“Metal mickey!” “Train tracks!” These are just a couple of nicknames that used to accompany having orthodontic treatment. Any child or adult that decided to go through this process probably had to put up with name-calling and a feeling of being “different” in the pursuit of improving the appearance of their teeth. However, orthodontics has come a long way since those days and now children are clamouring to have braces fitted so they can be part of the “in” crowd. This change in attitudes is a testament to all of those who are involved in this speciality. Orthodontic nurses play a particularly important role in ensuring that a patient's experience is a positive one. Having had braces when I was younger, I was interested to find out how their roles and attitudes have changed in the past decade. I also wanted to know how they really feel about the patients that walk through their door each day and whether this speciality of dental nursing is any different from general practice.

Zoe Smith has been an orthodontic nurse for 17 years and works in a specialist practice in Bedford. Her decision to go into the profession was the result of a childhood dream of becoming a dental nurse.

“I always wanted to be a dental nurse even from a young age,” she explains. “When I applied for this job I didn't know that it was an orthodontic position, I thought that I would be doing general dentistry. However, I got the job and I absolutely love it to bits, so much so that I am at the same practice all this time later.”

Zoe admits that she is “passionate” about her job and says that being an orthodontic nurse is very different to working in a general dental practice. She says that the time she gets to spend with patients largely contributes to her sense of job satisfaction.

We have all different colour braces and they have their colours picked out to match with their friends.

“I have never worked in general dentistry but from what I know from speaking to others, I have a lot more one-on-one time with patients and can therefore build up a great rapport with them. They visit us every four to six weeks for around two years so you end up having a good relationship with them.”

Zoe cites this close contact with patients as the most rewarding part of her job and says that it is something that is a key skill for orthodontic nurses to develop. A large part of her time with patients is spent not only giving them oral hygiene advice and ensuring that they know how to look after their appliance but also talking through their feelings about their treatment. Zoe works at an orthodontic practice where 95% of patients are children and they demand the most of her time and energy. She explains that seeing them upset is the down side to the job but she sees it as her responsibility to try and make sure that they understand why certain decisions have been made.

Awareness of how their teeth look has driven many adults to seek orthodontic treatment.

“I find it upsetting when children want a brace and they are not ready yet. It may be that they are not old enough or the teeth haven't come through yet so treatment can't begin. Sometimes they might not be able to have treatment because their teeth aren't that bad and then they get upset because their sister or best friend has got a brace and they haven't. They come to me at the desk and I try to explain the reasons and hopefully cheer them up a bit.”

This dramatic change in attitudes towards orthodontic treatment is something that Zoe has seen happen during her career. She says that braces are now like a “fashion accessory” and that when one person in a class gets them then the whole class wants to follow suit.

“When I first started in this job people would get upset because they didn't want a brace, now they get upset if they can't have one. We have all different colours and usually before they have even got to the practice they have their colours picked out to match their friends.”

Nina White an orthodontic nurse at the Eastman Dental Hospital in London agrees that attitudes have changed in the past few years and that patients are becoming much more focused on their appearance. She says that this awareness of how their teeth look has driven many adults to seek orthodontic treatment.

“We see a lot of adults here at the hospital. It is becoming a more common thing to do and I enjoy working with them. I find that because adults have chosen to go down the orthodontic path, they are very committed to their treatment and rarely miss an appointment.”

After completing her dental nurse training at the Eastman, Nina specialised for six months in orthodontics. She says that she finds it a more interesting branch of dentistry than general practice. This was confirmed when she spent a year in general practice after qualification and found the time pressures very demanding. She agrees with Zoe that the amount of time that you can spend with patients as an orthodontic nurse is one of the best parts of the job.

You see people really change throughout their treatment.

“It is totally different working here to working in a general dental practice. In practice you tend to be quite rushed off your feet and very busy. Here, you can spend lots of time with the patients and get more involved with their treatment, so you are not just running around like a headless chicken.”

Nina mainly works with trainee orthodontists who are qualified dentists undertaking a three-year specialisation course. She explains that working with trainees can be rewarding.

“Working with trainee orthodontists can be very good. I also work in an orthodontic practice in the evenings, so I get to see different people doing certain procedures in different ways. If someone seems to be struggling with something I might say that I have seen someone else do it in a certain way and they may pick up on that. I find that rewarding as I feel like I am helping.”

Nina is quick to point out that a hospital environment is very different from working in a practice. There are more dentists, patients and staff so it is important that there is good teamwork within the department. She says that this aspect of the job is one of the most important and the most enjoyable for her.

“Another thing I enjoy about my job is working with the team. We have got a large department with over 20 chairs and around 15 nurses so it is a challenge to make sure everything runs smoothly. I get a lot of satisfaction out of seeing everything run to plan and the team gets on very well which makes coming to work enjoyable.”

Nina and Zoe both agree that the most crucial part of their job as an orthodontic nurse is their focus on the patient. It is clear that spending time with each patient is an essential ingredient to getting the most out of every day. However, this time and effort is rewarded by the job satisfaction that you get from seeing positive results. As Zoe comments: “You see people really change throughout their treatment. They have more confidence and it can transform their life. Knowing that you are really doing something to help is the best thing about this job.”

For further information visit www.orthodontic-ong.co.uk