THE EDITOR'S CORNER

The approach of summertime is a reminder that every orthodontic office should have a standard operating procedure for any time when the doctor and/or his patients are on vacation. While the length of summer vacations may make them more critical, many of the instructions and arrangements that one might make to prepare for an extended summer vacation also apply to shorter vacations throughout the year.

Such an SOP might include the following:

1. Don't place an appliance just before a vacation that has high potential for emergency such as accessory springs and horizontal space closing devices. The latter, employing elastics, elastic thread ligature or loops, can quickly cause archwires to protrude beyond the distal ends of the buccal tubes and injure the cheeks. Similarly, get out of vertical loop archwires before vacations if you can. Loops themselves have a potential for emergency by traumatizing lips and cheeks, embedding in gum tissue, and breaking.

2. Don't place an appliance immediately before vacation that requires a high degree of cooperation such as a headgear or positioner.

3. Don't remove appliances and place a retainer immediately before vacation. Do not install a removable active or passive appliance unless you have at least one opportunity to check it before vacation. If possible postpone installation of an active removable appliance until after vacation. One adjustment may not be significant enough.

4. Do not cement bands that are not going to be actively in use during the vacation.

5. Check all bands for cement loss and recement questionable bands.

6. Before a prolonged vacation, send home a note with patient vacation instructions. For patients going to summer camp, request that the instructions be given to the patient's bunk counsellor

7. Give the patient an extra supply of rubber bands and instructions to write for more if they are lost, misplaced or used up.

8. Give the patient a supply of soft wax.

9. Give the patient a new toothbrush just for camp. His home toothbrush will not then spend weeks in transit to and from camp.

10. If possible, give the patient a reference to an orthodontist in the area to which he is going, to be used in case of emergency. This is particularly true for patients who may be traveling abroad.

11. If no specific orthodontist reference is made, instruct the patient to see a local orthodontist or dentist in an emergency. Instruct the patient to call your office in the event of any questionable problem. Give the patient your card with your office phone number on it.

12. For patients who broke or cancelled their last appointment before a vacation, send them a supply of elastics, headgear charts, wax, and vacation instructions.

13. Instruct patients to remove loose plastic appliances for swimming and keep in a safe place.

14. Use audiovisual material to reinforce instructions on toothbrushing, care of appliances, gum, etc.

15. Don't schedule observation visits just before a long vacation, unless there is some special reason such as the possibility of deciduous extraction and use of vacation time for eruption of permanent teeth.

16. Don't take diagnostic records before a long vacation.

17. Set aside enough time on the first and second days after vacation to handle emergencies.

18. Ask parents to call the office for an appointment during the last week of vacation before the patient will be returning.

19. When the orthodontist is going on vacation, he should be sure to make arrangements for covering his practice for emergencies with other orthodontists and/or dentists; to leave suitable emergency instructions with his telephone answering service or on the tape of his telephone answering machine. Remember that even in those states which permit extended use of auxiliary personnel, their work must be done under the orthodontist's supervision. Therefore, an auxiliary cannot be left in charge of your office to handle emergencies in your absence.

20. Unless your office is overstaffed, it is preferable for all personnel to take vacations at the same time.

21. Check with patients who have required the services of the office which covered for you. Make sure that your patients received the kind of care and attention that you want them to and think they are receiving.