Braces for Kids

[Margarita45]

Wondering if anyone has experience of braces for their kids…we been advised quite early that DS 9 will need braces in his teens. I can’t seem to find much info out there apart from the fact that the NHS only covers the cost of metal fixed braces.

We’ve had a look at ceramic (clear) fixed braces and think that might be the way to go since he’s already super conscious about his teeth. I know the ceramic ones are more expensive, but I can’t find out if the NHS contribute the cost of the metal ones and we pay for the difference? Or if it’s a case of nothing is covered if we don’t take the metal braces.

Im trying to find out early as they’ve suggested Invisalign first for him now to start the process of moving some teeth rather than waiting till all his adult teeth are in, but this isn’t covered at all. But it may be we’d have to pay for both sets…

They don’t pay at all towards ceramic, you would have to pay privately.

NHS braces are made of metal, but clear ceramic braces, which are less visible, are also available privately.
https://www.nhs.uk/conditions/braces-and-orthodontics/#:~:text=NHS%20braces%20are%20made%20of,visible%2C%20are%20also%20available%20privately.

Hi, I have worked in orthodontics.

The NHS dictate the type of braces that are used for NHS orthodontics.
Ceramic brackets is a private treatment as they cost a lot of money and if one is broken it can cost a lot to replace them.

9 years old is far too young to start orthodontics as the bone facial structure hasn't formed and your child is most likely still in mixed dentition.

Invisalign will not fix any over-jet issues, this needs to be assessed when your child is older.

No it is either/or.

Thanks. No overjet issues at this point, the Invisalign first was just thrown into conversation as a way to make some progress with malocclusion of front teeth whilst in mixed dentition.

Fixed braces as you say would come much later. I’m just trying to understand the financial impact or either (or both) sets vs simply waiting 3/4 years.

My DD (12) recently had fixed braces fitted. We had the option of the nhs metal (no charge) or to get the ceramics (££££), but opted for the metal as she said most of the people she’d seen at school had metal and she’s fine with them.
Orthodontist didn’t recommend Invisilign as she said they’re more likely to get lost/broken by younger patients.

A general ball park is £1800 to £3000 for fixed ceramic braces depending on complexity.
Invisalign will be £2000 upwards depending on complexity.
You cannot "top up" NHS fees it's either all NHS or all private treatment.
In general braces are not started until a child has lost all their baby teeth because, in general, face growth is not entirely predictable and you end up with not much benefit . There are exceptions eg when one tooth needs pushing over the bite but Invisalign tends to be very poor at this sort of movement .

My advice would be get on the nhs list as soon as your dentist will allow as waits are long. Both ds went on the list at 11 and had them fitted around 13. Fixed braces and they worked well and they did not mind them at all really.

The vast majority of kids get braces and I would say almost all of them have the metal ones. None of them bat an eyelid. Just go with the metal ones

DS (14) is about to start with Invisalign. We're in Ireland will have to pay €5k for the whole treatment. 😳

My dd went on the nhs list at 11 and is now 13.5 without any kind of appointment on the horizon. We saw a private dentist last year (her issues are reasonably severe) and he's told us to wait until this summer as she has too many baby teeth left.

She sees her nhs dentist every 3 months who removes one or two every appointment. Private dentist said nothing worth doing until then as she was still growing too much for anything to be worth it.

NHS financially you will not have pay anything unless your child breaks an appliance ( Twin block/ retainers) but each practice is different.

Ceramic braces cost £2500 upwards for both arches, and if any brackets are lost or broken you will have to pay for replacements on top of that.

Post operative instructions are really important in Orthodontics, what you can and cannot eat, how to clean you braces.

I have seen plenty of people with Clear Ceramic braces come in and the brackets have become stained from eating tomato based sauces and any foods with spices.

Thanks. I hadn’t really thought of ongoing maintenance if we went for ceramic/private. DS didn’t seem to phased about the metal ones when we chatted about it, in fact he said he’d like those ones as ‘braces aren’t something to be embarrassed about’ so he’d want people to see them. It’s obvs a different matter when he’s a teen!

He is however, super conscious of his teeth now and doesn’t smile the same way which is quite sad to see. The idea of having to wait years to do anything might be a stretch, hence the ‘Invisalign firsts’ idea to help with some of his self consciousness sooner. But tbh, I’m not sure we could cover both ‘Invisalign firsts’ now and private ceramics in a couple of years time. I also understand the Invisalign firsts are relatively new concept.

They are not a new concept , just a new marketing concept.
invisalign, like all "retainer" type braces have their limitations. They only tip front teeth and the movement they achieve tends to relapse really quickly . In adults permanent retainers have to be worn. In younger children because growth is still going on then retainers are not , typically worn.

Train tracks braces (whether metal or ceramic) are the gold standard in moving teeth .

You probably need to accept Invisalign firsts will only achieve a limited , short lasting result until your child is old enough to have lost all their baby teeth and had all their adult teeth in.

Any brace work done before then , in any system , will really be a short term fix which will need redoing.

Personally speaking the only times I would consider brace work for a child with baby teeth is when one tooth is "behind the bite" . A quick removable brace to push the tooth over can save a lot of work later on . Alternatively when child has a very narrow upper jaw then "twin block " expanding blocks or similar at pubertal growth spurt to guide growth.
Otherwise you are just doing work which will relapse and need redoing later on.

I think this is maybe what its for - currently the angle of his upper left incisor is forcing it to grown behind his central incisor…

This is the main issue he embarrassed about, although he’s got some other things going on too.

Not quite this is where a top front tooth has grown behind a lower front tooth like in this fuzzy photo. An early brace corrects this well and won't relapse.
The type of problem you are talking about is upper crowding, perhaps with other issues. This is very likely to relapse very quickly after Invisalign or any early treatment.

This is super helpful thanks!!!

I'm sure by the time your DS comes to having braces, a good few of his peers will also have them and so will want to go with the majority, which in my opinion will be the fixed metal type.

Just to share my experience and lessons learned from my two DCs and their braces.

DS - had NHS treatment with twin block retainers and wire braces. Worked a treat. No fuss or pain luckily just lots of check ups. Choice of colour for the wires was nice. No embarrassment at school as everyone else also seemed to have braces. At end of treatment we were offered a fixed permanent retainer or a removable one to be work at night.

We chose the removable which was a mistake. We absolutely should have gone for a fixed as his teeth have moved now and some of the great work has been undone to the point he may need to pay for treatment when he's older. We've told him that's on him for not wearing his retainer at night.

DD had private treatment because of Covid delays ( three year waiting list around here at the time she needed the treatment to start)

We opted for Invisalign as not much more expensive than traditional treatment. It works great and you don't need so many check ups which is good for not missing school.

The downside is she does not wear them around the clock like she's supposed to and we are constantly arguing about it even though she begged me to pay for the treatment and promised me faithfully that she would wear them all the time. I would opt for the traditional treatment over Invisalign if I could go back in time just because teenagers can be so infuriating!

Dd has been 5 years on a waiting list for NHS metal braces.
She has her first two teeth out on Monday.
If it's nhs you're after make sure you're on that list straight away.

I do hope that it is a qualified orthodontist who is advising Invisalign as initial treatment. A lot of private general practitioners will provide Invisalign having done a minimum amount of training. A dipOrth is the dentist you need to see. My DS had problems with all his upper incisors and canines erupting inside his lower teeth. I remember my sister ( a dentist like myself) saying that it was a good job I was a dentist since he was going to need years of treatment and he did.
He had three courses of ortho in the end. Initially by a good friend who was a consultant orthodontist, then after he retired the second course was done by a hospital orthodontist and finally full arch alignment was carried out by another good friend.
If your DS has upper teeth erupting inside the lower arch it can be a sign of a skeletal problem. This is so much harder to sort out after growth starts. I refer all potential skeletal problems very early to the hospital consultant. Early intervention can prevent the need for major jaw surgery.
Referrals via NHS now have to include photos so if skeletal problem is suspected the child is quickly referred on to hospital services.
Most departments triage so they can sort out any cases that will benefit from early intervention.

The fact you are being offered Invisalign suggests that the dentist is not an orthodontist. I wouldn’t let anyone near my DS without a postgraduate qualification in orthodontics. So much damage can be done if you don’t know what you are doing. I also would be very surprised if a nine year old wore Invisalign without a struggle. DS had removable appliances in the earlier treatments and it was a real struggle to get him to wear them 24/7. He hated wearing them at school so would wear them from when he got home until he woke up in the morning. This slowed up treatment but we got there in the end. He had fixed retention and refused to wear retainers, he’d had an appliance of one rye or another for 8 yrs and had had enough. His teeth are straight but not perfect.
Sorry I’ve rambled a bit but hope it is of some use.

Absolutely agree with this and would go further , anyone thinking about braces should see an orthodontist first , they have experience in many, many different types of brace systems , their limitations and advantages.
The saying is if you have a hammer everything looks like a nail, ie if you can only do Invisalign, quick fast braces, etc then you will attempt to treatment everything in this way .
I have provided braces for many years, trained in hospital as an orthodontic clinical assistant but I sent all of my complex brace patients to an orthodontist first for assesment and they would pass back cases that were in my remit.
Invisalign is a marketing success , there are many limitations to what it can do and certainly it relapses easier (as do all retainer type treatments ) than fixed braces.

DD is 9 and will have braces fitted to widen her jaw a few days before her 10th birthday, DS had the same, and most her friends at school start treatment v early. Widening the palate means that when the adult teeth come through there is more space and so they aren't crowded and don't need so much intervention. I think DS had his brace on for 6 months, it was a fixed metal one. No way would I trust a child to wear the Invisalign as much as they should. The NHS either pays for it all and tells you what fort I'd brace you can have if you pay for it all privately and can choose the course of treatment to a degree.

I think DS's whole course of treatment was about £7k and DD's is a bit more than that.