Recovery Factors That Affect Surgical Outcomes

Recovery Factors That Affect Surgical Outcomes

**Early Intervention with Invisalign First for Kids**

In pediatric care, orthodontic surgery, often referred to as orthognathic surgery, plays a crucial role in addressing severe jaw misalignments and bite issues that cannot be fully corrected with traditional orthodontic treatments. This type of surgery is essential for correcting problems such as overbite, underbite, crossbite, and open bite, which can significantly impact a child's ability to chew, speak, and even breathe properly. Misaligned jaws can also put teeth at risk of becoming worn down and can cause discomfort or pain in the jaw, known as temporomandibular joint (TMJ) disorders.


The necessity of orthodontic surgery in pediatric care is further supported by the long-term benefits it offers. By correcting jaw misalignment, surgery can improve facial aesthetics, chewing function, and speech clarity. Additionally, it can alleviate breathing difficulties and reduce the risk of TMJ disorders, contributing to an enhanced quality of life for the child.


Recovery from orthognathic surgery involves several factors that can significantly impact surgical outcomes. Initially, patients are placed on a liquid or soft diet to allow the jaw to heal properly, gradually reintroduce more solid foods as healing progresses. Some children may need space maintainers to prevent crowding Kids' dental alignment services disease. Proper oral hygiene is critical to prevent infection, and patients often require follow-up orthodontic treatments to fine-tune their bite alignment. The success rate of orthognathic surgery is remarkably high, with most patients reporting significant improvements in their quality of life and satisfaction with the results.


In pediatric care, the success of orthognathic surgery is not only measured by the surgical outcome but also by the child's overall satisfaction and improvements in their quality of life. A multidisciplinary approach, including orthodontists, oral surgeons, and other healthcare professionals, ensures that each child's unique needs are addressed, contributing to the high success rate of the procedure. By understanding the necessity and recovery factors of orthodontic surgery, healthcare teams can provide effective care and support to pediatric patients undergoing this transformative treatment.

Invisalign First is designed for children aged 6 to 10, using clear, removable aligners to address early orthodontic needs, promoting proper jaw development and teeth alignment without traditional braces. —

Recovery factors that influence surgical outcomes are diverse and play a crucial role in determining the speed and extent of postoperative recovery. Research has shown that psychosocial factors, including depression and social support, are significant predictors of surgical outcomes, even after accounting for clinical factors like presurgical health status[1]. Attitudinal and mood factors are particularly predictive, while personality factors have been found to be less so[1]. This suggests that preoperative consideration of these factors can help healthcare practitioners in estimating recovery.


Psychological well‐being is another critical preoperative risk that can influence recovery. Factors associated with poor multidimensional recovery include ASA grade, recovery tool baseline score, physical function, number of co-morbidities, previous surgery, and psychological well‐being[3]. Mixed results have been reported for age, BMI, and preoperative pain, highlighting the need for more consistent and high-quality studies[3]. The quality of evidence in this field is rated from very low to low, primarily attributed to the observational nature and heterogeneity of studies[3]. This indicates a need for further research to establish more reliable predictors of recovery.


Enhanced Recovery After Surgery (ERAS) guidelines have been shown to improve surgical outcomes by decreasing hospital length of stay and complications. ERAS elements, including early mobilization and postoperative analgesia, are associated with these positive outcomes[5]. The implementation of ERAS protocols can be influenced by the type of surgery and the number of ERAS elements applied, with procedures like pancreatic and orthopedic surgery often having greater reductions in hospital stays[5]. This suggests that standardized and comprehensive approaches to recovery can have a significant positive influence on surgical outcomes.


The role of healthcare systems in recovery is also important. Nursing programs emphasize the need for competent care and proper documentation, which are essential for ensuring that patients are well supported during their recovery[4]. However, the specific requirements and outcomes of these programs can be influenced by factors like program length and student performance criteria[4]. In conclusion, recovery factors that influence surgical outcomes are multi-fdimensional, including both psychosocial and clinical elements, as well as systemic approaches like ERAS guidelines.

**The HealthyStart System**

The recovery process following surgery in children is a highly individualized experience, significantly influencing the overall outcome. Factors such as the type of surgery, the child's overall health, and the quality of post-operative care play critical, yet diverse, effects on how well a child recovers.


The type of surgery is a primary factor that can impact recovery. For example, children undergoing major procedures like brain surgery or spinal fusion may experience more discomfort and require longer recovery time. In the case of brain surgery, children may feel fatigued for several months and need more rest, while also being at risk for complications like infection or pain at the surgical site[1]. In spinal fusion surgery, adolescents may face persistent pain and functional difficulties, making psychological support essential for their recovery[3]. The specific surgical procedure can also affect the level of post-operative pain and the need for pain management strategies.


The child's overall health before surgery is also a critical factor. Children with existing health problems may face additional risks during recovery, such as increased infection risk or complications from anesthesia. For example, children with chronic health problems may require more time to recover and may need more hospitalization days. Moreover, their ability to cope with post-operative pain and discomfort can be significantly different from that of a healthy child, making it essential to consider their health history when developing a recovery care.


The quality of post-operative care is a further critical factor that can significantly impact recovery outcomes. This includes not only the physical care provided by nurses and doctors but also the emotional support from parents and other care team. For children, having a trusted caregiver can be particularly important, as it helps them feel safe and comforted during a stressful time[5]. Encourage children to drink plenty of fluids and rest when needed, while also gradually building up their physical activities as per the surgeon's advice[1]. Moreover, effective pain management is essential to prevent chronic pain and promote a faster recovery[3]. In some cases, hospitals may offer "enhanced recovery strategies, which include early eating, early physical activities, and better pain management, all of which can lead to a faster and more comfortable recovery[2]."


In addition to these factors, the child's age and previous hospital experiences can also affect their recovery. For example, infants may require more attention to their emotional needs post-surgery, while adolescents may benefit from more open communication about their recovery process[5]. The support and understanding from the school can also play a critical in the recovery process, especially for children needing to gradually increase their school hours[1]. In all cases, a well- planned recovery process that includes these factors can lead to better outcomes and a faster recovery for children undergoing surgery.

**The HealthyStart System**

This non-invasive approach targets the natural development of children's teeth and jaw, using soft dental appliances to align teeth and address breathing issues, reducing the need for more invasive treatments.

Post-surgical care for pediatric orthodontic surgery, such as orthognathic surgery, is crucial for ensuring optimal recovery and outcomes. The recovery process is a critical phase where several factors can affect surgical results.


Immediate Postoperative Care


In the immediate postoperative period, pain management is a major concern. Effective pain control often requires prescribed medications, and in some cases, additional interventions may be necessary for patients experiencing refractory pain. Ice packs can help manage swelling, while moist heat may alleviate discomfort in the jaw muscles. It is essential for patients to follow postoperative instructions closely to avoid any immediate post-surgical issues.


Recovery Factors Affecting Outcomes




  1. Follow-Up Appointments and Oral Hygiene - Regular follow-up appointments with both the orthodontist and oral surgeon are crucial for monitoring healing progress. Patients must also adhere to a high standard of oral care to avoid any postoperative issues like dental or surgical sites.




  2. Postoperative Diet - Transitioning from a soft diet to regular foods under healthcare guidance is important. This gradual transition is necessary to ensure that the jaw and mouth heal properly without irritation.




  3. ERAS (Enhanced Recovery After Surgery) protocols - While not widely established for pediatric orthognathic surgery, ERAS elements such as hypothermia prevention, normovolemia maintenance, and minimized opioid use can improve recovery outcomes. However, surgeons often need more education on certain ERAS elements like preoperative nutritional screening and goal-directed fluid therapy.




  4. Rest and Emotional Support - Patients should rest and avoid strenuous activity until cleared by their surgeon. Emotional support is also important, as recovery can be a difficult time both physiognomical and physiognomical.




  5. Surgical Complications - Common surgical issues include hardware irritation, neurosensory alterations like numbness, and the need for hardware removal. These factors can affect recovery and require close monitoring by healthcare professionals.




In general, recovery from orthognathic surgery can take about two to three months, with patients typically out of work or school for at least one month. The recovery process is tailored to each patient's specific health and surgical factors. By following these guidelines and collaborating closely with healthcare professionals, patients can navigate the recovery phase effectively, achieving optimal healing and restoring oral function.

**Myobrace: A No-Braces Approach**

When it's time to focus on recovery factors that impact surgical outcomes, several key elements become crucial. These include rest, diet, and follow-up visits, all of which are essential for ensuring proper healing and addressing any complications that may have been caused by the surgery. The process of recovery is not just about physical healing but also about addressing psychological and social factors that influence a patient's ability to return to normal life.


Psychosocial Factors and Recovery


Psychosocial factors, such as depression, social support, and patient mood, play a significant role in recovery. Research indicates that these factors can be predictive of surgical outcomes, even when accounting for clinical variables like presurgical health status[1]. For example, patients with positive mental states and support from family and friends often experience more effective and efficient recovery. This emphasizes the importance of addressing mental health during the recovery process.


The Enhanced Recovery After Surgery (ERAS) Guidelines


The Enhanced Recovery After Surgery (ERAS) guidelines provide a structured protocol for postoperative care, which includes early mobilization, postoperative analgesia management, and dietary considerations[3]. Implementing these guidelines has been associated with a decrease in hospital length of stay and complications. This systematic and evidence-based care can improve patient outcomes by ensuring that all necessary steps are taken to support recovery.


Importance of Nutrition


A well-optimizing diet is essential for recovery. Nutrition support is critical for patients who are unable to meet their nutrient needs, as malnutrition can impair recovery and precipitate complications[4]. For surgical patients, malnutrition can result in increased complications and mortality rates. Nutrition support can be provided in various form, such as oral supplementation or tube feeding, and should be considered based on the patient's specific needs.


Follow-up and Patient-centered Recovery


Follow-up visits are crucial for monitoring healing and addressing any complications early. However, recovery is not just about clinical parameters; it also includes returning to preoperative habits and routines, resolving symptoms, overcoming mental strains, regaining independence, and enjoying life[5]. Patients often define recovery by their ability to return to normal activities and social interactions, which underelines the need for patient-centered care strategies.


In summary, effective recovery from surgery requires a comprehensive and multidisciplinary care that includes rest, diet, follow-up visits, and consideration of psychosocial factors. Implementing evidence-based protocols like ERAS and addressing nutritional needs can improve outcomes, while understanding patient perspectives can help in developing more effective recovery strategies.

Myobrace offers a brace-free solution that corrects poor oral habits, guiding jaw and teeth alignment development in children, promoting natural growth and oral health.

Emotional support and communication play a crucial role in the recovery process following surgery, significantly impacts surgical outcome. The journey of recovery is not just about physical healing but also about managing the emotional and psychological challenges that often come with it. Open communication is essential for addressing these challenges, as it fosters a nurturing environment where patients feel supported and cared for.


After surgery, patients often experience a range of emotions, from fear and anxiety to sadness and uncertainty. This emotional response can be overwhelming and may hinder the recovery process if not properly addressed. Emotional support from family, friends, support groups, and mental health providers can help manage these emotions by offering comfort, empathy, and a sense of control. When patients feel supported, they are more likely to communicate their needs and concerns to healthcare providers, which can lead to better pain management and adherence to rehabilitation plans.


Communication is a two way process that not only helps in expressing emotional needs but also in receiving appropriate care and guidance. Open lines of communication allow healthcare providers to understand the emotional state of their patients and make necessary adjustments to the treatment plan. This proactive communication empowers patients to take control of their recovery, leading to improved mental well-being and a faster healing process.


Emotional support also has a positive physical outcome. It can reduce stress and anxiety, which are associated with enhanced immune response, faster wound healing, and better sleep quality. A robust support system encourages patients to stay motivated and committed to their treatment plans, even during periods of low mood or frustration. This commitment is crucial for achieving optimal recovery and long-term health benefits.


In summary, emotional support and communication are vital recovery tools that enhance the healing process by addressing both the psychological and physical challenges of surgery. By prioritizing emotional well-being alongside physical recovery, individuals can navigate the post-surgery journey with resilience and achieve a more positive and successful outcome.

**Comprehensive Orthodontic Solutions**

When itcomes to recovery from surgery, especially in the care of a child, emotional support and open communication play a critical role in ensuring a positive recovery experience. The emotional well-being of a child during this time can be just as important as their physical health, as it directly influence their ability to recover and their long-term outcomes.


Psychosocial factors, such as emotional support and communication, have been found to be significant predictors of surgical outcomes. Research indicates that these factors can influence recovery speed and extent, even when accounting for clinical variables like presurgical health status[1]. For a child, having a supportive environment where they can understand what is being offered can help in reducing their mental strains and enhance their recovery process.


In the recovery process, open communication is essential. It not only provides the child with a sense of control and understanding but also offers them the ability to share their experiences and needs. This can lead to better pain management, reduced postoperative complications, and a more positive emotional state. For example, studies have found that patients who are more actively included in their care and recovery process often have better outcomes and are more likely to follow postoperative instructions[5]. This approach can also help in addressing any potential mental health challenges that may occur during recovery.


The role of family and support systems in this process is also critical. They can provide the necessary emotional support and help in ensuring that the child is well-informed about their recovery. This support can extend beyond the hospital stay, helping the child to read just to their habits and routines, which is a significant step in the recovery journey[5]. In summary, emotional support and open communication are not just additional benefits but are essential factors that contribute to a positive recovery experience for a child undergoing surgery. They help in addressing both the physical and emotional needs of the child, ensuring a more holistic recovery process.

When it concerns pediatric orthodontic surgery, the management of anesthesia and pain during recovery is crucial for ensuring optimal surgical outcomes. Enhanced Recovery After Surgery (ERAS) protocols, which have been widely adopted in many surgical specialties, focus on minimizing surgical stress and optimizing recovery. In the field of pediatric orthognathic surgery, while these protocols are not as formalized, elements such as hypothermia prevention, normovolemia maintenance, and intraoperative tranexamic acid use are commonly employed to improve patient recovery[1]. However, there is a need for further education and standardization of ERAS protocols tailored to pediatric patients.


Anesthesia management is a critical recovery issue. The use of local anesthetic blocks, such as inferior alveolar nerve blocks, can lead to temporary or, in some cases, permanent paresthesia, although the incidence is very high[2]. This underscores the importance of precise technique and patient monitoring during anesthesia.


In the recovery phase, pain management is a major concern. Effective pain control often requires a multidisciplinary approach, including medication and alternative techniques like jaw immobilization. The transition from a soft diet to regular foods and regular follow-up appointments are essential for progressive recovery[3]. Emotional support also cannot be overemized as patients may experience neurosensory alterations such as numbness or altered sensations, which typically resolve over time[3]. The overall recovery time for orthognathic surgery can vary, typically taking about two to three months, depending on factors like the type of surgery and patient health[5]. By understanding and effectively implementing these recovery factors, healthcare professionals can improve surgical outcomes and provide a more comprehensive care experience for pediatric patients undergoing orthodontic surgery.

When it comes to surgical procedures, especially in children, anesthesia is a comprehensive and effective method to ensure pain relief during and after the surgery. This section will look at the use of anesthesia and how it helps in pain recovery, ensuring the child's comfort throughout the surgical experience.


Anesthesia is designed to prevent pain during surgical procedures, and it is a safe and effective way to ensure that children remain comfortable throughout the surgery. There are several types of anesthesia, each with different effects and recovery time. General anesthesia, for example, makes the child lose consciousness, while regional anesthesia numbs a specific part of the body, such as the lower back or extremities. This type of anesthesia is often recommended for children because it reduces the risk of neurotoxicity, which can be a potential side effects of general anesthesia, especially in young children undergoing multiple or long procedures[2][4]. Regional anesthesia also has the benefit of faster recovery, less nausea, and a lower need for opioid pain medications post-surgery[2][3]. This not only helps in managing pain more safely but also reduces the side effects that can be more severe in children.


During recovery, children may experience side effects such as nausea, vomiting, or groginess. However, these are typically short-term and can be managed with appropriate medication. Anesthesiologists tailor the type and amount of anesthesia to each child's needs, ensuring safety and comfort before, during, and after the procedure[4]. Pain management is a joint effort between anesthesiologists, surgeons, and sometimes pain specialists, who work together to provide effective pain relief while also ensuring the child's safety and comfort[3][4]. This comprehensive care helps in ensuring that children recover well from surgery, with a lower risk of long-term effects and a faster return to normal activities.

When itcomes to recovery factors that influence surgical outcomes, follow-up care and long-term management play a significant role. These elements are often considered the final but most important part of the recovery and surgical outcome management.


Follow-up care is the practice of maintaining a patient's health status post-surgery by ensuring they are recovering as they should. This includes a number of activities such as postoperative pain management, physical mobilization, and addressing any complications that may havearising. Studies have found that patients undergoing enhanced recovery after surgery (ERAS) guidelines, which emphasize early mobilization and appropriate analgesia, have a lower risk of complications and readmission compared to traditional care[3]. This indicates that the structured follow-up care in ERAS can improve recovery and long-term outcomes.


In addition to follow-up care, long-term management is also important. Long-term care focuses on the patient's ability to return to their normal lifestyle and activities. This includes regaining independence, resolving symptoms, and overcoming mental strains[5]. For many patients, recovery is not just about the absence of complications but also about returning to their preoperative habits and routines, such as work, social interactions, and physical activities[5]. Long-term care strategies should incorporate these patient-centered goals to improve the patient's perceived recovery and well being.


Psychosocial factors also play a significant role in recovery. Studies have found that mood and attitudinal factors are strongly predictive of surgical outcomes, even after accounting for clinical factors[1]. This indicates that long-term care should also consider psychological support and social support to help patients fully recovery from their surgery.


In practice, follow-up and long-term care should be structured to include patient-centered strategies. This includes setting recovery goals based on the patient's lifestyle and values, addressing mental health issues, and ensuring that patients have the necessary support to return to their normal routines. In this, both the surgeon and the patient play a role in ensuring that the recovery is not just about clinical parameters but also about the patient's well being and return to normal life.

When it concerns surgical outcomes, especially in the recovery process following oral surgery, several factors play a crucial role in ensuring a smooth and successful healing journey. One of the most critical elements is the necessity of follow-up appointments. These visits are essential for monitoring the recovery progress and addressing any potential complications early on. By maintaining close communication with the dental care team, parents can ensure that their child's healing process is tailored to their specific needs.


Follow-up appointments allow the surgeon to assess how well the child is healing and provide additional instructions based on their progress. This proactive approach not only ensures that any emerging issues are detected promptly but also significantly enhance the healing process by allowing for timely intervention. Furthermore, these visits provide an essential check on the child's pain levels and any unusual symptoms, allowing for appropriate management and support.


In the management of a child's recovery after oral surgery, parents can play a pivotal role by following a structured approach. Selecting the right pediatric dentist is crucial as it ensures a skilled and experienced care team that can make a significant difference in the child's overall oral health journey. A positive rapport with the dentist can contribute to a more relaxed atmosphere during the surgery and recovery process.


Post-surgery instructions provided by the pediatric dentist must be followed diligently. These instructions often include guidelines on medication, dietary restrictions, and oral care routines. Strict adherence to these recommendations is vital for a smooth and complication-free recovery. Pain management is another critical aspect, where prescribed pain medication should be used as directed, and additional measures like cold compresses can help reduce swelling and discomfort.


In maintaining good oral hygiene during recovery, parents should follow specific instructions for cleaning the surgical site using a soft-bristled toothbrush and gentle care to avoid irritation. Encourage the child to rinse their mouth with a prescribed solution to promote cleanliness and prevent infection.


It is also important for parents to be vigilant and observe their child for any signs of complications such as excessive bleeding, persistent pain, or unusual swelling. If any concerning symptoms are detected, the pediatric dentist should be promptly for guidance. Early intervention can prevent potential issues and ensure a smoother recovery.


In the long term, ensuring the child's oral health requires a proactive and supportive approach. By being attentive, supportive, and proactive in following post-surgery guidelines and maintaining good oral hygiene, parents can significantly contribute to their child's oral health and well-being. This not only ensures a successful recovery but also a positive oral health journey in the years to follow.

When it's time to recover from surgery, the process can be both complex and personal. A successful recovery is not just about the physical aspect of surgery; it also includes psychological and social factors that play a significant role in outcomes. Here are some tips for a smoother recovery, taking into account these various factors.


Follow Instructions and Trust the Recovery process:
The first step in ensuring a successful recovery is to follow your doctor's instructions. This includes taking prescribed medications, attending follow-up care, and understanding the recovery process. Trusting the process can help reduce the risk of complications and give you the best chance of a successful recovery.


Psychosocial Factors:
Psychosocial factors such as depression, social support, and mood can strongly influence recovery. Patients with a more proactive and less depressed state of being often recover more speedly and fully. Enclose yourself with a support network of family and friends who can provide both physical and mental support during this time.


Enhanced Recovery After Surgery (ERAS) Guidelines:
ERAS guidelines have been widely successful in improving surgical outcomes by decreasing hospital stays and complications. These guidelines often include early mobilization, postoperative analgesia considerations, and postoperative diet and bowel management. By following these protocols, patients can experience a smoother and more successful recovery.


Understanding Recovery from the Patient's perspective:
To patients, recovery is not just about clinical parameters like hospital stay duration or absence of complications. Recovery also includes returning to preoperative habits and routines, resolving symptoms, overcoming mental strains, regaining independence, and enjoying life. By understanding these perspectives, patient-centered strategies can be more tailored to improve postoperative recovery.


In the end, a successful recovery is a personal and tailored process that requires both clinical and psychosocial support. By following these tips and understanding the comprehensive meaning of recovery, patients can ensure a smoother and more successful recovery after surgery.

When it's time for a child to recover from surgery, parents play a significant role in ensuring that their child's recovery is as effective and comfortable as possible. This recovery period is not just about physical health, but also about emotional well being and the environment at play. Here are some specific tips for parents to help their child recover more effectively, including considerations for environment, diet, and activities during the recovery period.


1. F

Dental braces

Dental braces (also known as orthodontic braces, or simply braces) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often used to correct underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces are often used in conjunction with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws.

Process

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The application of braces moves the teeth as a result of force and pressure on the teeth. Traditionally, four basic elements are used: brackets, bonding material, arch wire, and ligature elastic (also called an "O-ring"). The teeth move when the arch wire puts pressure on the brackets and teeth. Sometimes springs or rubber bands are used to put more force in a specific direction.[1]

Braces apply constant pressure which, over time, moves teeth into the desired positions. The process loosens the tooth after which new bone grows to support the tooth in its new position. This is called bone remodelling. Bone remodelling is a biomechanical process responsible for making bones stronger in response to sustained load-bearing activity and weaker in the absence of carrying a load. Bones are made of cells called osteoclasts and osteoblasts. Two different kinds of bone resorption are possible: direct resorption, which starts from the lining cells of the alveolar bone, and indirect or retrograde resorption, which occurs when the periodontal ligament has been subjected to an excessive amount and duration of compressive stress.[2] Another important factor associated with tooth movement is bone deposition. Bone deposition occurs in the distracted periodontal ligament. Without bone deposition, the tooth will loosen, and voids will occur distal to the direction of tooth movement.[3]

Types

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"Clear" braces
Upper and Lower Jaw Functional Expanders
  • Traditional metal wired braces (also known as "train track braces") are stainless-steel and are sometimes used in combination with titanium. Traditional metal braces are the most common type of braces.[4] These braces have a metal bracket with elastic ties (also known as rubber bands) holding the wire onto the metal brackets. The second-most common type of braces is self-ligating braces, which have a built-in system to secure the archwire to the brackets and do not require elastic ties. Instead, the wire goes through the bracket. Often with this type of braces, treatment time is reduced, there is less pain on the teeth, and fewer adjustments are required than with traditional braces.
  • Gold-plated stainless steel braces are often employed for patients allergic to nickel (a basic and important component of stainless steel), but may also be chosen for aesthetic reasons.
  • Lingual braces are a cosmetic alternative in which custom-made braces are bonded to the back of the teeth making them externally invisible.
  • Titanium braces resemble stainless-steel braces but are lighter and just as strong. People with allergies to nickel in steel often choose titanium braces, but they are more expensive than stainless steel braces.
  • Customized orthodontic treatment systems combine high technology including 3-D imaging, treatment planning software and a robot to custom bend the wire. Customized systems such as this offer faster treatment times and more efficient results.[5]
  • Progressive, clear removable aligners may be used to gradually move teeth into their final positions. Aligners are generally not used for complex orthodontic cases, such as when extractions, jaw surgery, or palate expansion are necessary.[medical citation needed][6]

Fitting procedure

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A patient's teeth are prepared for the application of braces.

Orthodontic services may be provided by any licensed dentist trained in orthodontics. In North America, most orthodontic treatment is done by orthodontists, who are dentists in the diagnosis and treatment of malocclusions—malalignments of the teeth, jaws, or both. A dentist must complete 2–3 years of additional post-doctoral training to earn a specialty certificate in orthodontics. There are many general practitioners who also provide orthodontic services.

The first step is to determine whether braces are suitable for the patient. The doctor consults with the patient and inspects the teeth visually. If braces are appropriate, a records appointment is set up where X-rays, moulds, and impressions are made. These records are analyzed to determine the problems and the proper course of action. The use of digital models is rapidly increasing in the orthodontic industry. Digital treatment starts with the creation of a three-dimensional digital model of the patient's arches. This model is produced by laser-scanning plaster models created using dental impressions. Computer-automated treatment simulation has the ability to automatically separate the gums and teeth from one another and can handle malocclusions well; this software enables clinicians to ensure, in a virtual setting, that the selected treatment will produce the optimal outcome, with minimal user input.[medical citation needed]

Typical treatment times vary from six months to two and a half years depending on the complexity and types of problems. Orthognathic surgery may be required in extreme cases. About 2 weeks before the braces are applied, orthodontic spacers may be required to spread apart back teeth in order to create enough space for the bands.

Teeth to be braced will have an adhesive applied to help the cement bond to the surface of the tooth. In most cases, the teeth will be banded and then brackets will be added. A bracket will be applied with dental cement, and then cured with light until hardened. This process usually takes a few seconds per tooth. If required, orthodontic spacers may be inserted between the molars to make room for molar bands to be placed at a later date. Molar bands are required to ensure brackets will stick. Bands are also utilized when dental fillings or other dental works make securing a bracket to a tooth infeasible. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), also known as molar tubes, are directly bonded to molar teeth either by a chemical curing or a light curing adhesive. Usually, molar tubes are directly welded to bands, which is a metal ring that fits onto the molar tooth. Directly bonded molar tubes are associated with a higher failure rate when compared to molar bands cemented with glass ionomer cement. Failure of orthodontic brackets, bonded tubes or bands will increase the overall treatment time for the patient. There is evidence suggesting that there is less enamel decalcification associated with molar bands cemented with glass ionomer cement compared with orthodontic tubes directly cemented to molars using a light cured adhesive. Further evidence is needed to withdraw a more robust conclusion due to limited data.[7]

An archwire will be threaded between the brackets and affixed with elastic or metal ligatures. Ligatures are available in a wide variety of colours, and the patient can choose which colour they like. Arch wires are bent, shaped, and tightened frequently to achieve the desired results.

Dental braces, with a transparent power chain, removed after completion of treatment.

Modern orthodontics makes frequent use of nickel-titanium archwires and temperature-sensitive materials. When cold, the archwire is limp and flexible, easily threaded between brackets of any configuration. Once heated to body temperature, the arch wire will stiffen and seek to retain its shape, creating constant light force on the teeth.

Brackets with hooks can be placed, or hooks can be created and affixed to the arch wire to affix rubber bands. The placement and configuration of the rubber bands will depend on the course of treatment and the individual patient. Rubber bands are made in different diameters, colours, sizes, and strengths. They are also typically available in two versions: Coloured or clear/opaque.

The fitting process can vary between different types of braces, though there are similarities such as the initial steps of moulding the teeth before application. For example, with clear braces, impressions of a patient's teeth are evaluated to create a series of trays, which fit to the patient's mouth almost like a protective mouthpiece. With some forms of braces, the brackets are placed in a special form that is customized to the patient's mouth, drastically reducing the application time.

In many cases, there is insufficient space in the mouth for all the teeth to fit properly. There are two main procedures to make room in these cases. One is extraction: teeth are removed to create more space. The second is expansion, in which the palate or arch is made larger by using a palatal expander. Expanders can be used with both children and adults. Since the bones of adults are already fused, expanding the palate is not possible without surgery to separate them. An expander can be used on an adult without surgery but would be used to expand the dental arch, and not the palate.

Sometimes children and teenage patients, and occasionally adults, are required to wear a headgear appliance as part of the primary treatment phase to keep certain teeth from moving (for more detail on headgear and facemask appliances see Orthodontic headgear). When braces put pressure on one's teeth, the periodontal membrane stretches on one side and is compressed on the other. This movement needs to be done slowly or otherwise, the patient risks losing their teeth. This is why braces are worn as long as they are and adjustments are only made every so often.

Young Colombian man during an adjustment visit for his orthodontics

Braces are typically adjusted every three to six weeks. This helps shift the teeth into the correct position. When they get adjusted, the orthodontist removes the coloured or metal ligatures keeping the arch wire in place. The arch wire is then removed and may be replaced or modified. When the archwire has been placed back into the mouth, the patient may choose a colour for the new elastic ligatures, which are then affixed to the metal brackets. The adjusting process may cause some discomfort to the patient, which is normal.

Post-treatment

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Patients may need post-orthodontic surgery, such as a fiberotomy or alternatively a gum lift, to prepare their teeth for retainer use and improve the gumline contours after the braces come off. After braces treatment, patients can use a transparent plate to keep the teeth in alignment for a certain period of time. After treatment, patients usually use transparent plates for 6 months. In patients with long and difficult treatment, a fixative wire is attached to the back of the teeth to prevent the teeth from returning to their original state.[8]

Retainers

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Main article: Retainer (orthodontic device)
Hawley retainers are the most common type of retainers. This picture shows retainers for the top (right) and bottom (left) of the mouth.

In order to prevent the teeth from moving back to their original position, retainers are worn once the treatment is complete. Retainers help in maintaining and stabilizing the position of teeth long enough to permit the reorganization of the supporting structures after the active phase of orthodontic therapy. If the patient does not wear the retainer appropriately and/or for the right amount of time, the teeth may move towards their previous position. For regular braces, Hawley retainers are used. They are made of metal hooks that surround the teeth and are enclosed by an acrylic plate shaped to fit the patient's palate. For Clear Removable braces, an Essix retainer is used. This is similar to the original aligner; it is a clear plastic tray that is firmly fitted to the teeth and stays in place without a plate fitted to the palate. There is also a bonded retainer where a wire is permanently bonded to the lingual side of the teeth, usually the lower teeth only.

Headgear

[edit]
Main article: Orthodontic headgear

Headgear needs to be worn between 12 and 22 hours each day to be effective in correcting the overbite, typically for 12 to 18 months depending on the severity of the overbite, how much it is worn and what growth stage the patient is in. Typically the prescribed daily wear time will be between 14 and 16 hours a day and is frequently used as a post-primary treatment phase to maintain the position of the jaw and arch. Headgear can be used during the night while the patient sleeps.[9][better source needed]

Orthodontic headgear usually consists of three major components:

Full orthodontic headgear with head cap, fitting straps, facebow and elastics
  1. Facebow: the facebow (or J-Hooks) is fitted with a metal arch onto headgear tubes attached to the rear upper and lower molars. This facebow then extends out of the mouth and around the patient's face. J-Hooks are different in that they hook into the patient's mouth and attach directly to the brace (see photo for an example of J-Hooks).
  2. Head cap: the head cap typically consists of one or a number of straps fitting around the patient's head. This is attached with elastic bands or springs to the facebow. Additional straps and attachments are used to ensure comfort and safety (see photo).
  3. Attachment: typically consisting of rubber bands, elastics, or springs—joins the facebow or J-Hooks and the head cap together, providing the force to move the upper teeth, jaw backwards.

The headgear application is one of the most useful appliances available to the orthodontist when looking to correct a Class II malocclusion. See more details in the section Orthodontic headgear.

Pre-finisher

[edit]

The pre-finisher is moulded to the patient's teeth by use of extreme pressure on the appliance by the person's jaw. The product is then worn a certain amount of time with the user applying force to the appliance in their mouth for 10 to 15 seconds at a time. The goal of the process is to increase the exercise time in applying the force to the appliance. If a person's teeth are not ready for a proper retainer the orthodontist may prescribe the use of a preformed finishing appliance such as the pre-finisher. This appliance fixes gaps between the teeth, small spaces between the upper and lower jaw, and other minor problems.

Complications and risks

[edit]

A group of dental researchers, Fatma Boke, Cagri Gazioglu, Selvi Akkaya, and Murat Akkaya, conducted a study titled "Relationship between orthodontic treatment and gingival health." The results indicated that some orthodontist treatments result in gingivitis, also known as gum disease. The researchers concluded that functional appliances used to harness natural forces (such as improving the alignment of bites) do not usually have major effects on the gum after treatment.[10] However, fixed appliances such as braces, which most people get, can result in visible plaque, visible inflammation, and gum recession in a majority of the patients. The formation of plaques around the teeth of patients with braces is almost inevitable regardless of plaque control and can result in mild gingivitis. But if someone with braces does not clean their teeth carefully, plaques will form, leading to more severe gingivitis and gum recession.

Experiencing some pain following fitting and activation of fixed orthodontic braces is very common and several methods have been suggested to tackle this.[11][12] Pain associated with orthodontic treatment increases in proportion to the amount of force that is applied to the teeth. When a force is applied to a tooth via a brace, there is a reduction in the blood supply to the fibres that attach the tooth to the surrounding bone. This reduction in blood supply results in inflammation and the release of several chemical factors, which stimulate the pain response. Orthodontic pain can be managed using pharmacological interventions, which involve the use of analgesics applied locally or systemically. These analgesics are divided into four main categories, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and local anesthesia. The first three of these analgesics are commonly taken systemically to reduce orthodontic pain.[13]

A Cochrane Review in 2017 evaluated the pharmacological interventions for pain relief during orthodontic treatment. The study concluded that there was moderate-quality evidence that analgesics reduce the pain associated with orthodontic treatment. However, due to a lack of evidence, it was unclear whether systemic NSAIDs were more effective than paracetamol, and whether topical NSAIDs were more effective than local anaesthesia in the reduction of pain associated with orthodontic treatment. More high-quality research is required to investigate these particular comparisons.[13]

The dental displacement obtained with the orthodontic appliance determines in most cases some degree of root resorption. Only in a few cases is this side effect large enough to be considered real clinical damage to the tooth. In rare cases, the teeth may fall out or have to be extracted due to root resorption.[14][15]

History

[edit]

Ancient

[edit]
Old Braces at a museum in Jbeil, Lebanon

According to scholars and historians, braces date back to ancient times. Around 400–300 BC, Hippocrates and Aristotle contemplated ways to straighten teeth and fix various dental conditions. Archaeologists have discovered numerous mummified ancient individuals with what appear to be metal bands wrapped around their teeth. Catgut, a type of cord made from the natural fibres of an animal's intestines, performed a similar role to today's orthodontic wire in closing gaps in the teeth and mouth.[16]

The Etruscans buried their dead with dental appliances in place to maintain space and prevent the collapse of the teeth during the afterlife. A Roman tomb was found with a number of teeth bound with gold wire documented as a ligature wire, a small elastic wire that is used to affix the arch wire to the bracket. Even Cleopatra wore a pair. Roman philosopher and physician Aulus Cornelius Celsus first recorded the treatment of teeth by finger pressure. Unfortunately, due to a lack of evidence, poor preservation of bodies, and primitive technology, little research was carried out on dental braces until around the 17th century, although dentistry was making great advancements as a profession by then.[citation needed]

18th century

[edit]
Portrait of Fauchard from his 1728 edition of "The Surgical Dentist".

Orthodontics truly began developing in the 18th and 19th centuries. In 1669, French dentist Pierre Fauchard, who is often credited with inventing modern orthodontics, published a book entitled "The Surgeon Dentist" on methods of straightening teeth. Fauchard, in his practice, used a device called a "Bandeau", a horseshoe-shaped piece of iron that helped expand the palate. In 1754, another French dentist, Louis Bourdet, dentist to the King of France, followed Fauchard's book with The Dentist's Art, which also dedicated a chapter to tooth alignment and application. He perfected the "Bandeau" and was the first dentist on record to recommend extraction of the premolar teeth to alleviate crowding and improve jaw growth.

19th century

[edit]

Although teeth and palate straightening and/or pulling were used to improve the alignment of remaining teeth and had been practised since early times, orthodontics, as a science of its own, did not really exist until the mid-19th century. Several important dentists helped to advance dental braces with specific instruments and tools that allowed braces to be improved.

In 1819, Christophe François Delabarre introduced the wire crib, which marked the birth of contemporary orthodontics, and gum elastics were first employed by Maynard in 1843. Tucker was the first to cut rubber bands from rubber tubing in 1850. Dentist, writer, artist, and sculptor Norman William Kingsley in 1858 wrote the first article on orthodontics and in 1880, his book, Treatise on Oral Deformities, was published. A dentist named John Nutting Farrar is credited for writing two volumes entitled, A Treatise on the Irregularities of the Teeth and Their Corrections and was the first to suggest the use of mild force at timed intervals to move teeth.

20th century

[edit]

In the early 20th century, Edward Angle devised the first simple classification system for malocclusions, such as Class I, Class II, and so on. His classification system is still used today as a way for dentists to describe how crooked teeth are, what way teeth are pointing, and how teeth fit together. Angle contributed greatly to the design of orthodontic and dental appliances, making many simplifications. He founded the first school and college of orthodontics, organized the American Society of Orthodontia in 1901 which became the American Association of Orthodontists (AAO) in the 1930s, and founded the first orthodontic journal in 1907. Other innovations in orthodontics in the late 19th and early 20th centuries included the first textbook on orthodontics for children, published by J.J. Guilford in 1889, and the use of rubber elastics, pioneered by Calvin S. Case, along with Henry Albert Baker.

Today, space age wires (also known as dental arch wires) are used to tighten braces. In 1959, the Naval Ordnance Laboratory created an alloy of nickel and titanium called Nitinol. NASA further studied the material's physical properties.[17] In 1979, Dr. George Andreasen developed a new method of fixing braces with the use of the Nitinol wires based on their superelasticity. Andreasen used the wire on some patients and later found out that he could use it for the entire treatment. Andreasen then began using the nitinol wires for all his treatments and as a result, dental doctor visits were reduced, the cost of dental treatment was reduced, and patients reported less discomfort.

See also

[edit]
  • Mandibular advancement splint
  • Oral and maxillofacial surgery
  • Orthognathic surgery
  • Prosthodontics
  • Trismus
  • Dental implant

References

[edit]
  1. ^ "Dental Braces and Retainers". WebMD. Retrieved 2020-10-30.
  2. ^ Robling, Alexander G.; Castillo, Alesha B.; Turner, Charles H. (2006). "Biomechanical and Molecular Regulation of Bone Remodeling". Annual Review of Biomedical Engineering. 8: 455–498. doi:10.1146/annurev.bioeng.8.061505.095721. PMID 16834564.
  3. ^ Toledo SR, Oliveira ID, Okamoto OK, Zago MA, de Seixas Alves MT, Filho RJ, et al. (September 2010). "Bone deposition, bone resorption, and osteosarcoma". Journal of Orthopaedic Research. 28 (9): 1142–1148. doi:10.1002/jor.21120. PMID 20225287. S2CID 22660771.
  4. ^ "Metal Braces for Teeth: Braces Types, Treatment, Cost in India". Clove Dental. Retrieved 2025-02-06.
  5. ^ Saxe, Alana K.; Louie, Lenore J.; Mah, James (2010). "Efficiency and effectiveness of SureSmile". World Journal of Orthodontics. 11 (1): 16–22. PMID 20209172.
  6. ^ Tamer, Ä°pek (December 2019). "Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review". Turkish Journal of Orthodontics. 32 (4): 241–246. doi:10.5152/TurkJOrthod.2019.18083. PMC 7018497. PMID 32110470.
  7. ^ Millett DT, Mandall NA, Mattick RC, Hickman J, Glenny AM (February 2017). "Adhesives for bonded molar tubes during fixed brace treatment". The Cochrane Database of Systematic Reviews. 2 (3): CD008236. doi:10.1002/14651858.cd008236.pub3. PMC 6464028. PMID 28230910.
  8. ^ Rubie J Patrick (2017). "What About Teeth After Braces?" 2017 – "Health Journal Article" Toothcost Archived 2021-10-18 at the Wayback Machine
  9. ^ Naten, Joshua. "Braces Headgear (Treatments)". toothcost.com. Archived from the original on 19 October 2021.
  10. ^ Boke, Fatma; Gazioglu, Cagri; Akkaya, Sevil; Akkaya, Murat (2014). "Relationship between orthodontic treatment and gingival health: A retrospective study". European Journal of Dentistry. 8 (3): 373–380. doi:10.4103/1305-7456.137651. ISSN 1305-7456. PMC 4144137. PMID 25202219.
  11. ^ Eslamian L, Borzabadi-Farahani A, Hassanzadeh-Azhiri A, Badiee MR, Fekrazad R (March 2014). "The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators". Lasers in Medical Science. 29 (2): 559–64. doi:10.1007/s10103-012-1258-1. PMID 23334785. S2CID 25416518.
  12. ^ Eslamian L, Borzabadi-Farahani A, Edini HZ, Badiee MR, Lynch E, Mortazavi A (September 2013). "The analgesic effect of benzocaine mucoadhesive patches on orthodontic pain caused by elastomeric separators, a preliminary study". Acta Odontologica Scandinavica. 71 (5): 1168–73. doi:10.3109/00016357.2012.757358. PMID 23301559. S2CID 22561192.
  13. ^ a b Monk AB, Harrison JE, Worthington HV, Teague A (November 2017). "Pharmacological interventions for pain relief during orthodontic treatment". The Cochrane Database of Systematic Reviews. 11 (12): CD003976. doi:10.1002/14651858.cd003976.pub2. PMC 6486038. PMID 29182798.
  14. ^ Artun J, Smale I, Behbehani F, Doppel D, Van't Hof M, Kuijpers-Jagtman AM (November 2005). "Apical root resorption six and 12 months after initiation of fixed orthodontic appliance therapy". The Angle Orthodontist. 75 (6): 919–26. PMID 16448232.
  15. ^ Mavragani M, Vergari A, Selliseth NJ, Bøe OE, Wisth PL (December 2000). "A radiographic comparison of apical root resorption after orthodontic treatment with a standard edgewise and a straight-wire edgewise technique". European Journal of Orthodontics. 22 (6): 665–74. doi:10.1093/ejo/22.6.665. PMID 11212602.
  16. ^ Wahl N (February 2005). "Orthodontics in 3 millennia. Chapter 1: Antiquity to the mid-19th century". American Journal of Orthodontics and Dentofacial Orthopedics. 127 (2): 255–9. doi:10.1016/j.ajodo.2004.11.013. PMID 15750547.
  17. ^ "NASA Technical Reports Server (NTRS)". Spinoff 1979. February 1979. Retrieved 2021-03-02.
[edit]
  • Useful Resources: FAQ and Downloadable eBooks at Orthodontics Australia
  • Orthos Explain: Treatment Options at Orthodontics Australia
  • Media related to Dental braces at Wikimedia Commons
 

 

For the state of being, see Patience. For other uses, see Patient (disambiguation).
  • v
  • t
  • e
Part of a series on Patients
Patients
Concepts
  • Doctor-patient relationship
  • Medical ethics
  • Patient participation
  • Patient-reported outcome
  • Patient safety
Consent
  • Informed consent
  • Adherence
  • Informal coercion
  • Motivational interviewing
  • Involuntary treatment
Rights
  • Patients' rights
  • Pregnant patients' rights
  • Disability rights movement
  • Patient's Charter
  • Medical law
Approaches
  • Patient advocacy
  • Patient-centered care
  • Patient and public involvement
Abuse
  • Patient abuse
  • Elder abuse
Medical sociology
  • Sick role
 

A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.

Etymology

[edit]

The word patient originally meant 'one who suffers'. This English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning 'I am suffering', and akin to the Greek verb πάσχειν (paskhein 'to suffer') and its cognate noun πάθος (pathos).

This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care.[1]

 

Outpatients and inpatients

[edit]
Patients at the Red Cross Hospital in Tampere, Finland during the 1918 Finnish Civil War
Receptionist in Kenya attending to an outpatient

An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for the visit, tests, or procedure/surgery, which should include the names and titles of the participating personnel, the patient's name and date of birth, signature of informed consent, estimated pre-and post-service time for history and exam (before and after), any anesthesia, medications or future treatment plans needed, and estimated time of discharge absent any (further) complications. Treatment provided in this fashion is called ambulatory care. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is called outpatient surgery or day surgery, which has many benefits including lowered healthcare cost, reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limited urinary-tract, eye, or ear, nose, and throat procedures and procedures involving superficial skin and the extremities). More procedures are being performed in a surgeon's office, termed office-based surgery, rather than in a hospital-based operating room.

A mother spends days sitting with her son, a hospital patient in Mali

An inpatient (or in-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as with coma or persistent vegetative state, patients can stay in hospitals for years, sometimes until death. Treatment provided in this fashion is called inpatient care. The admission to the hospital involves the production of an admission note. The leaving of the hospital is officially termed discharge, and involves a corresponding discharge note, and sometimes an assessment process to consider ongoing needs. In the English National Health Service this may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home.[2]

Misdiagnosis is the leading cause of medical error in outpatient facilities. When the U.S. Institute of Medicine's groundbreaking 1999 report, To Err Is Human, found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year,[3] early efforts focused on inpatient safety.[4] While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in a doctor's office or outpatient clinic or center.[citation needed]

Day patient

[edit]

A day patient (or day-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used by psychiatric hospital services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.

Alternative terminology

[edit]

Because of concerns such as dignity, human rights and political correctness, the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used include health consumer, healthcare consumer, customer or client. However, such terminology may be offensive to those receiving public health care, as it implies a business relationship.

In veterinary medicine, the client is the owner or guardian of the patient. These may be used by governmental agencies, insurance companies, patient groups, or health care facilities. Individuals who use or have used psychiatric services may alternatively refer to themselves as consumers, users, or survivors.

In nursing homes and assisted living facilities, the term resident is generally used in lieu of patient.[5] Similarly, those receiving home health care are called clients.

Patient-centered healthcare

[edit]
See also: Patient participation

The doctor–patient relationship has sometimes been characterized as silencing the voice of patients.[6] It is now widely agreed that putting patients at the centre of healthcare[7] by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction.[8]

When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible.[9] Incidents, such as the Stafford Hospital scandal, Winterbourne View hospital abuse scandal and the Veterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience.[10] Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services.[11]

There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct.[12] Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect',[9] that are difficult to capture with institutional monitoring.[13]

One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints.[14] Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn about and improve patient experience.[15]

See also

[edit]
  • Casualty
  • e-Patient
  • Mature minor doctrine
  • Nurse-client relationship
  • Patient abuse
  • Patient advocacy
  • Patient empowerment
  • Patients' Bill of Rights
  • Radiological protection of patients
  • Therapeutic inertia
  • Virtual patient
  • Patient UK

References

[edit]
  1. ^ Neuberger, J. (1999-06-26). "Do we need a new word for patients?". BMJ: British Medical Journal. 318 (7200): 1756–1758. doi:10.1136/bmj.318.7200.1756. ISSN 0959-8138. PMC 1116090. PMID 10381717.
  2. ^ "Unpaid carers' rights are overlooked in hospital discharge". Health Service Journal. 8 September 2021. Retrieved 16 October 2021.
  3. ^ Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn, L. T.; Corrigan, J. M.; Donaldson, M. S. (2000). Kohn, Linda T.; Corrigan, Janet M.; Donaldson, Molla S. (eds.). To Err Is Human: Building a Safer Health System. Washington D.C.: National Academy Press. doi:10.17226/9728. ISBN 0-309-06837-1. PMID 25077248.
  4. ^ Bates, David W.; Singh, Hardeep (November 2018). "Two Decades Since: An Assessment Of Progress And Emerging Priorities In Patient Safety". Health Affairs. 37 (11): 1736–1743. doi:10.1377/hlthaff.2018.0738. PMID 30395508.
  5. ^ American Red Cross (1993). Foundations for Caregiving. St. Louis: Mosby Lifeline. ISBN 978-0801665158.
  6. ^ Clark, Jack A.; Mishler, Elliot G. (September 1992). "Attending to patients' stories: reframing the clinical task". Sociology of Health and Illness. 14 (3): 344–372. doi:10.1111/1467-9566.ep11357498.
  7. ^ Stewart, M (24 February 2001). "Towards a Global Definition of Patient Centred Care". BMJ. 322 (7284): 444–5. doi:10.1136/bmj.322.7284.444. PMC 1119673. PMID 11222407.
  8. ^ Frampton, Susan B.; Guastello, Sara; Hoy, Libby; Naylor, Mary; Sheridan, Sue; Johnston-Fleece, Michelle (31 January 2017). "Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care". NAM Perspectives. 7 (1). doi:10.31478/201701f.
  9. ^ a b Reader, TW; Gillespie, A (30 April 2013). "Patient Neglect in Healthcare Institutions: A Systematic Review and Conceptual Model". BMC Health Serv Res. 13: 156. doi:10.1186/1472-6963-13-156. PMC 3660245. PMID 23631468.
  10. ^ Bloche, MG (17 March 2016). "Scandal as a Sentinel Event--Recognizing Hidden Cost-Quality Trade-offs". N Engl J Med. 374 (11): 1001–3. doi:10.1056/NEJMp1502629. PMID 26981930.
  11. ^ Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. London: Stationery Office. 6 February 2013. ISBN 9780102981476. Retrieved 23 June 2020.
  12. ^ Weingart, SN; Pagovich, O; Sands, DZ; Li, JM; Aronson, MD; Davis, RB; Phillips, RS; Bates, DW (April 2006). "Patient-reported Service Quality on a Medicine Unit". Int J Qual Health Care. 18 (2): 95–101. doi:10.1093/intqhc/mzi087. PMID 16282334.
  13. ^ Levtzion-Korach, O; Frankel, A; Alcalai, H; Keohane, C; Orav, J; Graydon-Baker, E; Barnes, J; Gordon, K; Puopulo, AL; Tomov, EI; Sato, L; Bates, DW (September 2010). "Integrating Incident Data From Five Reporting Systems to Assess Patient Safety: Making Sense of the Elephant". Jt Comm J Qual Patient Saf. 36 (9): 402–10. doi:10.1016/s1553-7250(10)36059-4. PMID 20873673.
  14. ^ Berwick, Donald M. (January 2009). "What 'Patient-Centered' Should Mean: Confessions Of An Extremist". Health Affairs. 28 (Supplement 1): w555 – w565. doi:10.1377/hlthaff.28.4.w555. PMID 19454528.
  15. ^ Reader, TW; Gillespie, A; Roberts, J (August 2014). "Patient Complaints in Healthcare Systems: A Systematic Review and Coding Taxonomy". BMJ Qual Saf. 23 (8): 678–89. doi:10.1136/bmjqs-2013-002437. PMC 4112446. PMID 24876289.
[edit]
Wikimedia Commons has media related to Patients.
 
Look up patient in Wiktionary, the free dictionary.
  • Jadad AR, Rizo CA, Enkin MW (June 2003). "I am a good patient, believe it or not". BMJ. 326 (7402): 1293–5. doi:10.1136/bmj.326.7402.1293. PMC 1126181. PMID 12805157.
    a peer-reviewed article published in the British Medical Journal's (BMJ) first issue dedicated to patients in its 160-year history
  • Sokol DK (21 February 2004). "How (not) to be a good patient". BMJ. 328 (7437): 471. doi:10.1136/bmj.328.7437.471. PMC 344286.
    review article with views on the meaning of the words "good doctor" vs. "good patient"
  • "Time Magazine's Dr. Scott Haig Proves that Patients Need to Be Googlers!" – Mary Shomons response to the Time Magazine article "When the Patient is a Googler"