and problems.
Professor Ulfat Bashir