Page 2 | Getting my head around orthodontics for teens...

cheeesenonion · 2025-04-01T19:04:55+00:00

Railtrack braces on a teen on the bottom row to correct badly placed teeth, with rubber bands attached to the upper row to correct skeletal overbite - once the braces are on, how frequently does the child usually need to see the orthodontist to get everything tightened and checked and so on? Do most people in the UK pay for this privately, or do most people get this sort of thing done by NHS? Are some areas in the UK better than others in relation to getting work done by NHS? Any other advice you could give me? I am just trying to get my head round it all!

Sourwitch · 02/04/2025 18:59

Bingbong2000 · 02/04/2025 08:37

The NHS only pays now if there is a medical reason rather than just cosmetic eg and overbite is medical but wonky teeth is cosmetic. Sometimes train tracks and sometimes a removable one. Process lasts 2-3 years. The thing I didn't know was afterwards they have to have retainer at least twice a week at night for ever. These cost £100 ( not covered by NHS) and can crack quite quickly. So I wouldn't rush into starting the process early

Not sure about that. Half of DD’s friends have braces and it was to fix wonky teeth.

Youaremythtaken · 02/04/2025 21:42

BarbaricYawp · 02/04/2025 10:22

I agree you need to make a case for clinical need, e.g. pain or difficulty chewing etc, for the NHS to cover orthodontics but my experience is that it's about the form of words you use rather than any objective test. They have to be under 18 at the beginning of treatment but if it goes on past then it continues to be paid for until the process is over. Unlike a pp, my DS was also provided with a retainer FOC. His treatment was a few years ago now but I think we waited 6 or 8 months for the initial appointment and then 3-4 months between appointments, and the whole thing took a couple of years, including a hiatus while we waited for a second tooth to grow into the space vacated by a baby tooth that had to be extracted. He saw the same orthodontist throughout and it took place in a private practice despite being NHS funded. Hope your DC manages to get what they need. The term "British teeth" isn't a compliment.

This definitely wasn't our experience. We didn't have to make a case at all. They got referred to the orthodontist who had a good look and gave the yes or no for treatment. We weren't asked about pain or difficulty eating or anything like that. It definitely felt like an objective test the orthodontist carried out - they had to meet certain criteria.

To pick up the point in another post that suggests you get better treatment privately...in our case my 2 went to orthodontists who offer NHS and private so I imagine the care is the same. Certainly our eldest has beautiful straight teeth now and i can't fault the care she had or see how her teeth could look any better.

Hols23 · 02/04/2025 21:53

Youaremythtaken · 02/04/2025 21:42

This definitely wasn't our experience. We didn't have to make a case at all. They got referred to the orthodontist who had a good look and gave the yes or no for treatment. We weren't asked about pain or difficulty eating or anything like that. It definitely felt like an objective test the orthodontist carried out - they had to meet certain criteria.

To pick up the point in another post that suggests you get better treatment privately...in our case my 2 went to orthodontists who offer NHS and private so I imagine the care is the same. Certainly our eldest has beautiful straight teeth now and i can't fault the care she had or see how her teeth could look any better.

Show quote history

Our experience was exactly the same as yours. DD's teeth were overcrowded but not causing any problems. Treatment has been free, appointments every 8 weeks and very pleased with the outcome

TheSandgroper · 03/04/2025 02:55

In Australia. Dd had a 9mm overbite, from memory. She had her lower jaw broken, titanium inserts screwed on and a titanium thingy into her chin for bone to grow over so her jaw was lengthened and they changed the angle. Wisdom teeth came out about 6 months prior.

So, blocks first in primary school, train tracks top and bottom, wisdom teeth out then jaw surgery at the end of year 10, braces off, retainers in, retainers out. Retainers to be used regularly for the rest of her life. Braces took about 20 months, I think.

She was in hospital for about three days - surgery, 24 hours in intensive care and about 48 hours on the ward. They wanted her eating (purees) properly before she could leave and to be sure any bleeding had stopped.

She had long been unable to swallow tablets and when she sang, she was a bit tinny, I thought. The opening to the eosophagus was given enough room to open up properly so she can now swallow even the biggest tablets and her singing voice has a lovely, round timbre.

HumphreyCushionintheHouse · 03/04/2025 03:26

My 13 yr old has had braces on for a year now. We go once a month for adjustments, change wires, new ties and new elastic bands when needed. She had an overbite at the front, and a side cross bite. They estimated it’d take 2 yrs, but now it’s looking like we’ll be done in a few months, so total 15 months approximately.

Once she’s finished w braces, she’ll wear a retainer to sleep in. There’s also talk of getting her wisdom teeth removed, if final X-rays show they’ll come in and ruin all the good work from the braces.

Theextraordinaryisintheordinary · 03/04/2025 03:36

Just paid 3k for braces for my child after being on the waiting list for three years. She’d only had the braces on two weeks when a letter came to say she’d reached the top of the NHS list and could now have her braces fitted. Gutted! We’d contacted recently to check where she was on the list but they couldn’t say.

Original poster

cheeesenonion · 03/04/2025 10:55

TheSandgroper · 03/04/2025 02:55

In Australia. Dd had a 9mm overbite, from memory. She had her lower jaw broken, titanium inserts screwed on and a titanium thingy into her chin for bone to grow over so her jaw was lengthened and they changed the angle. Wisdom teeth came out about 6 months prior.

So, blocks first in primary school, train tracks top and bottom, wisdom teeth out then jaw surgery at the end of year 10, braces off, retainers in, retainers out. Retainers to be used regularly for the rest of her life. Braces took about 20 months, I think.

She was in hospital for about three days - surgery, 24 hours in intensive care and about 48 hours on the ward. They wanted her eating (purees) properly before she could leave and to be sure any bleeding had stopped.

She had long been unable to swallow tablets and when she sang, she was a bit tinny, I thought. The opening to the eosophagus was given enough room to open up properly so she can now swallow even the biggest tablets and her singing voice has a lovely, round timbre.

Thank you for this, I am glad it has all worked out so well! Please can I check, is it that the blocks and the rail tracks basically didn't work, hence need for surgery, or were the train tracks to prep for surgery ie surgery always seen as needed?

Were you given the choice at any time whether to go for surgery or wait and see? (I have been by one orthodontist...)

And finally, does your dd have any ongoing pain from the operation at any time?

Nice to hear about the singing sound changes!

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TheSandgroper · 03/04/2025 12:11

@cheeesenonion The blocks went in in year 5 or 6, I can’t remember. As she closed her mouth, they pushed her bottom jaw forward and stretched it so it meant her mandible grew faster to reach it’s natural length and angle early. Then they measured the speed and depth of her overbite that developed has the rest of her face grew. Yeah, that overbite came back well and truly.

The braces were to rearrange her teeth as they were not pretty. The surgery dealt with her bottom jaw. Two separate issues.

The surgeon did want to do the surgery while the braces were on because their management would take into account the change of jaw position. As the jaw was being implanted, he also put new wires in to fit and orthodontist appointments carried on as scheduled. We did choose the date of the surgery to suit her school holiday schedule.

The surgeon did point out that he has a lot of adult customers. I think deviations show up in later age as wear, tear, stiffness and menopause come into play. Medicare did pay a smallish proportion of the cost so there must be some benefit that can be shown. I wondered about malnutrition in old age if things weren’t done.

Her pain levels were to be expected from a bone broken in two places so good management was required for a bit. Then just care and attention for the normal six weeks so that mucked up her summer. If she doesn’t wear her retainers and then starts to wear them again, her teeth/jaw can ache as her teeth are shoved back into position. See, while you can move teeth around with braces, you can’t alter the socket they sit in and they will always want to sit snugly in that socket. So, the retainer keeps the teeth where the braces have forced them.

Madam didn’t want to get it done. She couldn’t see the need and nor could DH, really. She has his jaw and teeth. And, of course, were were changing her beautiful face. Her face is her face. We had a very upset house for some months. However, last year she saw a profile photo I took of her laughing (it shows her underbite perfectly) and is now perfectly happy with the outcome.

Medicare paid a little, private insurance paid a lot and we still paid $10k just for the surgery stuff. The wisdom teeth was day surgery in a hospital for medical reasons so that was a cost but insurance got most of it and the braces was over $8k and insurance paid about 20% from memory. But, from a mothering point of view, I feel I have set her health and nutrition right for her lifetime. Can you tell I am still rather scarred from the experience?

ghostyslovesheets · 03/04/2025 12:13

Leafy2018 · 02/04/2025 08:41

My daughter was assessed for braces but it wasn’t bad enough for NHS so we went private. Her friend has braces treatment at the same orthodontists but on NHS and she has far fewer appointments and her teeth are not making the same progress.

All 3 of mine had braces with the same ortho - 2 NHS one private- absolutely no difference in care

Original poster

cheeesenonion · 04/04/2025 09:11

TheSandgroper · 03/04/2025 12:11

@cheeesenonion The blocks went in in year 5 or 6, I can’t remember. As she closed her mouth, they pushed her bottom jaw forward and stretched it so it meant her mandible grew faster to reach it’s natural length and angle early. Then they measured the speed and depth of her overbite that developed has the rest of her face grew. Yeah, that overbite came back well and truly.

The braces were to rearrange her teeth as they were not pretty. The surgery dealt with her bottom jaw. Two separate issues.

The surgeon did want to do the surgery while the braces were on because their management would take into account the change of jaw position. As the jaw was being implanted, he also put new wires in to fit and orthodontist appointments carried on as scheduled. We did choose the date of the surgery to suit her school holiday schedule.

The surgeon did point out that he has a lot of adult customers. I think deviations show up in later age as wear, tear, stiffness and menopause come into play. Medicare did pay a smallish proportion of the cost so there must be some benefit that can be shown. I wondered about malnutrition in old age if things weren’t done.

Her pain levels were to be expected from a bone broken in two places so good management was required for a bit. Then just care and attention for the normal six weeks so that mucked up her summer. If she doesn’t wear her retainers and then starts to wear them again, her teeth/jaw can ache as her teeth are shoved back into position. See, while you can move teeth around with braces, you can’t alter the socket they sit in and they will always want to sit snugly in that socket. So, the retainer keeps the teeth where the braces have forced them.

Madam didn’t want to get it done. She couldn’t see the need and nor could DH, really. She has his jaw and teeth. And, of course, were were changing her beautiful face. Her face is her face. We had a very upset house for some months. However, last year she saw a profile photo I took of her laughing (it shows her underbite perfectly) and is now perfectly happy with the outcome.

Medicare paid a little, private insurance paid a lot and we still paid $10k just for the surgery stuff. The wisdom teeth was day surgery in a hospital for medical reasons so that was a cost but insurance got most of it and the braces was over $8k and insurance paid about 20% from memory. But, from a mothering point of view, I feel I have set her health and nutrition right for her lifetime. Can you tell I am still rather scarred from the experience?

I really appreciate all those details. It sounds horrendous and I am really pleased for you all that it has worked out well.

If we are able to try rails and elastics first I think the description of the surgery would motivate DC to keep the elastics on so as to try to avoid it!

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Sourwitch · 04/04/2025 09:23

TheSandgroper · 03/04/2025 12:11

@cheeesenonion The blocks went in in year 5 or 6, I can’t remember. As she closed her mouth, they pushed her bottom jaw forward and stretched it so it meant her mandible grew faster to reach it’s natural length and angle early. Then they measured the speed and depth of her overbite that developed has the rest of her face grew. Yeah, that overbite came back well and truly.

The braces were to rearrange her teeth as they were not pretty. The surgery dealt with her bottom jaw. Two separate issues.

The surgeon did want to do the surgery while the braces were on because their management would take into account the change of jaw position. As the jaw was being implanted, he also put new wires in to fit and orthodontist appointments carried on as scheduled. We did choose the date of the surgery to suit her school holiday schedule.

The surgeon did point out that he has a lot of adult customers. I think deviations show up in later age as wear, tear, stiffness and menopause come into play. Medicare did pay a smallish proportion of the cost so there must be some benefit that can be shown. I wondered about malnutrition in old age if things weren’t done.

Her pain levels were to be expected from a bone broken in two places so good management was required for a bit. Then just care and attention for the normal six weeks so that mucked up her summer. If she doesn’t wear her retainers and then starts to wear them again, her teeth/jaw can ache as her teeth are shoved back into position. See, while you can move teeth around with braces, you can’t alter the socket they sit in and they will always want to sit snugly in that socket. So, the retainer keeps the teeth where the braces have forced them.

Madam didn’t want to get it done. She couldn’t see the need and nor could DH, really. She has his jaw and teeth. And, of course, were were changing her beautiful face. Her face is her face. We had a very upset house for some months. However, last year she saw a profile photo I took of her laughing (it shows her underbite perfectly) and is now perfectly happy with the outcome.

Medicare paid a little, private insurance paid a lot and we still paid $10k just for the surgery stuff. The wisdom teeth was day surgery in a hospital for medical reasons so that was a cost but insurance got most of it and the braces was over $8k and insurance paid about 20% from memory. But, from a mothering point of view, I feel I have set her health and nutrition right for her lifetime. Can you tell I am still rather scarred from the experience?

Out of curiosity, why the need for the lower jaw surgery etc, could they not just put braces in to straighten her teeth and remove some if they were over crowed?

Zingy123 · 04/04/2025 09:26

My DC both waited about 4 years for treatment. They are now seen every 6-8 weeks. DC1 has had their braces on for 4 years now. It's a big commitment. DC2 has to go to a hospital 35 miles away from home.

Original poster

cheeesenonion · 04/04/2025 09:46

Sourwitch · 04/04/2025 09:23

Out of curiosity, why the need for the lower jaw surgery etc, could they not just put braces in to straighten her teeth and remove some if they were over crowed?

Show quote history

I can't answer for the other poster, but I am being told that surgery might be needed for DC because it is a skeletal overbite - whether surgery is ultimately needed depends on severity of the skeletal overbite and whether it is likely to get worse in future and health implications of that.

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elliejjtiny · 04/04/2025 10:00

We have known ds4 would need braces from before he was born so we first saw the orthodontist when I was still pregnant with him which was quite surreal. He has had check ups with the orthodontist since he was born and he should be getting braces in the next couple of years. They don't do a clinic near us though so we will have to go to the dental hospital an hour away for all his check ups.

Sourwitch · 04/04/2025 10:07

cheeesenonion · 04/04/2025 09:46

I can't answer for the other poster, but I am being told that surgery might be needed for DC because it is a skeletal overbite - whether surgery is ultimately needed depends on severity of the skeletal overbite and whether it is likely to get worse in future and health implications of that.

Show quote history

Thanks for answering.

This thread got me thinking as I’m sure I have an overbite and my profile is hellish when I close my mouth. From what I’ve seen if before and after photos the surgery results are amazing.

My stupid dentist wouldn’t even allow me to have a brace and he filled every tooth by the time I was a teenage and I’m sure it was needless.

Sorry about that rant! I bet you DC will look great after the work

loobylou44 · 04/04/2025 10:26

My daughter had braces and surgery due to an open bite. All of this was covered by the NHS and they have been fantastic all the way through. When she was 16 she had 4 wisdom teeth removed and then braces fitted. She had these on for about 18 months before the teeth were in position ready for surgery. She had her upper jaw broken in 2 places, moved and fixed with plates and screws. She was in hospital for 1 night and then home with her jaws banded shut with elastic bands. Recovery was really hard for her with a liquid diet for a month before moving onto purées. She’s now nearly 6 months post op and is eating mostly normal. She’s due to get her braces removed in the next month or so.

TheSandgroper · 05/04/2025 06:37

@Sourwitch braces move your teeth around. One of dd’s problems was her bottom jaw was desperately short. So, break the jaw on both sides, insert titanium to add length and change the angle, allowing bone to grow over. Braces were to tidy her teeth. Braces and jaw surgery were in conjunction with each other but they were two separate problems.

Maray1967 · 05/04/2025 06:57

FortyElephants · 01/04/2025 20:12

What do you need to get your head around? If they are entitled to NHS treatment they will be referred by their dentist. It takes a good year usually to get to the top of the list. Once on they are tightened every 6-12 weeks. I don't know if most teens get them on the NHS, I see a lot at the clinic when I take DS but have no idea if they are paying or not.

I have a 17 year old currently wearing train track braces on the NHS. We’re in Merseyside - it might be different elsewhere.

it took over three years - almost four -on the waiting list …
orthodontics treatment is being rationed. Teeth need to be quite badly crooked in order to qualify on the NHS. We were not guaranteed treatment at the initial visit even though one of his teeth was entirely sitting behind the rest. We were given a leaflet advertising private treatment of £3k plus if he was not allowed NHS treatment.
they were fitted last November and he had them tightened last month. Next appointment is not until July.
If any teeth need to be removed your own dentist has to do it so you end up scheduling appointments with both your dentist and the orthodontist.

That said, it’s going well, and we’re told he should only need twelve months on them.

Longma · 05/04/2025 07:27

Dd was eligible for NHS braces but we decided to pay - this meant we could shortened the wait time significantly, have appointments outside of school hours and she could chose white and clear braces.
We paid for an all-in price regardless of how long it might take.

She had regular appointments with just a few weeks between. This was in addition to her ordinary dentist appointments.

Barrenfieldoffucks · 05/04/2025 07:33

Daughter is nearly 15, and shortly to have her braces removed.

Process was this:

Around June 2023, told that she would need braces by regular NHS dentist that she sees every 6 months. That there were 2 levels of priority...those who needed them put on promptly (defined as within a year I think) and those who could wait. She was the former.

He referred her to orthodontist.

Appt came through for about September 2023 I think it was for initial consultation.

Appt for October 2023 for fitting.

6-8 weekly appointments for checking and band changes etc.

She will have them removed at the end of April 2025, then go back a week later for a retainer.

This was all free under NHS.

Son is likely to need the same, but dentist wants to allow a month or so after all baby teeth come out to see what happens.

Her teeth weren't too bad I didn't think, though she did have one growing quite high out of her gum. She didn't need any extractions which they were surprised at, and just had the traditional train tracks. I'll find a pic. She is so pleased with the progress.

Barrenfieldoffucks · 05/04/2025 07:38

This was about 4 or 5 months ago.

Getting my head around orthodontics for teens...

Skyrain · 05/04/2025 07:58

My son had an underbite which resulted in NHS orthodontist treatment from the age of 10 to try and resolve it. However, when he was around 14 we were advised that the only option was jaw surgery as the braces weren’t having the desired effect.
After a consultation with the surgeon, my son was not keen as he would have to have both upper and lower jaws operated on. I spent a lot of time researching other orthodontists who would be able to help without surgery and we ended up going privately and getting alternative orthodontic care which involved him wearing headgear to bed for many years to adjust his jaw position. This continued into when he was at university but the outcome has been good and his jaw position is much better. It was a long time for treatment but when we discuss it now he still feels he made the correct choice to opt for this treatment over surgery.
We still saw the original NHS orthodontist, as my daughter was in braces as well, and he was very interested in the treatment that my son was getting and the outcome, but said that this would not be funded on the NHS. We have had a great outcome for my daughter with the NHS but for my son the private option gave a result that the NHS said they couldn’t do without surgery.

Sourwitch · 05/04/2025 09:47

TheSandgroper · 05/04/2025 06:37

@Sourwitch braces move your teeth around. One of dd’s problems was her bottom jaw was desperately short. So, break the jaw on both sides, insert titanium to add length and change the angle, allowing bone to grow over. Braces were to tidy her teeth. Braces and jaw surgery were in conjunction with each other but they were two separate problems.

Thank you. I wish my dentist had referred me, as I’m sure I would have looked a lot better from the side!

Original poster

cheeesenonion · 06/04/2025 13:30

Barrenfieldoffucks · 05/04/2025 07:38

This was about 4 or 5 months ago.

That is a pretty amazing change!

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Original poster

cheeesenonion · 06/04/2025 13:32

Skyrain · 05/04/2025 07:58

My son had an underbite which resulted in NHS orthodontist treatment from the age of 10 to try and resolve it. However, when he was around 14 we were advised that the only option was jaw surgery as the braces weren’t having the desired effect.
After a consultation with the surgeon, my son was not keen as he would have to have both upper and lower jaws operated on. I spent a lot of time researching other orthodontists who would be able to help without surgery and we ended up going privately and getting alternative orthodontic care which involved him wearing headgear to bed for many years to adjust his jaw position. This continued into when he was at university but the outcome has been good and his jaw position is much better. It was a long time for treatment but when we discuss it now he still feels he made the correct choice to opt for this treatment over surgery.
We still saw the original NHS orthodontist, as my daughter was in braces as well, and he was very interested in the treatment that my son was getting and the outcome, but said that this would not be funded on the NHS. We have had a great outcome for my daughter with the NHS but for my son the private option gave a result that the NHS said they couldn’t do without surgery.

This is really helpful, thank you very much.

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