Cover
Foreword to Second Edition
How to use this book
Acknowledgements
Chapter 1: Definition of orthodontics and factors influencing orthodontic treatment
1. CLASSIFICATION OF OCCLUSION
2. THE MIXED DENTITION
3. INDICATIONS FOR TREATMENT
4. UNDERLYING CAUSES OF MALOCCLUSION OF THE TEETH
5. PROBLEMS WHEN THE ARCH IS NOT INTACT
6. BRUXISM
7. DIGIT SUCKING
8. DENTAL HEALTH
9. CONDITION OF THE SURROUNDING SOFT TISSUES
Chapter 2: The first appointment
1. THE CLINICAL ASSESSMENT RECORDS
2. RADIOGRAPHS
3. PHOTOGRAPHS
4. RISKS OF ORTHODONTIC TREATMENT
5. DISCUSSION AND CONSENT
6. TAKING BASELINE RECORDS
7. ORTHODONTIC MODELS
Chapter 3: Occlusal indices
1. DENTAL HEALTH COMPONENT
2. AESTHETIC COMPONENT
3. THE PAR INDEX
4. ICON
5. MANAGEMENT
Chapter 4: Motivation
1. RETENTION
2. PATIENTS WHO ARE MOTIVATED AND READILY COMPLY
Chapter 5: Leaflets
Chapter 6: Oral hygiene
1. FOR REMOVABLE APPLIANCES
2. FOR FIXED APPLIANCES
3. WAYS PATIENTS CAN HELP THEMSELVES TO PREVENT PROBLEMS
4. GETTING THE MESSAGE ACROSS
5. SUPPORT
6. THE UNENTHUSIASTIC PATIENT
7. THE NURSE'S ROLE
Chapter 7: Removable appliances
1. ADVANTAGES: WHAT THEIR BENEFITS ARE
2. DISADVANTAGES: WHAT THEY CANNOT ACHIEVE
3. PARTS OF A REMOVABLE APPLIANCE
4. MAKING, FITTING AND ADJUSTMENT
Chapter 8: Transpalatal arches, lingual arches and quad helix
1. MAKING AND FITTING OF ARCHES
2. REMOVAL OF ARCHES
3. QUAD HELIX
4. REMOVAL OF QUAD HELIX
Chapter 9: Rapid maxillary expansion
1. TAKING IMPRESSIONS
2. FITTING THE APPLIANCE
3. WHEN SCREW TURNING HAS BEEN COMPLETED
4. WHEN THE PALATE HAS CONSOLIDATED
5. FITTING THE RETAINER
Chapter 10: Headgear
1. HOW THE HEADGEAR IS ASSEMBLED
2. FITTING HEADGEAR
3. CHAIRSIDE FITTING PROCEDURE
Chapter 11: Functional appliances
1. THE PROBLEM
2. THE SOLUTION
3. TYPES OF FUNCTIONAL APPLIANCE
4. FIRST APPOINTMENT
5. FITTING APPOINTMENT
6. SUBSEQUENT APPOINTMENTS
Chapter 12: Temporary anchorage devices and magnets
1. WHAT THEY ARE
2. WHAT THEY DO
3. THE ADVANTAGES OF TADS
4. THE DISADVANTAGES OF TADS
5. HOW THE DEVICE IS FITTED
6. MAGNETS
Chapter 13: Fixed appliances: what they do and what is used
1. PATIENT EXPECTATION: THE POPULAR CULTURE OF TRAIN TRACKS
2. PEER PRESSURE
3. STAGES OF TREATMENT IN FIXED APPLIANCE THERAPY
4. WHAT IS USED IN FIXED APPLIANCE THERAPY?
5. THE ATTACHMENTS
6. ARCHWIRES
7. PLIERS
8. HAND INSTRUMENTS
9. AUXILIARIES
10. A FIXED APPLIANCE TRAY
11. CEMENTS
12. ADHESIVES
13. ETCHANT/PRIMER
14. MICROBRUSHES
15. LIP RETRACTORS
16. CHEEK RETRACTORS
17. AIDS TO PATIENT COMFORT
18. INTERPROXIMAL REDUCTION
Chapter 14: Fixed appliances: direct bonding
1. COMMUNICATION
2. ALLERGY AWARENESS
3. ORAL PIERCING
4. LOCAL ANAESTHETIC
5. FITTING A FIXED APPLIANCE USING THE DIRECT BONDING TECHNIQUE
6. METHOD 1: THREE VISITS
7. METHOD 2: TWO VISITS
8. METHOD 3: TWO VISITS
9. This method involves two visits for:
10. METHOD 4: ONE VISIT
11. This method involves just one visit for:
12. OTHER USES AND APPLICATIONS FOR FIXED APPLIANCES
Chapter 15: Fixed appliances: indirect bonding and lingual orthodontics
1. LINGUAL ORTHODONTICS
2. THE INDIRECT BONDING TECHNIQUE
Chapter 16: Ectopic canines
1. WHAT IS AN ECTOPIC CANINE?
2. THE PROBLEM
3. CLINICAL INTERVENTION: WHAT THE TREATMENT INVOLVES
Chapter 17: Debonding
1. PREPARATION
2. PROCEDURE
Chapter 18: Retention and retainers
1. REMOVABLE RETAINERS
2. FIXED RETAINERS
Chapter 19: Aligners
1. TYPES OF ALIGNERS
2. INTERPROXIMAL REDUCTION
Chapter 20: Multi‐disciplinary orthodontics
1. RESTORATIVE
2. SURGICAL
3. CLEFT LIP AND PALATE
Chapter 21: Adult orthodontics
1. ORTHODONTIC SOLUTIONS
Chapter 22: Mandibular advancement devices
1. SOCIAL PROBLEMS
2. WHAT CAUSES THE SNORING NOISE?
3. WHAT ARE THE SOLUTIONS?
4. WHAT IS NEEDED
5. THE PROCEDURE
6. OUTCOME
7. CONCLUSION
Chapter 23: Study models and digital storage of records
1. STUDY MODELS
2. STAGE MODELS
3. WORKING MODELS
4. CO‐ORDINATION MODELS
5. PLANNING MODELS
6. WAFER IMPRESSIONS
7. DEBONDING IMPRESSIONS
8. FINAL IMPRESSIONS
9. THE DIGITAL METHOD
Chapter 24: Descriptions and photographs of the most commonly used instruments and auxiliaries
Chapter 25: Certificate in Orthodontic Nursing, extended duties and ongoing training
1. WHAT IS IT?
2. WHO IS ELIGIBLE TO GO ON THE COURSE?
3. THE FEE STRUCTURE FOR THE COURSE
4. WHAT DOES THE COURSE INVOLVE?
5. THE SYLLABUS FOR THE CERTIFICATE IN ORTHODONTIC NURSING
6. MODULE IN THE TAKING OF IMPRESSIONS
7. MODULE IN CLINICAL PHOTOGRAPHY
Chapter 26: Orthodontic therapists
1. THE SYLLABUS FOR ORTHODONTIC THERAPY
2. THE SYLLABUS FOR CLINICAL ORTHODONTICS
Chapter 27: The Orthodontic National Group for Dental Nurses and Therapists
1. AIMS
2. OBJECTIVES
3. STRUCTURE OF THE GROUP
4. EDUCATION
5. JOURNAL
6. LINKS WITH THE BRITISH ORTHODONTIC SOCIETY
7. THE FUTURE
8. CONTACT DETAILS
Useful contacts
Glossary
Index
End User License Agreement

List of Illustrations

Chapter 1
1. Figure 1.1 Cephalometric tracing.
2. Figure 1.2 Incisor classification.
3. Figure 1.3 Large overjet.
4. Figure 1.4 Side view of severe overjet.
5. Figure 1.5 Bite stripping lower gingivae.
6. Figure 1.6 Damage to labial gingivae caused by the bite.
7. Figure 1.7 Bite causing trauma to the palate.
8. Figure 1.8 Class III.
9. Figure 1.9 Diagram of buccal segment occlusion.
10. Figure 1.10 Hypodontia.
11. Figure 1.11 Lower incisor trapped outside the bite.
12. Figure 1.12 Scissors bite.
13. Figure 1.13 Anterior open bite due to digit sucking.
14. Figure 1.14 Leaflet on digit sucking.
15. Figure 1.15 Tongue tie.
Chapter 2
1. Figure 2.1 Sample of assessment form from a specialist orthodontic practice....
2. Figure 2.2 Sample of assessment form from a hospital orthodontic department....
3. Figure 2.3 Drawing showing relation of FM angle.
4. Figure 2.4 Diagram of incisor relationship.
5. Figure 2.5 Diagram of buccal segment occlusion.
6. Figure 2.6 Example of OPT radiograph.
7. Figure 2.7 Example of cephalometric radiograph.
8. Figure 2.8 Leaflet on risks of orthodontic treatment.
9. Figure 2.9 Am I sure?
10. Figure 2.10 Radiograph showing resorption.
11. Figure 2.11 Consent forms giving consent to orthodontic treatment.
12. Figure 2.12 Consent form giving consent to having dental photography.
13. Figure 2.13 Orthodontic ruler.
14. Figure 2.14 Lip retractors.
15. Figure 2.15 Photographic mouth mirrors.
16. Figure 2.16 Example of trimmed orthodontic models.
Chapter 3
1. Figure 3.1 Dental health component.
2. Figure 3.2 IOTN dental health component ruler (disposable).
3. Figure 3.3 Aesthetic component.
4. Figure 3.4 PAR index ruler (disposable). Abbreviations: xbite, xb, crossbite...
Chapter 4
1. Figure 4.1 Retainers leaflet.
2. Figure 4.2 Inside a Retainer Leaflet.
Chapter 5
1. Figure 5.1 British Orthodontic Society information leaflets.
2. Figure 5.2 Ortho‐Care information leaflet.
3. Figure 5.3 ‘Your first visit to the orthodontist’ leaflet.
Chapter 6
1. Figure 6.1 Retainer Brite for cleaning removable appliances.
2. Figure 6.2 Incisal erosion due to fizzy drinks drunk from a can.
3. Figure 6.3 Cervical caries.
4. Figure 6.4 Decalcification of teeth after debanding.
5. Figure 6.5 Effect of plaque on teeth.
6. Figure 6.6 Disclosing tablets showing plaque.
7. Figure 6.7 Possibly the best oral hygiene.
8. Figure 6.8 Possibly the worst oral hygiene.
9. Figure 6.9 Travel toothbrush.
10. Figure 6.10 Swirl Plus fluoride mouth rinse.
11. Figure 6.11 Interdental brush.
12. Figure 6.12 Disclosing tablets.
13. Figure 6.13 Food and drink leaflet.
14. Figure 6.14 ‘How to keep your teeth and gums healthy’ leaflet.
15. Figure 6.15 ‘Why bother to look after your teeth’ leaflet.
Chapter 7
1. Figure 7.1 Removable appliance with expansion screw.
2. Figure 7.2 Expansion screw and choice of key types.
3. Figure 7.3 Baseplate.
4. Figure 7.4 Upper removable appliance.
5. Figure 7.5 Removable appliance with Z spring.
6. Figure 7.6 Adams clasp (crib) and a labial bow.
7. Figure 7.7 British Orthodontic Society leaflet.
8. Figure 7.8 Ortho‐Care leaflet.
9. Figure 7.9 Removable appliance tray.
10. Figure 7.10 Close‐up of Adams plier.
11. Figure 7.11 Box for storage of removable appliance when not in mouth.
12. Figure 7.12 Mouthguard (single arch).
13. Figure 7.13 Mouthguard (both arches).
14. Figure 7.14 Pre‐ and post‐treatment study models in box.
15. Figure 7.15 Open bite due to digit sucking.
16. Figure 7.16 Anti‐habit appliance.
Chapter 8
1. Figure 8.1 Transpalatal arch.
2. Figure 8.2 Quad helix cemented in place.
Chapter 9
1. Figure 9.1 Fitting the RME.
2. Figure 9.2 RME three weeks later.
3. Figure 9.3 RME appliance in situ post treatment.
4. Figure 9.4 Safety swivel key for turning the screw.
5. Figure 9.5 Diastema after RME appliance treatment.
6. Figure 9.6 British Orthodontic Society leaflet.
Chapter 10
1. Figure 10.1 Head cap.
2. Figure 10.2 Modules.
3. Figure 10.3 Modules fitted to head cap.
4. Figure 10.4 Facebow with safety locking device.
5. Figure 10.5 Headgear leaflet.
6. Figure 10.6 Mauns heavy‐duty wire cutters.
7. Figure 10.7 Band with tube for headgear.
Chapter 11
1. Figure 11.1 Functional appliance in the mouth.
2. Figure 11.2 Clark Twin Block: lateral view.
3. Figure 11.3 Clark Twin Block: front view.
4. Figure 11.4 Clark Twin Block: lateral view.
5. Figure 11.5 Diagram of position of blocks on appliances.
6. Figure 11.6 MOA showing rest for lower teeth in the postured position.
7. Figure 11.7 Herbst appliance.
8. Figure 11.8 British Orthodontic Society leaflet.
9. Figure 11.9 Ortho‐Care leaflet.
10. Figure 11.10 Case for functional appliance.
Chapter 12
1. Figure 12.1 British Orthodontic Society leaflet.
2. Figure 12.2 TAD being inserted.
3. Figure 12.3 TAD fully inserted.
4. Figure 12.4 TAD being inserted.
5. Figure 12.5 TAD tray.
6. Figure 12.6 Magnets in situ.
7. Figure 12.7 Magnets in situ.
Chapter 13
1. Figure 13.1 British Orthodontic Society leaflet.
2. Figure 13.2 Ortho‐Care leaflet.
3. Figure 13.3 Upper and lower fixed appliances with metal brackets.
4. Figure 13.4 Molar band with tube.
5. Figure 13.5 Band with additional slot on buccal tube for headgear.
6. Figure 13.6 Tray of first molar bands.
7. Figure 13.7 Green anterior and blue posterior separating rings, separating s...
8. Figure 13.8 Metal bracket.
9. Figure 13.9 Clarity™ aesthetic bracket.
10. Figure 13.10 VS™ PLUS adhesive‐coated appliance system, open blister.
11. Figure 13.11 Metal brackets on orientation card.
12. Figure 13.12 Clarity™ advanced adhesive‐coated bracket system on orientation...
13. Figure 13.13 Buccal tube.
14. Figure 13.14 Eyelet.
15. Figure 13.15 Cleat.
16. Figure 13.16 Stainless steel archwire.
17. Figure 13.17 Posted archwire.
18. Figure 13.18 Reverse curve archwire.
19. Figure 13.19 Australian wires.
20. Figure 13.20 Archwire storage.
21. Figure 13.21 Sample fixed appliance tray set‐up.
22. Figure 13.22 Bite stick, Mershon pusher, Mitchell trimmer and ligature direc...
23. Figure 13.23 Ligature, Kobayashi ligature, Quicklig and mosquitos.
24. Figure 13.24 Narrow, medium and wide chain.
25. Figure 13.25 Coloured chain.
26. Figure 13.26 Elastomerics in mosquitos.
27. Figure 13.27 Range of coloured O‐rings.
28. Figure 13.28 Archwire with sleeving.
29. Figure 13.29 Protective bumper which fits over fixed appliance brackets.
30. Figure 13.30 Rotation wedges.
31. Figure 13.31 Space closing modules.
32. Figure 13.32 NiTi power springs.
33. Figure 13.33 NiTi coil spring.
34. Figure 13.34 Intra‐maxillary elastics.
35. Figure 13.35 Elastic placer.
36. Figure 13.36 Separating module on plier.
37. Figure 13.37 Separating springs.
38. Figure 13.38 Selection of pliers.
39. Figure 13.39 Dividers.
40. Figure 13.40 Ortholux™ luminous curing light.
41. Figure 13.41 Cements.
42. Figure 13.42 Transbond TX™ light curing adhesive.
43. Figure 13.43 Transbond TX™ light curing primer.
44. Figure 13.44 Transbond™ Plus self‐etching primer.
45. Figure 13.45 Microbrush.
46. Figure 13.46 Mirahold™ lip retractors.
47. Figure 13.47 Lip retractors.
48. Figure 13.48 Cheek retractors.
49. Figure 13.49 Relief wax.
Chapter 14
1. Figure 14.1 Lip stud.
2. Figure 14.2 Hooks on brackets.
3. Figure 14.3 Safety glasses for use with LED light.
4. Figure 14.4 Orthodontic prophy paste.
5. Figure 14.5 Box containing a selection of molar bands.
6. Figure 14.6 Bite stick, Mershon pusher, Mitchell trimmer and ligature direct...
7. Figure 14.7 Mirror probe, College tweezers, ligature director and Mitchell t...
8. Figure 14.8 Orientation card.
9. Figure 14.9 Acid etch and primer in Dappen's pots.
10. Figure 14.10 Transbond™ self‐etching primer.
11. Figure 14.11 Bracket‐holding tweezers.
12. Figure 14.12 Light wire pliers.
13. Figure 14.13 Weingart pliers.
14. Figure 14.14 Ligature and pin cutters.
15. Figure 14.15 Distal end cutters.
16. Figure 14.16 Mathieu forceps.
17. Figure 14.17 Mosquito forceps.
18. Figure 14.18 Box of coloured O‐rings.
19. Figure 14.19 Self‐ligating brackets (still with their identifying spots)....
20. Figure 14.20 Advanced APC™ II bracket in open blister.
21. Figure 14.21 Sample fixed appliance tray.
Chapter 15
1. Figure 15.1 Lingual appliance.
2. Figure 15.2 Lingual appliance with gold brackets.
3. Figure 15.3 Lingual appliance: note shape of archwire.
4. Figure 15.4 Lingual wire placer.
5. Figure 15.5 Lingual angled distal end cutter, lingual distal end cutters, li...
6. Figure 15.6 Lingual Weingart pliers, lingual debonding pliers and lingual li...
Chapter 16
1. Figure 16.1 (a, b) Radiographs of ectopic canines.
2. Figure 16.2 Diagram explaining parallax.
3. Figure 16.3 Cone beam CT images.
4. Figure 16.4 Cone beam CT images.
5. Figure 16.5 Radiograph of bilateral upper ectopic canines in an older child....
6. Figure 16.6 Surgically exposed palatal canines.
7. Figure 16.7 Upper removable appliance with untrimmed whip arm.
8. Figure 16.8 Untrimmed whip arm.
Chapter 17
1. Figure 17.1 Tray for deband.
2. Figure 17.2 Anterior bracket‐removing pliers.
3. Figure 17.3 Band‐removing pliers.
4. Figure 17.4 Band‐slitting pliers.
5. Figure 17.5 Adhesive‐removing pliers.
6. Figure 17.6 Debonding bur.
7. Figure 17.7 Band and bracket removal tray.
Chapter 18
1. Figure 18.1 Labial bow and Adams crib.
2. Figure 18.2 (a) Upper and (b) lower Hawley retainer.
3. Figure 18.3 Begg retainer.
4. Figure 18.4 (a) Original design of a Barrer spring appliance.(b) A Barre...
5. Figure 18.5 Essix retainer.
6. Figure 18.6 Adams pliers.
7. Figure 18.7 Retainer cases.
8. Figure 18.8 Fixed retainer to prevent diastema reopening.
9. Figure 18.9 Fixed retainer.
10. Figure 18.10 Wire for fixed retainers.
11. Figure 18.11 (a–c) Retainer leaflets.
Chapter 19
1. Figure 19.1 Patient wearing upper and lower clear aligners.
2. Figure 19.2 British Orthodontic Society interproximal reduction leaflet.
3. Figure 19.3 Interproximal reduction kit.
4. Figure 19.4 Interproximal strip.
Chapter 20
1. Figure 20.1 Leaflet for orthognathic surgery.
2. Figure 20.2 Drawing showing Frankfort plane.
3. Figure 20.3 Radiograph of ectopic canines.
4. Figure 20.4 Radiograph of cleft patient.
5. Figure 20.5 Cleft patient prior to orthodontic treatment.
6. Figure 20.6 (a–f) A cleft patient's journey.
7. Figure 20.7 (a–e) A cleft patient's journey.
8. Figure 20.8 (a–e) A cleft patient's journey.
9. Figure 20.9 (a–e) A cleft patient's journey.
Chapter 21
1. Figure 21.1 Bonding using both metal and aesthetic brackets.
2. Figure 21.2 Upper and lower aesthetic brackets.
3. Figure 21.3 Lingual appliance with gold brackets.
4. Figure 21.4 Bite stripping labial gingivae.
5. Figure 21.5 British Orthodontic Society leaflet.
6. Figure 21.6 Aligners.
Chapter 22
1. Figure 22.1 British Orthodontic Society leaflet.
2. Figure 22.2 Mandibular advancement device.
3. Figure 22.3 Lateral view of mandibular advancement device.
Chapter 23
1. Figure 23.1 Example of the method of trimming orthodontic models.
2. Figure 23.2 Models stored in box.
3. Figure 23.3 Model box.
4. Figure 23.4 British Orthodontic Society guidelines for digital study models....
5. Figure 23.5 British Orthodontic Society guideline for orthodontic records....
Chapter 24
1. Figure 24.1
2. Figure 24.2
3. Figure 24.3
4. Figure 24.4
5. Figure 24.5
6. Figure 24.6
7. Figure 24.7
8. Figure 24.8
9. Figure 24.9
10. Figure 24.10
11. Figure 24.11
12. Figure 24.12
13. Figure 24.13
14. Figure 24.14
15. Figure 24.15
16. Figure 24.16
17. Figure 24.17
18. Figure 24.18
19. Figure 24.19
20. Figure 24.20
21. Figure 24.21
22. Figure 24.22
23. Figure 24.23
24. Figure 24.24
25. Figure 24.25
26. Figure 24.26
27. Figure 24.27
28. Figure 24.28
29. Figure 24.29
30. Figure 24.30
31. Figure 24.31
32. Figure 24.32
33. Figure 24.33
34. Figure 24.34
35. Figure 24.35
36. Figure 24.36
37. Figure 24.37
38. Figure 24.38
39. Figure 24.39
40. Figure 24.40
41. Figure 24.41
42. Figure 24.42
43. Figure 24.43
44. Figure 24.44
45. Figure 24.45
46. Figure 24.46
47. Figure 24.47
48. Figure 24.48
49. Figure 24.49
50. Figure 24.50
51. Figure 24.51
52. Figure 24.52
53. Figure 24.53
54. Figure 24.54
55. Figure 24.55
56. Figure 24.56
57. Figure 24.57
58. Figure 24.58
59. Figure 24.59
60. Figure 24.60
61. Figure 24.61
62. Figure 24.62
63. Figure 24.63
64. Figure 24.64
65. Figure 24.65
66. Figure 24.66
67. Figure 24.67
68. Figure 24.68
69. Figure 24.69
70. Figure 24.70
71. Figure 24.71
72. Figure 24.72
73. Figure 24.73
74. Figure 24.74
75. Figure 24.75
76. Figure 24.76
77. Figure 24.77
78. Figure 24.78
79. Figure 24.79
80. Figure 24.80
81. Figure 24.81
Chapter 26
1. Figure 26.1 Guidelines on the supervision of orthodontic therapists.
Chapter 27
1. Figure 27.1 ONG logo.

This edition first published 2020
© 2020 John Wiley & Sons Ltd

Edition History
John Wiley & Sons (1e, 2010)

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Library of Congress Cataloging‐in‐Publication Data

Names: Grist, Fiona, author.
Title: Basic guide to orthodontic dental nursing / Fiona Grist. Other titles: Basic guide to dentistry series.
Description: Second edition. | Hoboken, NJ : Wiley‐Blackwell, 2020. | Series: Basic guide to dentistry series | Includes index.
Identifiers: LCCN 2019035284 (print) | LCCN 2019035285 (ebook) | ISBN 9781119573692 (paperback) | ISBN 9781119573708 (adobe pdf) | ISBN 9781119573746 (epub)
Subjects: MESH: Orthodontics | Dental Assistants
Classification: LCC RK521 (print) | LCC RK521 (ebook) | NLM WU 400 | DDC 617.6/43–dc23
LC record available at https://lccn.loc.gov/2019035284
LC ebook record available at https://lccn.loc.gov/2019035285

Cover Design: Wiley
Cover Image: Courtesy of David Morris

How to use this book

The aim of this book is to give the dental nurse in general practice an introduction to the world of orthodontics and orthodontic dental nursing. It may also be helpful to trainee nurses working in an orthodontic environment.

Orthodontics is specialist branch of dentistry and has its own vocabulary. The information in this book is a basic guide, so it does not set out to:

examine clinical features (why the problem arose)
cover treatment planning (what is the best choice of treatment)
treatment mechanics (how the appliances achieve what they do).

Its objective is to describe what the dental nurse needs to know so they can work efficiently at the chairside when treating an orthodontic patient.

If you feel you want to develop your knowledge further there are several excellent orthodontic textbooks available. The career pathways for orthodontic dental nurses are now wide and the possibilities are extensive. Nurses have an important place in the dental team. This book aims to be a helpful first guide on what is hoped be a long and interesting journey.

Different procedures for various treatments are outlined in this book. While it is the nurse’s role to assist the clinician, there are areas that are their sole responsibility; these are highlighted in the text in italics.

A quick glance into the stock cupboards and cabinets in an orthodontic surgery reveals quite different contents from that of a general dental surgery. There will be nothing with which to fill teeth or fissure seal, or root canal trays. Anything that helps to irrigate a periodontal pocket, whiten a tooth, prepare abutments for a bridge or fit veneers will be missing. Cupboards in orthodontic units and practices may share the basics, such as mirrors, probes and College tweezers, and use the same alginates and disposable sundries, but beyond that they have very little in common. However, these cupboards are full and it is not possible to cover all materials or equipment that is in use, or every method or procedure.

Just as we had to learn what was needed for restorative, endodontic and prosthetic procedures, we need to learn what is needed for orthodontic treatment, which instruments are used for what procedure and why they are used.

Each chapter will cover a topic, with a short background and guide to what you will need to prepare so that the treatment can be undertaken as efficiently as possible. It is hoped that the photographic examples are helpful, the aim being to show the instruments as clearly as possible. The photographs are not all on the same scale.

This book does not go into detail regarding decontamination and sterilisation. The areas to focus on are those that concern the effect repeated sterilisation has on stiffening box joints on pliers. It can also have a detrimental effect on pliers that have cutting edges. When sterilising pliers and instruments with beaks, always have the beaks open. The same procedures and protocols apply in orthodontics as in other specialties. These you already know. As dental care professionals it is up to the nurse to ensure that they are fully aware and comply with all the current legislation, standards and codes of practice.

As with every skill, be it orthodontic treatment or baking a cake, everyone will have their individual method of working and their favourite tools. There is no hard‐and‐fast rule that says each procedure must be carried out using only certain instruments in the same way or in an exact order. Every clinician has their preferred methods of working and each and every nurse organises the layout of their trays as they like them. This is as it should be – do what works best for you.

There is a saying,

You don't know what you don't know

This book contains a lot of information but at the same time there will certainly be omissions. Every day brings new materials, new techniques and new treatment philosophies. Orthodontics is inevitably becoming split into specialties within a specialty. The pace of development and change ensures that what is current today is not so tomorrow.

I hope that this book achieves what it sets out to do, which is to provide enough written and visual information for a reasonable grounding of basic knowledge. Its aim is to encourage dental care professionals, especially dental nurses, to understand more about orthodontic nursing.

As trained or trainee dental nurses there is so much that you are already expert at doing, so this book will not cover knowledge you already have or skills you already possess. It does not set out to be comprehensive, but aims to give you a basic insight into the world of orthodontic nursing – it is merely a guide.

Acknowledgements

This is the second time I have written acknowledgements for this book and there are now so many more people to thank! So many that is seems like a mini chapter in itself. Firstly, the tremendous support from my home team: my husband Michael and grand‐daughter Kate had unlimited patience when computers, cameras and all manner of technology was out to get me. They just quietly sorted it out. I could not have done it without them.

The format and structure of the original book, which benefited from the expertise and enthusiasm of Alan Hall, has remained, enlarged and hopefully improved. Jo Clark has generously taken over the task as my ‘go‐to’ clinical guru. She has been helpful with providing material for new photographs, advice and encouragement, not least in offering her proofreading skills. Her expert eye looked over my shoulder to ensure I had not got my clinical wires crossed. Also thanks to Maureen Dickinson who tried to make sure I did not leave out major facts whilst busily including the minor ones. They devoted many hours to this and I am truly grateful. Colin Anderson was my ‘lay’ proofreader, who also spent hours crossing the t’s and dotting the i’s. My thanks to you all for sharing your expertise so generously and for giving the book the benefit of your time, knowledge and experience with such graciousness.

Special thanks must also go to my young photographer, Kate Meheux, whose contribution to the aesthetic appeal and clarity of this book was huge. She was efficient, knowledgeable and enthusiastic and was a pleasure to work with over the many hours we spent chasing our vision.

I must thank David Morris who again gave permission for the images on the cover, Steven Jones who allowed me to re‐use his photographs of TADs, Paul Ward who supplied photographs of fixed lingual appliances, Simon Littlewood who supplied the image of a Barrer spring retainer and Daljit Gill for his RME and cone beam CT images. Tracey Buckfield at NEBDN was helpful with permission to reproduce the Certificate in Orthodontic Nursing Syllabus as was Elena Scherbatykh at the GDC with the Certificate of Orthodontic Therapists Syllabus. The Occlusal Indices are reproduced by kind permission of Professor Steve Richmond and Ortho‐Care (UK) Ltd. There were also many images supplied by Alan Hall, and Jo Clark let me photograph a wide variety of her orthodontic goodies. I appreciate the kindness of Alison Williams in sharing her knowledge of aligners with me. My sincere thanks also to Alex Cash, and Wendy Bull in the office, for sending me full records of four of his cleft patients, Douglas, Emily, Georgia and Harvey. I want to thank them specially for kindly agreeing to be part of this book. I have tried to give an idea of their treatment journey and show you how great they look now.

Without a doubt one of the most noticeable aspects of this edition is the updating of many of the clinical photographs. This has been made possible by a generous offer from Jonathan Sandler to access his vast database. I am more than grateful for this and his permission to use these photos in the book and the help given by Sue Mallender and Anne McTighe: merely looking at his seemingly endless files was a masterclass in clinical photography.

Orthodontics has some of the very best supply companies and I appreciate their encouragement and willingness to help. These include Richard Garford, Kelvin Scott and Lisa Howorth at Ortho‐Care, David Rees and his helpful staff at TOC, Justyn Gumienna at TB Orthodontics, and Mandy Mills at 3M Unitek. All have been really generous with their time.

I have had the pleasure of working with the Orthodontic National Group for Nurses and Therapists from the beginning. Their contribution to the role of dental nurses today was encouraged by their vision. It would be impossible to include everyone but special mention must go to Janet Robins, Maureen Dickinson, Alex Moss and Sally Dye.

I am grateful to Anjli Patel, Chair of Publications and Joe Noar, Head of Clinical Governance at BOS for their help with permission to use PILs and Guidelines. Anshu Sood and Rod Ferguson kindly allowed me to use the BOS Courses on Impression Taking and Clinical Photography. Ann Wright used all her co‐ordinating skills with this too!

My respect for the British Orthodontic Society is unquantifiable. They have long been in the forefront of fostering the ‘team’ approach in orthodontics in the UK and have blazed a trail for other specialties to follow. The Society has always, and continues to be, hugely supportive of orthodontic nurses and therapists. Thanks to Professor Jonathan Sandler for generously agreeing to write a foreword for this book. Special thanks to Ann Wright, Ann Humphrys and Tony Kearney at BOS headquarters in Bridewell Place for their unflagging good humour and willingness to help and share their expertise. You may not realise it but your bar is high, you really do set the standard.

Caroline Holland first encouraged me to write an article on orthodontic nursing. Initially sure I couldn't, she encouraged me to give it a try, for which I will always be in her debt, as without her I would never have written a word.

Nearly all the names on this page are members of the orthodontic family; they share a passion for their work and have themselves made a significant contribution to their specialty, not to mention their patients, colleagues and the sphere of research. They have been gracious in sharing their expertise. All omissions and errors are down to me.

Huge thanks to the team at Wiley‐Blackwell, especially Loan Nguyen, Susan Engelken, Jayadivya Saiprasod, Jolyon Phillips, Baskar Anandraj and Nick Morgan. Knowing you were there was good, but hearing your voices at the end of the phone was better. Thanks for all the hand holding.

Last, but by no means least, to you, who have made it to the bottom of the page. Teachers of English will say this piece is woeful as it repeats the words ‘generous’, ‘thanks’ and ‘appreciate’ too often. They are correct but these words are precisely what this page is all about. I hope that you feel inspired to keep turning the pages and that you begin, or are continuing, to enjoy your work in orthodontics, probably the best job in the world!

BASIC GUIDE TOORTHODONTIC DENTAL NURSING

Dedication

Foreword to Second Edition

How to use this book

Acknowledgements