Calls are being made to overhaul a system that allows dentists to perform orthodontics after five children required years of extra treatment after orthodontic work overseen by a dentist.
The Herald is aware of at least two families whose children needed tens of thousands of dollars of corrective treatment after orthodontic work at a clinic where there are no specialist orthodontists.
In one case, the parents of three siblings chose the Auckland clinic where they believed there were specialists, and because it promoted less time in braces and no tooth extractions.
The mother of those children, Cath Darroch, said the clinic's advertising was misleading because the treatment was actually overseen by a dentist, who has less training than an orthodontist.
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Darroch complained to the Health and Disability Commissioner, who referred the complaint to the Dental Council of New Zealand.
The council found the dentist at that clinic, which the Herald has chosen not to name, was competent and the clinic's advertising was not misleading because a dentist is allowed to carry out orthodontic work.
However, the New Zealand Association of Orthodontists (NZAO) says dentists practising the specialty is a serious problem that needs addressing urgently.
Darroch, who spent $30,000 on her children's teeth including $16,000 worth of pre-paid orthodontic work at the clinic, said they ended up having five years of dental work that should have taken two.
Darroch's concerns included receding gums, wires poking into gums and treatment to a child too young.
A specialist orthodontist who later assessed the teeth said the clinic's work was not up to scratch.
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Now, the North Shore mum is calling for change including that dentists must advertise their qualifications so other patients don't go through what her children did.
Denise Dryland, whose children attended the same clinic, said her two children were psychologically scarred from their treatment and were now afraid to see a dentist.
"We are appalled. My son endured much more time and grief in the hands of [the clinic] than what was discussed during the initial consultation."
Through his lawyer, Harry Waalkens, QC, the dentist said he had hundreds of happy patients every year and he "utterly rejected" the suggestion the advertising was misleading.
A specialist orthodontist is a dentist with three additional years of training through a Doctor of Clinical Dentistry.
NZAO president Dr Kieran O'Neill said the association repeatedly supported orthodontist and public complaints about dentists referring to themselves as orthodontists or performing specialist orthodontic services.
"There are patients and parents who are unaware their dentist isn't an orthodontist and by omission, they think they are.
"You wouldn't ask your doctor to do brain surgery on you. That's what the public have to be aware of. These people are not trained to do complex work."
Dentists receive about 80 hours of orthodontic training whereas orthodontists receive 5000 hours, including treating complex patients.
"Legally they're able to do orthodontics, but whether they're competent is another story.
"It's a big problem in some cases, in some practices, in some cities and others are not. It tends to be recidivist dentists or dental practices."
University of Otago Professor of Orthodontics Dr Mauro Farella said the system needed improving and there needed to be more opportunity for dentists to do extra training once qualified.
Part 1: Dentists doing orthodontics
Part 2: Investigation, advertising and injury