Who Can Perform Orthodontic Treatment? Is BDS qualified and licensed to Perform?

BDS and MDS in Ortho Tug of War

In India, the law does not explicitly prohibit graduate Bachelor of Dental Surgery (BDS) doctors from performing braces treatment. However, there are certain aspects to consider:
Understanding the Roles:

  • Dentist (BDS): A general dentist is qualified to diagnose and treat a wide range of oral health issues. Their training includes basic orthodontics.
  • Orthodontist (MDS in Orthodontics): An orthodontist is a dental specialist who has completed an additional 2-3 year postgraduate degree (MDS) specifically in orthodontics. Their training focuses extensively on the diagnosis, prevention, and treatment of dental and facial irregularities, including complex orthodontic cases.
    Legal and Ethical Considerations:
  • The Dentists Act, 1948 defines a “dentist” as a person with a registrable dental degree (BDS or equivalent). It empowers registered dentists to practice dentistry. The Act doesn’t explicitly restrict BDS graduates from performing orthodontic procedures like braces.
  • The Dental Council of India (DCI) sets the standards for dental education and practice in India. Their Code of Ethics emphasizes that dentists should practice methods of healing founded on a scientific basis and should not attempt procedures beyond their knowledge and expertise.
  • Medical Negligence: Performing treatments without adequate training and competence can be considered medical negligence. If a general dentist undertakes a complex orthodontic case that requires specialist knowledge and skills, and if this leads to harm to the patient, they could be held liable for negligence. Several court cases in India have highlighted that providing treatment beyond one’s expertise is medical negligence.
  • Standard of Care: All dentists, including general dentists, are expected to provide a certain standard of care to their patients. For orthodontic treatment, this standard is generally considered to be higher and requires specialized knowledge of biomechanics, growth and development, and various orthodontic techniques.
  • Informed Consent: Obtaining informed consent is crucial. Patients must be fully informed about the qualifications of the treating doctor and the complexity of the procedure. If a general dentist is performing braces treatment, the patient has the right to know their qualifications and the potential limitations compared to treatment by a specialist orthodontist.
    Practical Implications:
  • While BDS graduates are not legally barred from performing basic orthodontic treatments, they are generally expected to refer complex cases to orthodontists.
  • Treating complex malocclusions often requires the advanced knowledge and skills acquired during an MDS in Orthodontics.
  • Many professional dental organizations and guidelines implicitly suggest that comprehensive orthodontic treatment, including braces for complex cases, is best provided by an orthodontist.
  • Some advanced orthodontic treatments, like Invisalign, might be administered by general dentists who have undergone specific training and certification, as it may not be deemed to address substantial or severe orthodontic difficulties in all cases. However, even in these cases, proper diagnosis and treatment planning are critical.
    References:
    While specific laws explicitly prohibiting BDS doctors from performing braces are not readily available, the following principles and regulations are pertinent:
  • The Dentists Act, 1948.
  • Code of Ethics issued by the Dental Council of India.
  • Consumer Protection Act, 1986 (and subsequent amendments), which holds healthcare professionals accountable for deficient services and negligence.
  • Various court judgments related to medical negligence in dental practice, which emphasize the importance of practicing within one’s competence.
    In summary:
    The law in India does not have a blanket prohibition on BDS doctors performing braces treatment. However, ethical guidelines, the risk of medical negligence, and the standard of care expected in orthodontics strongly suggest that complex orthodontic cases should be treated by qualified orthodontists (MDS in Orthodontics). General dentists (BDS) should ideally focus on basic orthodontic care and refer more intricate cases to specialists to ensure optimal patient outcomes and avoid potential legal repercussions. Patients also have the right to be informed about the qualifications of their treating dentist and the recommended course of treatment.

Conclusion:
While Indian law doesn’t explicitly forbid BDS graduates from performing braces treatment, ethical guidelines, the expected standard of care, and the risk of medical negligence strongly suggest that comprehensive orthodontic treatment, especially for complex cases, should be undertaken by dentists holding an MDS in Orthodontics. BDS doctors are advised to handle basic orthodontic issues and refer complex cases to specialists.

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