Psychological support for orthognathic patients -- what do orthodontists want?
OBJECTIVE
(1) To evaluate consultant orthodontist opinion on referral of orthognathic patients to a liaison psychiatrist or psychologist and (2) To investigate the value of training orthodontic specialists in recognition of patients with psychological profiles that might affect orthognathic outcome.


METHODS
Questionnaire-based study.


METHODS
A structured questionnaire was distributed to all consultant orthodontists in the UK.


RESULTS
Approximately 40% of consultants thought that up to 10% of their orthognathic patients would benefit from psychological assessment by appropriately trained personnel. Twenty per cent of consultants were not certain what proportion of their patients would benefit from referral and over half the respondents said they do not refer any orthognathic patients for assessment. The most common reasons for referral were past/current psychiatric history (36%), unrealistic expectations (32%), 'gut instinct' (14%), no significant clinical problem (13%). Reasons not to refer were: nobody to refer to (30.5%), fear of patient reacting badly (15.8%), not sure who to refer to (14.7%), response from mental health team not useful (12.4%), waiting list too long (9.6%). The majority of clinicians felt they would benefit from training in this field (84.7%), as over 80% reported no teaching or training in psychological assessment/management.


CONCLUSIONS
Although we have no evidence to prove that interdisciplinary care is better for patients, clinical experience and reports from clinicians working in large centres, tells us there are probable advantages. The development of a training programme for both orthodontists and mental health teams would seem to be beneficial for both clinicians and patients.
Juggins
K J
KJ
Department of Orthodontics, The John Radcliffe Hospital, Oxford and UCL Eastman Dental Institute, UK. kjjuggins@hotmail.com
Feinmann
C
C
Shute
J
J
Cunningham
S J
SJ
D006801:Humans; D007400:Interprofessional Relations; D019647:Oral Surgical Procedures / Q000523:psychology*; D009970:Orthodontics; D017060:Patient Satisfaction; D010552:Personality Assessment; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011584:Psychology / Q000193:education; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom