Objectives: 1. Determine the workload that casual attendances create for a hospital orthodontic department. 2. Determine the reasons for casual attendances. 3. Determine methods by which the number of casual attendances can be reduced.
Methods: A prospective audit at the Orthodontic Department, James Cook University Hospital, Middlesbrough. Gold standard: there should be no casual attendances at all.
Results: 100 casual attenders were seen between 21/03/06 and 23/06/06. The type of appliance each patient was wearing and the exact nature of their problem were recorded. Casual attendances accounted for 6% of the total workload during the period studied. 75% of casual attenders had fixed appliances. Of these, 30% had a loose bracket. Upper second premolar brackets were the most commonly affected. Other common reasons for casual attendance included archwires becoming dislodged from molar tubes, soft tissue trauma from distal ends of archwires and lost elastic modules or powerchain. Casual attendances due to problems with removable appliances, functional appliances and retainers were less common.
Conclusions: Casual attendances accounted for a small proportion of the total workload during the period studied. However, the gold standard was not achieved. Further investigation is required, in order to determine the reasons why loose brackets are so common, and therefore change practice to reduce the number of casual attendances.