The consultant as advocate.

Another second opinion consultation, you whisper to yourself as you prepare to greet the young patient who is awaiting your initial evaluation. Ben Stevenson was referred by a member of your study club. You recall reviewing this 11-year-old boy's radiographs early this morning. The film shows approximately 50% root development of the succedaneous teeth with immobile deciduous canines and molars. The maxillary arch is bracketed, and an archwire is in place. As you greet Ben and his parents, you have the feeling that the first few minutes of the consultation will be devoted more to listening than speaking on your part. Mr and Mrs Stevenson explain that the braces were placed last week by Ben's pedodontist, after Mrs Stevensonwas told that her sonwould be receiving an appliance to “help Ben's lower jaw grow.” She said she had scheduled Ben for what she thought was a brief appointment, but he emerged from the operatory with brackets on his teeth. Shewanted to knowwhether treatment was necessary, because she “just didn't feel right about the whole thing.” Your clinical evaluation shows mild maxillary incisor crowding with normal overjet and overbite for a boy of Ben's age. He has a well-coordinated dentoskeletal pattern, mirroring his parents' balanced profiles. As you remove your gloves and place the dental mirror aside, you explain that treatment philosophies among practitioners commonly differ, but you'd like to communicate with the pedodontist to discuss the case background before making a recommendation. In a polite but firm reply, Mrs Stevenson says that she knows you have the recent panoramic film, and she would think that Ben's clinical presentation, combined with the film, would give you enough information to answer the question regarding his immediate need for treatment. You diplomatically concede that you would not yet treat Ben but would rather await further growth and development. Mr Stevenson then pipes up to ask what the family's next step might be. As a consultant, should you offer to advocate on the family's behalf by communicating with the pedodontist to explain your recommendation?