Title: Retention coordination after orthodontic restorative treatment: A two cycle audit
Abstract:
Aim: To assess the provision and coordination of orthodontic retention following joint orthodontic-restorative treatment. Gold standards were: (1) 100% of patients receiving restorative treatment after orthodontics should receive appropriate retention post-restoration; and (2) 100% should have a documented orthodontic review following completion of restorative care.
Methods: A two-cycle audit was undertaken at Birmingham Dental Hospital. Cycle one retrospectively identified patients receiving one or more resin-bonded bridges (RBBs) between January–June 2025 using laboratory records and clinical notes to confirm joint orthodontic care. Data was collected using a standardised Excel data sheet. Outcome measures included provision, type and timing of retention, and documented referral for orthodontic review. Following cycle one, a standardised referral pathway and clinician guidance were introduced. Cycle two used identical methodology with prospective data collection to evaluate intervention impact.
Results: In cycle one (n=25), orthodontic retention was provided in 96% of cases and restorative retention in 80%. Orthodontics most commonly provided dual-modality retention (Hawley and Essix), while restorative teams predominantly provided Essix retainers. Only 55% of patients had a documented orthodontic review arranged following restorative treatment, below the gold standard.
Discussion: Although retention provision was generally good, inconsistencies existed regarding responsibility, timing, and interdepartmental communication, highlighting challenges within multidisciplinary orthodontic care.
Conclusions & Action Plan: Implementation of a structured referral pathway aims to improve communication, ensure appropriate provision of retention, and standardise follow-up. The re-audit demonstrated an improvement in the pathway, with retention being provided more frequently and reviewed appropriately with orthodontics. These preliminary findings will support assessment of the sustainability of these improvements and help inform wider service development.
