If you disagree with the proposed NEVER EVENT please tell us why. This is a very important part of the survey. If you agree, no comment is necessary. Thank you for completing this survey! 

Question Title

* 1. Orthodontists should NEVER be treating the wrong patient. (Many practices treat multiple patients with the same name. The doctor should always be treating the patient corresponding to the treatment chart he is viewing.)

Question Title

* 2. Orthodontic treatment should NEVER be started without first establishing a
definitive treatment plan.  (This includes “therapeutic diagnosis” for a limited period of time to test if a proposed approach is viable.  It does not negate the fact that in any given case, the original treatment plan may have to be changed as treatment progresses.) 

Question Title

* 3. Orthodontic treatment should NEVER be started without first reviewing a patient’s medical history including any medications being taken. (Patients who present with certain underlying medical conditions or who are on a specific  pharmacotherapeutic regimen, e.g. Bisphosphonates, may need to have their treatment plan or goals modified.)

Question Title

* 4. Radiographs should NEVER be acquired without first evaluating the need for that film’s acquisition.
(Utilizing “standing orders” for a panoramic film as part of an initial exam is acceptable provided the practitioner has first determined that no other radiographs exist that negate the need to acquire this film)

Question Title

* 5. Radiographs, once taken, should NEVER be unread or unanalyzed. (If a determination was made that an image was needed, it should be evaluated.)

Question Title

* 6. The practitioner should NEVER specify an unintended tooth to be extracted.
(While the incorrect tooth may be extracted by referred to practitioners, orthodontists should not be ordering the incorrect tooth to be extracted.)

Question Title

* 7. Patients should NEVER be treated unless the provider is wearing PPE that is appropriately related to the procedure being performed.  (The use of PPE should reflect the degree of protection required relative to the procedure being  performed. For example, fluid impervious gowns would not need to be worn when performing an initial screening exam where only a tongue depressor was being used.)

Question Title

* 8. Other than in emergency situations, treatment should NEVER be initiated on minor children without the consent / informed consent of the parent or legal / custodial guardian.  (Someone other than the legal / custodial guardian, like an underage older sibling, aunt, nanny, etc. does not have legal standing to be able to grant consent / informed consent to treatment for the child.)

Question Title

* 9. Patients should NEVER be exposed to excessive or additional radiation unless there is a clear indication of the need for the additional radiographic imaging. (An example of this would be routinely acquiring CBCT imagery for all new patients. CBCT acquisition would be appropriate if the initially acquired 2D images are inconclusive or do not provide sufficient diagnostic information.)

Question Title

* 10. All patients and personnel working in the facility where treatment is being provided should NEVER be subjected to sexual harassment or a hostile work environment. (To be considered a hostile work environment the owner / manager of the facility must first be made aware that such an untoward occurrence is happening; or, has happened and has the potential to be repeated.)

Question Title

* 11. Except in emergency situations, in-office treatment should NEVER be rendered by untrained or unlicensed personnel or by those exceeding the scope of services they are allowed to perform.  (The statement refers to all in-office non-emergency situations.)

Question Title

* 12. Treatment should NEVER be initiated or continued if the patient has active and / or untreated periodontal disease. (Specific limited clinical conditions such as emergencies, sporadic / episodic marginal gingival inflammation or hypertrophies, functional impairment, OR cases that are being concurrently treated with a periodontist the general dentist are not included in this statement.)

Question Title

* 13. Orthodontic treatment should NEVER be continued if the patient’s lack of cooperation results in the risks of any potential harms outweighing the potential benefits to be obtained. (Orthodontic therapy carries a number of potential risks / harms.  An orthodontist should not be complicit by allowing a patient to injure himself due to the patient’s non-compliance.)   

Question Title

* 14. Orthodontic treatment should NEVER be initiated without first conducting an appropriate clinical exam. (An appropriate clinical exam is based on the patient’s clinical presentation and is a diagnostic and treatment planning pre-requisite to the initiation of any comprehensive orthodontic treatment.)

Question Title

* 15. Root resorption should NEVER go undiscovered during the course of treatment. (While some degree of root resorption is a common side effect of orthodontic therapy, and is not indicative of negligent treatment, it is easily discoverable during mid-treatment. This statement does not encompass situations where the patient refuses mid treatment radiographs or where treatment is limited in scope or in time)

Question Title

* 16. Patients should NEVER be intentionally misled regarding the diagnosis, treatment plan, the mechanics to be used, and the expected benefits or outcomes in regard to undergoing orthodontic treatment. (As most orthodontics is elective in nature, patients should never be coerced, misled, or mis-educated into accepting treatment.)

Question Title

* 17. A patient’s treatment should NEVER be “placed on hold” for an “extended period of time” because of non-clinical or financial reasons. (In those situations, treatment should either be actively continued, discontinued, or the doctor patient relationship terminated for those patients who are experiencing non-clinical or financial issues. Placing patients on hold or refusing to appoint them should only be condoned when there is a clinical basis to support such actions.)

Question Title

* 18. Patients should NEVER contract a communicable / transmissible disease in the orthodontic office. (Universal precautions coupled with office policy regarding providers and staff who are ill should protect the public from also becoming ill.)

Question Title

* 19. Orthodontists should NEVER allow the patient to harm himself because of the patient’s refusal to accept referral for required ancillary care.  (Patient’s cannot accept the responsibility for an untoward result by allowing a doctor to render inappropriate or negligent treatment.)

Question Title

* 20. Patients should NEVER be treated differently because of the source of payment for their treatment. (Patients who are on Medicaid or other 3rd party payer plans cannot be treated differently because the amount of compensation the doctor will receive might be less.)

Question Title

* 21. Orthodontic treatment should NEVER be performed unless a patient is wearing protective eyewear. (This statement does not include an initial screening examination or the acquisition of orthodontic records.  It does relate to all active treatment visitations.)

Question Title

* 22. Treatment should NEVER be initiated on transfer patients without appropriate records  being acquired prior to commencing treatment.  (This statement relates to all clinical or administrative data, whether from the previous practitioner and / or data that the new practitioner deems necessary in order to continue rendering treatment to the patient.)

Question Title

* 23. A patient’s orthodontic treatment should NEVER be compromised as a result
of lost or missing data. (This statement does not include the occasional misplaced radiograph or photograph but is related to the concern that all required patient data should have been acquired, be readily available, and appropriately “backed-up”.)

Question Title

* 24. Orthodontic patients and their guests should NEVER be subject to injury as a result of neglect or disrepair of the clinical premises. (Whether the office space is owned or leased, the premises should not pose a hazard to those visiting or working in the facility.)   

Question Title

* 25. Orthodontists should NEVER fail to follow up with third party communications relating to the treatment or overall care of the patient. (This statement relates to radiographs, reports, or calls from other concurrently treating or covering practitioners.)

Question Title

* 26. What services do you provide in your office?

Question Title

* 27. How many years have you been in practice?

Question Title

* 28. What type of practice do you work in?

Question Title

* 29. Please indicate the geographic area that most closely corresponds to the location of your practice.

Question Title

* 30. If you believe that there are still never events that we have not included or addressed please list them below; If not, thank you very much for completing the survey.

T