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This apprenticeship standard is in development and is not yet ready to use

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An apprenticeship standard is only available for delivery when both the standard and assessment plan is approved and a funding band (core government contribution) has been assigned to the standard.

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Orthodontic Therapist

Details of standard

Occupation summary

This occupation is found in Dentistry.

The broad purpose of the occupation is to become a registered professional who fits, adjusts and removes braces to patient’s teeth, working to the prescription of an orthodontist or dentist competent in orthodontics. They provide holistic advice on maintaining oral and general health for patients who are undergoing orthodontic treatment.

In their daily work, an employee in this occupation interacts with patients of all ages who present with dental malocclusions (problems with the development, alignment and the way teeth fit together), the wider orthodontic and dental team, parents, guardians and carers.

An employee in this occupation will be responsible for undertaking reversible orthodontic procedures, which include bonding brackets on the teeth, fitting and changing wires and accessories that connect to the brackets, fitting removable appliances and retainers, following an appropriate prescription. They will respond appropriately to a treatment plan from the orthodontist, gaining valid consent from the patient and guardian, and giving appropriate advice. They will be able to make appliances safe in the absence of the dentist and respond appropriately to emergencies.

The scope of practice for orthodontic therapists is set out by the General Dental Council who regulate this occupation. Further details of the regulatory requirements can be found in the following General Dental Councils documents: ‘Preparing for Practice,’ ‘Standards for Education’ and ‘Standards for the Dental Team’.

Orthodontic Therapists work as part of wider dental team that includes dentists or orthodontists, dental nurses, dental hygienists, dental therapists, dental technicians, clinical dental technicians, practice managers, administrators and laboratory staff. Depending on the practice they work in, Orthodontic Therapists may supervise colleagues, trainees or students. The dentist or orthodontist prescribes the treatments that an Orthodontic Therapist will carry out, including taking impressions, placing fixed brackets and arch wires on teeth, fitting tooth separators, undertaking radiographs and occlusal bite registration.

During the apprenticeship apprentices must be supervised by a suitably trained orthodontist on the specialist list maintained by the General Dental Council.

They must be a Registered General Dental Council dental nurse, dental hygienist, dental therapist or dental technician prior to commencing this apprenticeship

Typical job titles include:

Orthodontic Therapist

Entry requirements

Must be registered on the General Dental Council Register as a registered dental nurse, dental hygienist, dental therapist or dental technician. Employers usually require applicants to have a period of clinical post-qualification experience (usually at least 2 years).


Occupation duties

Duty

KSBs

Duty 1 Work to current best practice for orthodontic therapy and patient care

K1 K2 K3 K4 K5 K6 K7

S1

B1 B2

Duty 2 Work safely and independently in a patient’s mouth in accordance with the orthodontist’s prescription

K8 K9 K10 K11 K12

S2 S3 S4 S5 S6 S7

B1 B2

Duty 3 Use appropriate communication at all times and through all media

K13 K14 K15 K16 K17 K18 K19 K20

S8 S9 S10 S11

B1 B2

Duty 4 Involve patients, parents and guardians in the patient’s care and decision making

K15 K21

S12 S13 S14

B1 B2

Duty 5 Take impressions or scans of the teeth

K22

S15 S16

B1 B2

Duty 6 Identify, select and use equipment, instruments and materials

K23

S7 S17

B1 B2

Duty 7 Clean and prepare tooth surfaces

K24 K25 K26

S18

B1 B2

Duty 8 Fit orthodontic appliances

K25 K27

S15 S19 S20

B1 B2

Duty 9 Make a patient’s orthodontic appliance safe in the absence of the orthodontist

K28

S21 S22

B1 B2

Duty 10 Change or repair archwires inside a patient’s mouth

K29

S23

B1 B2

Duty 11 Remove fixed appliances, orthodontic adhesives and cement

K25 K30

S24

B1 B2

Duty 12 Provide holistic advice on maintaining oral and general health

K31 K32 K33 K34 K35 K36

S25 S26 S27

B1 B2

Duty 13 Seek advice and receive referrals made by other healthcare professionals

K37 K38 K39

S28 S29 S30

B1 B2

Duty 14 Recognise and deal with medical emergencies

K40 K41

S31

B1 B2

Duty 15 Be a reflective practitioner within the wider dental team

K3 K17 K42 K43 K44 K45 K46 K47

S30 S32 S33 S34

B1 B2


KSBs

Knowledge

K1: The General Dental Council scope of practice, your role as an orthodontic therapist and that of others in the dental team, local clinical guidelines and policies Back to Duty

K2: The principles of an evidence-based approach to learning, clinical and professional practice Back to Duty

K3: Ways to maintain your professional knowledge and competence Back to Duty

K4: The principles of clinical decision making and your role in the decision-making process Back to Duty

K5: What is meant by patient-centred care, the importance of safeguarding and your duty of care, the signs of abuse or neglect including local and national systems and ways to raise concerns where appropriate Back to Duty

K6: The scientific principles of medical ionizing radiation and statutory regulations Back to Duty

K7: Current health and safety policy legislation related to your role as an orthodontic therapist Back to Duty

K8: The range of contemporary orthodontic treatment options, their impact, outcomes, limitations and risks Back to Duty

K9: The need for an accurate and current patient history, the importance of each component of the patient assessment process and the needs of different patient groups including children, adults, older people or those with special care requirements throughout the patient care process Back to Duty

K10: The importance of an orthodontist’s s prescription Back to Duty

K11: The cause of malocclusion and its possible impact of a poor bite or malpositioned teeth on medical, psychological and sociological aspects of health. Back to Duty

K12: The potential routes of transmission of infectious agents in dental practice, mechanisms for the prevention of infection, the scientific principles of decontamination and disinfection and their relevance to health and safety Back to Duty

K13: A range of communication methods, including verbal and non-verbal, listening skills and be aware of the barriers to communication Back to Duty

K14: The importance of maintaining confidentiality and protecting all data relating to patients and their treatment Back to Duty

K15: The need to explain and check patients’ and guardians’ understanding of treatments, options, costs and informed consent Back to Duty

K16: How to manage anxiety or challenging behaviour including relevant behavioural change techniques Back to Duty

K17: How to manage lines of communication within your team or with wider healthcare professions Back to Duty

K18: The principles of information governance Back to Duty

K19: The use of a range of communication methods and technologies and their appropriate application in support of clinical practice Back to Duty

K20: The importance of and the need to maintain accurate and current records in accordance with legal and statutory requirements and best practice Back to Duty

K21: The need to treat all patients equally, with respect and dignity, appreciating the importance of patient and guardian choice Back to Duty

K22: Dental, craniofacial anatomy and physiology relevant to orthodontic therapy, the range of normal human structures and functions and the principles that derive from the biomedical, behavioral and materials sciences as they apply to the practice of orthodontic therapy Back to Duty

K23: A range of orthodontic equipment, instruments, materials and appliances such as braces, retainers, headgear, face bows, pliers, archwires, brackets, bands, cements and adhesives including their uses and limitations Back to Duty

K24: The scientific principles underpinning the use of biomaterials and their limitations with emphasis on those used in dentistry Back to Duty

K25: Different types of adhesives and cement, when to use them and how to apply or remove them from teeth Back to Duty

K26: Types of instruments for cleaning and preparing tooth surfaces Back to Duty

K27: A range of orthodontic appliances such as fixed and removable braces and retainers, their use and ways to fit them Back to Duty

K28: Problems associated with orthodontic appliances, how to recognise them and the appropriate action to take Back to Duty

K29: How archwires that fit into appliances affect the patient’s mouth, teeth and overall wellbeing and when to change or repair them Back to Duty

K30: When and why appliances should be removed in accordance with the prescription Back to Duty

K31: The cause of oral disease in relation to dental decay and gum disease and basic facial structure formation with a focus on abnormalities and acute conditions that may arise Back to Duty

K32: The significance of changes in patients reported oral health Back to Duty

K33: A range of common oral health problems and the need for appropriate follow-up care Back to Duty

K34: The principles of preventive care and the importance of providing patients with comprehensive and accurate preventive education and instruction Back to Duty

K35: The role of health promotion, how health promotion strategies are implemented including demographic and social trends and the principles of planning oral health care for communities to meet needs and demands Back to Duty

K36: Ways to encourage self-care and motivation, the health risks of poor diet, substance misuse and substances such as tobacco and alcohol on oral and general health Back to Duty

K37: The need to monitor and review treatment outcomes including when to seek advice Back to Duty

K38: The referral process, the management and organisation of local referral networks Back to Duty

K39: The importance of an appropriate and timely referral Back to Duty

K40: The types of medical emergencies that may occur and ways to deal with them Back to Duty

K41: The risks around the clinical environment and manage these in a safe and efficient manner complying with current best practice guidelines Back to Duty

K42: Your own role in relation to the rest of the dental team and to any trainees or students you may supervise including when to escalate and report Back to Duty

K43: The importance of appraisal, training and ongoing review including ways to give and receive feedback Back to Duty

K44: The importance of maintaining your own network of dental professionals, specialists and other stakeholders involved in the care and support of patients Back to Duty

K45: The wider dental and healthcare system you work in Back to Duty

K46: A range of reflective models and how to use them in your own practice and in maintaining your own professional development portfolio Back to Duty

K47: The importance of quality and ways to encourage continual improvement Back to Duty

Skills

S1: Adhere to legal and ethical responsibilities in line with General Dental Council requirements, taking responsibility for the integrity of own actions and completed work recognising the limits of your competence and experience Back to Duty

S2: Identify normal and abnormal facial growth, physical, mental and dental development Back to Duty

S3: Take a patient medical and social history, checking the patient’s level of experience and expectations Back to Duty

S4: Carry out screening for the orthodontic need for treatment either under the direction of an orthodontist or direct to patients Back to Duty

S5: Recognise the early stages of chronic problems with the soft tissues of the mouth Back to Duty

S6: Recognise urgent care problems related to orthodontic treatment and take appropriate action in line with their scope of practice Back to Duty

S7: Implement and perform effective decontamination and infection control procedures Back to Duty

S8: Communicate appropriately, effectively and sensitively Back to Duty

S9: Maintain patient confidentiality at all times Back to Duty

S10: Assess and manage patient anxiety, discomfort or challenging behaviour through effective communication, reassurance and relevant behavioural techniques Back to Duty

S11: Create, update and store contemporaneous patient records Back to Duty

S12: Make effective decisions regarding the care of patients in line with the orthodontist’s treatment plan and in partnership with the patient and their parent/guardian Back to Duty

S13: Put patients’ interests first and act to protect them Back to Duty

S14: Respect patients’ dignity and choices obtaining and documenting valid consent for all treatments and personal care delivery Back to Duty

S15: Take impressions or scans of patient’s teeth as prescribed by the referring practitioner Back to Duty

S16: Use impressions or scans of the teeth to produce study models Back to Duty

S17: Select and use the correct orthodontic equipment, instruments and materials to ensure appropriate and safe orthodontic care of the patient Back to Duty

S18: Clean and prepare tooth surfaces ready for orthodontic treatment Back to Duty

S19: Undertake a basic orthodontic assessment of a patient’s mouth Back to Duty

S20: Fit the brackets and wires which make up braces in accordance with the prescription Back to Duty

S21: Fit, adjust, remove or repair a range of orthodontic appliances that the patient may wear as prescribed by the orthodontist. In the absence of a prescription, be able to make safe removable and fixed appliance components Back to Duty

S22: Make the appliance safe and ensure continuing care is provided as soon as possible Back to Duty

S23: Insert, ligate, remove, trim or repair archwires from appliances under prescription Back to Duty

S24: Remove the brackets and wires which make up appliances and the cement from the tooth surface that has held the bracket to the tooth safely and as prescribed, without causing damage to the tooth surface Back to Duty

S25: Contribute to relevant tests and diagnostic procedures Back to Duty

S26: Apply evidence-based oral health advice including toothbrushing, interdental cleaning, care of braces and removable orthodontic appliances, diet and hydration advice Back to Duty

S27: Encourage and support self-care and motivation providing appropriate advice Back to Duty

S28: Recognise and manage patients with acute oral conditions and know the referral process Back to Duty

S29: Identify where patients’ needs may differ from the treatment plan or prescription and direct patients for advice where appropriate Back to Duty

S30: Work with colleagues in a way that is in the patients’ best interests Back to Duty

S31: Recognise and manage medical emergencies Back to Duty

S32: Take part in appraisal and ongoing review Back to Duty

S33: Co-operate with members of the wider dental or healthcare team, taking responsibility for establishing personal networks Back to Duty

S34: Reflect on own practice, recognising how reflection can be used to continually improve the quality of patient care and professional development Back to Duty

Behaviors

B1: Act in a manner consistent with the GDC standards for the dental team which include communication, professionalism, teamwork and clinical skills Back to Duty

B2: Act in a non-discriminatory manner respecting diversity and upholding the rights, dignity and autonomy of others Back to Duty


Qualifications

English & Maths

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment. For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL.


Additional details

Occupational Level:

4

Duration (months):

13

Review

Status: In development
Proposal approved Standard approved Assessment plan approved
Level: 4
Reference: ST0701
Version: 1
Date updated: 22/05/2019
Route: Health and science
Typical duration: 13 months
Employers involved in creating the standard: Genix Healthcare, Bradford Teaching Hospitals NHS Foundation Trust, BUPA Dental Care, Central Manchester University Hospitals NHS Trust, Crystal Peaks Orthodontics, Sheffield, Junction Dental, Heckmondwike, Kings College Hospital NHS Foundation Trust, Leamington Spa Orthodontics, Leeds Teaching Hospitals NHS Foundation Trust, Manchester University NHS Foundation Trust, Ortho Studio, Rotherham, Orthodontics by Eva, Winchester, Saltaire Orthodontics, Bradford, Smile Orthodontics, Norwich, United Lincoln Hospitals Trust

Version log

Version Date updated Change Previous version
1 22/05/2019 Standard published

Not available