Miss Daljit Dhariwal 2018-01-05 Person 2 5 0

facts: my daughter was referred to Mrs Dhariwal by my orthodontist. She has a severe occlusion with a canine misplaced that has no space between the second front tooth and the first premolar. At the appointment we discussed the possible treatments. Ms Dhariwal discussed at length two options: first option, extracting the canine (preferred by her) second extracting the premolar (preferred by me - also given the independent advices from further dentist in the Italian NHS and private sector in UK). Her letter stated that Two options were available and we "will return to clinic in two months with the decision on how they wish to proceed." When we communicate her the decision to follow option two (i.e. saving the canine) she questioned why we had made such choice and basically refused to go ahead, saying that she changed her mind after having further consultation with the colleagues. When I have asked her what was the technical rationale why she changed her mind, she said that she wanted to go for the less risky option (extracting the canine). When I asked her to quantify the risk of going for the second option (extracting the premolar) she was unable of unwilling to comment further on the risk of trying to save the canine. Basically she takes decision based on risk assessment without knowing (or telling) what the risk is. She also needed to consult with (evidently) more expert colleagues. Laymen question: why was I not referred directly to the more expert colleagues? I had to ask for a second consultation at the JR. The rules are such that if you want a second consultation you need a second referral. Basically, your orthodontist has to write again to the JR the same letter he has written for the first referral. The appointment office (outpatients department) is painfully slow and the whole procedure takes about 2 months.