Adult braces

[Allhailkingcharlie]

Has anyone ever had them on the NHs? Or used Invisalign?

@ricekrispi I welt to the dentist with severe tartar behind my teeth as it was difficult to clean all the crevises since I had a lot of over crowding. The dentist suggested referring me and it just went from there. It took a long time all in, lots of waiting lists but so worth it.

It can be, but there's a tool called Pul which you can buy on Amazon which makes it SO much easier. The tightness of a new tray also reduces massively the further into treatment you get. Taking an ibuprofen half an hour before changing to a new tray (and timing this so you do it right before bed) helps a lot. You do get used to it, but the first few weeks are a bit sore.

Because they , like all removable appliances, can only tilt teeth , rather than moving them bodily like fixed braces . Because they are designed by computer quite often the teeth can be over tilted and need correction . They cannot adjust height of teeth or fill large gaps.

There are some retainer type braces that are now using different attachments to create more refined movements , a sort of cross between fixed and removable braces , but retainer braces are very much more restricted in type of movements that can be achieved and more importantly the refinements in bite which a fixed brace can achieve cannot be done with a retainer system . This is a good overview of the limitations of aligners type systems https://www.theorthodontists.com.au/blog/what-orthodontic-issues-can-and-can-t-invisalign-fix

I am currently wearing top and bottom fixed braces. Top set is ceramic, so they are white which makes them barely noticeable. Total cost was £3900 which included an up front payment, then monthly payments and includes a fixed retainer at the end.

I did have braces as a teen, but over time my teeth have moved back. I will echo the previous posters who have said to go and see a proper orthodontist. My orthodontist says Invisalign is great for some people, and she does offer it, but a lot of her patients have had Invisalign with a cosmetic dentist when it hasn’t really been suitable and she is now fixing he damage the Invisalign has done - apparently it tilts teeth rather than moves the root which is what conventional braces do.

There is a limit to how much you can widen the jaw and this is almost always done during the pre pubertal growth spurt ie just before a teenager or, in the case of boys , pre teen hits their growth spurt . Indeed this approach means many fewer children have teeth out for braces.

It is not used in adults , in general, because they have finished growing . An adult who needs jaw expansion will need surgery and this is one of the only times the NHS will provide orthodontic treatment, combined with surgery.

Expanding the dental arch in an adult will result in very unstable results , quite often with bite problems and mobile teeth because teeth are pushed out of the bone holding them in . This is why the direct to the public brace companies have so many problems with complaints because a customer never sees a dentist the only way teeth can be moved is by pushing them outwards which can cause all of the problems above.

So in an adult , in general , space can only be achieved by inter proximal reduction (tooth shaving) or extractions.

Thanks for answering @TheGoodBanana. I may ask my dentist what she thinks when I have my next check up.

@ricekrispi I hope they agree to refer you. It's a long process so be prepared for that but I didn't mind having my braces in at all.

I'm having QuickStraight Fitted next week! I can't wait. £3k x

Meant to add, I'm 43, peri-menopausal and my teeth are definitely getting worse x

I'm nearly 51 and start my first ever braces next week - am doing clear aligners on top and bottom and I'm really excited, but apprehensive about getting them in and out

@Lollygaggle

I'm talking from literal firsthand experience of having braces, on the nhs without jaw surgery.

Thanks for the links!

Here was where I had mine done as an nhs patient :) via nhs referral. As stated they accept patients up to the age of 25

www.guysandstthomas.nhs.uk/our-services/orthodontics

top and bottom invisalign about 5 yrs ago. 5k. very happy. recommend it.

I am amazed as they will have had to complete an individual funding request for your orthodontics if you were above 18 when referred and it was after 2006 and did not need a combined oral surgery and orthodontic approach. It is extremely unusual for this to happen and in most parts of the country unless you are in need of a combined approach you will not get adult orthodontics. Indeed the referral system , which is mostly electronic , will not let you refer if above 18 and not meeting this criteria eg quoting from below paper
NHS orthodontic care may be approved for adults on a case-by-case basis if there is a severe dental health issue or complex multi-disciplinary needs.
https://www.nature.com/articles/sj.bdj.2015.51#Sec9

I would be surprised if the acceptance now is vastly different from all other London and U.K. hospitals eg https://dental.bartshealth.nhs.uk/orthodontics-referrals/. And https://mft.nhs.uk/dental/about/referral-information-for-dental-practitioners/orthodontic/. For example.

Orthodontic referral criteria is for England and Wales. Scotland and NI have their own criteria.

I am also nearing the end of my invisilign and it is the best thing I ever spent money on!!

I can't believe the difference and only wish I'd done it sooner!

@Lollygaggle prepare to be amazed! If you would like to pm me I'll send you my hospital notes and pictures / ID. I had them from 2016-2021 and I was 22.

Even the links you provided yourself do not explicitly state that they are only provided for patients requiring jaw surgery.

The last link even states "any cases including routine cases if required for teaching purposes" - this is exactly what happened to me I was at the postgraduate centre at Guys and my orthodontist was a student, which I mentioned in my first reply to the op.

I never said my case wasn't complex but I had no jaw surgery, I was over 18, and it was on the nhs

Not interested in derailing ops thread any further and actually quite confused as to why you are so intent on disproving my actual lived experience. Pm me if you want to chat further :) x

Unfortunately your experience will not be replicated in the vast majority of the country . Even more unfortunately most people working in dental and orthodontic practices will have experienced the frustration of people who have been told something is available on the NHS when , for all intents and purposes , it is not. The squeeze in dental funding means even essential services like urgent cancer referrals are no longer hitting target of two weeks.

This is from the British Orthodontic Society and pre is the situation in the vast majority of places.

Can I have treatment within the NHS as an adult?
In principle, adult orthodontic treatment can be provided under the terms of the NHS provided the need for treatment is sufficient. However, as a general rule the NHS contracts held by most orthodontists do not include adult patients.
In some areas there are no orthodontists at all with NHS contracts to treat adults. An enquiry to your local PCT or Health Board may be useful. Adult treatment under NHS contract incurs the standard NHS charge for complex dental treatments which is currently around £250.
For the most severe problems, notably those requiring jaw surgery, treatment for adults may be provided by the NHS through the hospital service. A referral from your dentist or orthodontist is needed to access these services. However, hospitals do not normally accept routine orthodontic cases for treatment and in the majority of cases adult orthodontics is carried out under private contract.

£5400 for 10 months of treatment for a complex cause? Sounds way too short.

Crazy money