By law, any registered dentist can provide orthodontic treatment and can call themselves an orthodontist – this simply means that they use braces on some of their patients. The General Dental Council (GDC) regulates dentists and it states that any registered dentist can work in any area of dentistry - as long as they feel competent (able) to do so. Only a registered dentist who has also successfully completed a 3 year formal training program in orthodontics (or equivalent) is recognised by the GDC as a specialist in orthodontics. You can find out if a dentist is registered as a specialist in orthodontics
An orthodontic therapist is a registered member of the dental team. They assist dentists/orthodontists in carrying out orthodontic treatment and provide some aspects of the treatment themselves. They can only work to the treatment prescribed from a dentist/orthodontist and within their competence (ability) and scope of practice as defined by the GDC.
Your regular dentist will monitor your child's dental development when there are lots of deciduous (baby) teeth present. Most children begin orthodontic treatment around the age of 12 or 13, once all their permanent (adult) teeth have erupted. In a few instances it is better to start orthodontic treatment sooner and your dentist may want to make an earlier referral.
Sometimes adult orthodontic treatment can be more complicated than it is for children. Adults may have already had some teeth removed or they may have teeth with large fillings or crowns present. Although adult orthodontic treatment may take a little longer than in children, it is still possible so long as the teeth and gums are healthy.
Fitting the brace should not be painful. For a fixed brace, the brackets are simply glued onto the surface of the teeth and then a thin wire joins the brackets together. No anaesthetic is needed.
After the brace has been fitted you can expect some aching and tenderness as the teeth start to move, but this mostly wears off after 5 to 7 days. The amount of discomfort varies from person to person and some patients do experience a degree of tenderness for a longer period. It may be helpful to take your normal painkillers for a day or two after the brace has been fitted. Some further discomfort may be experienced when the brace is adjusted.
Simple straightening can sometimes be completed in 6 months, particularly if the treatment goal is just to straighten the upper front 6 teeth and accept the way that the teeth bite together. However, a relatively short treatment like this usually produces limited changes and this is not always a long-term solution as often this isn't enough time to move the whole tooth, including the roots, into the ideal position. This may mean that the teeth are more likely to try and move back to their original positions once the braces are removed. On average, it takes between 18 to 24 months to improve the way that the teeth look as well as improving the way that they bite together. However, treatment may take longer for more difficult orthodontic problems – for example if your front teeth are very prominent (stick out) or if you have teeth which are a long way from their ideal position.
"Six Month Smiles" is a company that provides dentists with a tooth-straightening kit after the dentist has completed a 2 day hands-on training course run by the company. The dentist information section of the company website states that the kit is designed for dentists "who have little or no orthodontic experience". The aim of "Six Month Smiles" is to only straighten the teeth that you can see when you smile, using tooth-coloured braces and wires, with an average treatment time of 6 months. For some patients this works fine, but for other patients just straightening the front teeth may potentially impact on the health of the gingivae (gums) and bone around the teeth as well as changing the way that the teeth bite together. Our advice to any patient who is considering "Six Month Smiles" treatment is to make sure that you have considered all of the treatment options available to correct the way that your teeth look and bite together and that you are aware of the pros and cons of each option. A specialist in orthodontics will be able to provide you with this information. If you do decide to sign up for treatment with a dentist who offers "Six Months Smiles", you could always ask them to show you examples of their patients who have completed treatment with this technique.
"Fastbraces" is similar to "Six Month Smiles" in that it is a company that provides dentists with a tooth-straightening kit after they have completed a 1 day training course in the "Fastbraces" technique. The "Fastbraces" website claims that this system can straighten teeth in 3 to 12 months. However, no scientific evidence has yet been produced to suggest that one type of brace is faster than another. If this were the case, then every dentist and orthodontist would be using the fastest brace system! If you do decide to sign up for treatment with a dentist who offers "Fastbraces", you could always ask them to show you examples of their patients who have completed treatment with this technique.
The "Damon System" is essentially a type of orthodontic bracket (the metal part of the brace that is attached to the tooth) known as a self - ligating bracket. This type of bracket is capable of holding the archwire (the part of the brace which joins the teeth together) by means of a sliding clip built into the bracket. Conventional orthodontic brackets use either a coloured elastic band or a small wire tie to hold the archwire in place. The company who designed and manufacture the Damon system claims that there are a number of advantages to using self-ligating brackets in preference to the conventional brackets: faster brace treatment, fewer treatment appointments, greater patient comfort and less need to remove teeth to correct any crowding present. However, a Cochrane review of the literature concluded that there was insufficient evidence to support the use of self-ligating brackets over conventional brackets or vice versa. We always strive to provide our patients with the latest evidence-based treatment – therefore we use conventional orthodontic brackets in our practice.
You will usually need regular appointments with your orthodontist every 2 months to adjust your brace. It is not advisable to start treatment if you know that you will not be able to keep these appointments (if you are moving away from the area for example).
Yes, definitely, as the orthodontist only looks after the braces. Your teeth are actually at greater risk during orthodontic treatment and it is particularly important that you keep in contact with your regular dentist to monitor your dental health.
That depends upon the type of orthodontic problem which needs correcting - a decision can only be made after a detailed case assessment. No one wants to have teeth removed as part of orthodontic treatment. However, every course of orthodontic treatment needs to be tailored to the needs of the individual and for some patients, teeth will need to be removed in order to get the best appearance and ensure a long-term healthy smile.
Moving the roots of the teeth outwards to try and create space may thin the layer of bone over the root surface and may increase the risk of the gum receding. Too much expansion may also increase the prominence of the teeth (make the front teeth look as if they "stick out") - with adverse effects on the overall appearance.
All patients under 18 years of age are entitled to an orthodontic assessment which is paid for by the NHS. The NHS currently funds orthodontic treatment for those patients whose dental health will benefit from undergoing orthodontic treatment as indicated by the "Index of Orthodontic Treatment Need" (IOTN). The IOTN is essentially a means of measuring and categorising the severity of a patient's orthodontic problem. If the severity of a patient's orthodontic problem is above the "need for orthodontic treatment" threshold on IOTN, then the NHS will fund orthodontic treatment for that patient. The NHS contract for orthodontics funds all braces, adjustments and repairs required during the entire treatment. The only exception is the charge for replacement of removable braces lost or damaged beyond repair. There is also a charge for replacement retainers when they need to be replaced through natural "wear and tear". The NHS currently does not fund treatment for patients who are older than 18 years of age.
Since April 2006, each orthodontist has a set amount of NHS orthodontic treatment that they can provide in each financial year for those patients who are entitled to NHS orthodontic treatment. The NHS contract for each orthodontist has been determined and implemented by NHS England. Unfortunately, the number of patients who attend our practice requesting NHS orthodontic treatment is far greater than the number that we are allowed to provide treatment for each year. As a result, there is a long wait for NHS orthodontic treatment.
That will depend upon the level of treatment difficulty and the estimated time that it will take to correct your orthodontic problem, as well as the type of brace that you choose for your treatment. A written quotation will be given to you but is normally only possible after the orthodontist has had a chance to assess your orthodontic problem.
Some musicians who play a brass or woodwind instrument may find that orthodontic treatment affects their ability to practise and perform. Inexperienced musicians will probably find that wearing a brace doesn't change their performance very much, but more experienced, proficient players may notice a greater change. Removable braces can be removed whilst playing and so may not affect playing at all. It makes sense to avoid having your brace fitted at a time when you have important music exams, auditions or performances. With practice, most patients can adjust to playing a brass or woodwind instrument whilst wearing braces. For more detailed information, follow this link to the British Orthodontic Society website.
If you are wearing a removable brace, you should take your brace out of your mouth and wear a good mouthguard whenever you take part in contact sports such as hockey and rugby. You should take out your removable brace when swimming – the brace may come out and get lost in the swimming pool! If you have a fixed orthodontic brace, you should wear a mouthguard that fits over the top of the brace when you take part in contact sports. You can buy a mouthguard from our reception that is specifically designed for this purpose.
As with most things in life, there are potential risks as well as benefits to undergoing orthodontic treatment. At the point when you are ready to discuss your orthodontic treatment options, you will be given a booklet which will explain in detail the potential risks involved in undergoing orthodontic treatment. You will be asked to sign a form to confirm that you have been informed about these possible risks. Many of these risks can be minimised by applying common sense and following the advice of your orthodontist.
The Medical Entry Standard for the Army, Royal Navy and Royal Air Force states that potential candidates applying for either full or reserve service, who are undergoing orthodontic treatment with fixed or removable active appliances, will normally be graded P8 (unsuitable for entry) but may re-apply on successful completion of their orthodontic treatment. Retainers, either fixed or removable, must continue to be worn and will not preclude entry to the military. The removal of active appliances simply to facilitate service entry is not to be undertaken or advised, as candidates presenting having had appliances removed before their orthodontic treatment has been successfully completed will also be graded P8.