Your dentist may have recommended that your son or daughter have an orthodontic assessment as they have noticed, or you have mentioned to the dentist, that your son or daughter’s teeth are:
- Not straight
- Sticking out at the top
- Still not come through
- Not meeting/biting properly
When an opinion and possible treatment is needed it’s important to know what your choices are for their treatment. This leaflet will give you an overview of orthodontic assessment and treatment and how you can access these services.
What is an orthodontic assessment?
In order to decide on the treatment needed by your son or daughter a referral is made for them to see a specialist orthodontist, either at a hospital or practice near to you. They will examine the teeth and jaws to “diagnose” what is wrong with the teeth and then make a plan on how they will correct them. This is the most important stage of the journey – getting this part right will help direct the treatment correctly.
NHS assessment
In 2006 there were stricter rules applied to patients to qualify for orthodontic treatment.
Currently children under 18 who have an IOTN of 4 or 5 are automatically eligible. If your son or daughter has an IOTN 3 score this is in the “borderline” category for treatment and there is a further aesthetic score applied to them. In order to qualify IOTN 3’s have to have an aesthetic score of 6 or above. The orthodontist will inform you of the IOTN score at your assessment.
Since 2006 the funding for growth in orthodontic services has been restricted, so if there is a growth in the demand for treatment then it means there is not enough service provision – this is why some practices have a waiting list for assessments and treatment, sometimes up to 2-3 years in areas with high demand.
New contracts commencing in April 2019 have reduced the availability of orthodontic services in this region. You may face longer waiting time for assessment and treatment, but this is not necessarily an issue for your son or daughter, especially if they are under 13 years of age. If they are 13 years or older, then bear in mind when their treatment is going to start – it could overlap important school periods like GCSEs or A Levels. Also be aware that during treatment you may have to bring them to appointments during school or work hours.
Private consultation
As an alternative, you may want to consider having an assessment done privately, especially if your son or daughter is desperate to have their teeth fixed. You are likely to be seen in a matter of weeks rather than months, and you can still find out if your son or daughter would qualify for NHS treatment if that is what you want. The other benefits include earlier assessments (before the age of 10), more range of treatment options and no waiting list for treatment. If they’re ready to start treatment then they can go ahead within a few weeks of their assessment.
You may also be able to benefit from being able to schedule the more routine appointments after school or Saturdays if the practice offers this.
Brace treatment options
Fixed braces
For most teenagers, treatment will be with fixed (train track) braces. They will be made of stainless steel so will show as grey/silver squares on their teeth with a sliver wire running through them.
Braces will be a bit uncomfortable to start with, they will rub on the inside of the lips and cheeks and the teeth will feel sore. Thankfully this is usually short lived.
Some patients will need to have teeth removed in order to get the best outcome so be prepared for this when treatment is discussed with you. Don’t be afraid to ask the orthodontist the reasons for any extractions requested and whether there are any alternative treatments possible.
Removable braces
A removable brace is generally recommended for younger patients, who still have some baby teeth present. E.g. to correct a narrow upper jaw or cross-bites, protruding front teeth.
Both of these options are available on the NHS for your Son or Daughter’s treatment where necessary. They will also provide one pair of night time retainers after the treatment is completed which are recommended for long term wear to control future tooth movement.
Self-funded or private treatment gives you access to a greater range of treatment for your son or daughter including cosmetic (less visible) brace options, Invisalign or even braces fitted on the inside surface of the teeth. These types of treatment might be more desirable for more image conscious older teenagers or any budding musicians/ actors / singers.
Invisalign braces are only available privately, but do offer potential advantages over other types of braces, namely; they are almost invisible, easier to tolerate, removable for activities such as music/singing/sports and they are also removable for cleaning – meaning that dental and gum health should be easier to maintain. Modern advances in Invisalign technology mean that Invisalign clear removable aligner braces are now available for a wider range of ages and orthodontic problems, even when some baby teeth are still present.
Most private orthodontists will have payment plans with affordable monthly payments to spread the fees for treatment.