missing front teeth implant advise

[implant2026]

My 19-year old has two missing teeth in his front lower jaw (the 2 lower central incisors). At the moment the baby teeth are still there but these are small, causing issues with bite. He's been to an Orthodontist near his university in London and they've said the baby teeth need to be extracted, posts put in its place, Invisalign used to create space for two implants and then the implants placed. All to take about 4-5 months if all goes well at an eye watering starting price of about £15k. (starting? where will it end?) I value your advise on the following:

1. Can an NHS orthodonotist be seen for this? DS says his NHS dentist said no but I'd like to know others' experiences as bite is obviously affected
2. Can anyone recommend a good orthodontist (or is this not allowed?) I've heard that things can go horribly wrong with infections etc and am quite anxious
3. Any comments about the price? It seems so steep.
4. Can't one just do nothing? Yes, bite is affected and X-Ray shows the teeth have dark patches which is apparently indicative of the body extracting nutrients from the teeth.

Thank you in advance for your time/views sharing experience.

I've known teenagers to get implants on the NHS, but no idea whether your son will still qualify. (I was a secondary school teacher.)

I had one implant for one top front tooth 10 yrs ago. It was a slow process and cost around 4k.

When I was 20, I paid nothing to have my two top front teeth crowned - my NHS dentist told me to sign at the bottom of a form which he signed. The crowns lasted 35 yrs, until the root of one of them started to be absorbed by my upper jaw.

Sorry I can't give more info, but thought I'd post what little I know.

I'll add that I remember one specific pupil who had a condition whereby he had extra teeth above his 'normal' teeth for want of a better expression.

ISTR that he needed the extra row pulled out and implants and braces for the gaps below. This was all done in the maxillofacial department of an NHS hospital - his NHS dentist had referred him there.

I'm puzzled as to why your son's dentist hasn't referred him on, OP. I'm in Scotland, but I believe that the rules for NHS dental treatment are the same here as in England?

Didn't his dentist warn you about this when he was younger? It would surely have cost much less if he had been referred before he was 18. I've had the same thing but with a molar. Eventually the baby tooth came out but I was in my 30s so it hung on a long time. I have just left a gap but it isn't visible unless my mouth is very wide. With front teeth the implants will be needed at some point.

I think they need to be under 17 when they start treatment.

If he has younger siblings it would be a good idea to get x rays to check in case they also have missing teeth as it's genetic. At least you can consider earlier referral for them.

I have a family member who was told they don’t advise work like this on their teeth until they are over 18 and all teeth are through and they have stopped growing

My 14yo has several missing adult teeth including front lower incisors and is under the care of the NHS. She will qualify for free implants when she's old enough, but I have been told (don't know whether it's true) that that's because she was referred before she was 18.

I was let down by a local dentist when I turned 18. Instead of doing as he was bid by the dental hospital, he filed down one broken front tooth and put on a monstrosity of (I later found out) a temp crown on the other. I recall bursting into tears when I looked in the mirror at home. [I had been under the community dentist, but had to move to another dentist when I aged out.]

I would have been 19, going on 20 when I switched to another NHS dentist, on the recommendation of others. Thanks to him, I got permanent NHS crowns and didn't pay a penny. He ascertained that I was a full-time student and, filled up all the necessary paperwork for me. That's why I'm wondering whether the OP's son might be entitled to NHS help.

I remember walking into the Russian Dept at Glasgow Uni with my new teeth and the professor having a look at my crowns because his daughter was going to need the same.

The NHS had given me a natural looking pair of porcelain crowns.

I wonder whether what my dentist filled up was the equivalent of this:

https://www.nhs.uk/nhs-services/help-with-health-costs/nhs-low-income-scheme-lis/

ISTR that students in my day used to go along to the local dentistry school for treatment.

I was actually referred to the one in Edinburgh, but they referred me back to my local dentist for the crowns and - I now realise - were astonished at what he actually fitted. Unfortunately, they only asked me whether I was happy with them and I was too shy to say "No."

(Edinburgh was going to do cosmetic work on my jaw and it was obvious to me that the local dentist disapproved. Whether or not he was intent on punishing me for my vanity, I've no idea.)

My implant and the matching new crown were done by Blackhills [private] Dental Hospital 10 yrs ago.

https://life.studentbeans.com/post/do-students-pay-for-dental-care

Unless your son has problems so severe that his jaws need operations , over the age of 18 braces are not available on the NHS .

Likewise , in most/all areas implants are not available on the NHS unless at least 6 adult teeth are naturally missing and even then in decades of practice I have never seen a NHS patient accepted for implants , although that might be different in somewhere like London.

Locally to me parents are advised to start saving if it is likely their child may need implants . To put it into context the NHS budget for restorative care in my area will cover a couple of oral cancer /cleft palate patients a year and that’s it.

Implants are around £2500 to £3500 each and Invisalign is an expensive way to move teeth , fixed is better and cheaper but will be £2000 to £4000 ish depending on complexity. Prices will be more expensive in a big city practice and London most expensive .

In general advice is to leave baby teeth in as long as possible, some will last until people are in their 40s or 50s before they loosen and fall out, others won’t last as long.

You can get an opinion from any orthodontist/ restorative dentist but ask for a copy of the x rays to save needing these redoing.

when he was younger they said he needs to wait until jaw has fully grown. That's now, when he is nearly 20.

I'm sorry that they did that to you.

I had a jaw issue when I was a teen, but was referred straight away and then told to come back at 20.

Thanks. His baby teeth are not wobbly. So they can probably last some time but the orthodontist had said it has to be done sooner or later and DS thinks doing it while at university is better than having it done while at work, time wise. Ah. so Invaslign is just one of the products that can be used.

Thanks to all who replied. Any recommendation for a good Orthodontist in London?

But how many can afford to save for implants?

FWIW, a former colleague had her teeth straightened when she was in her 40s and she used regular fixed braces. She got a very good result.

The first day the kids at work saw her, she was inundated with care advice from teenagers eager to give their words of wisdom to a teacher, including "An dinnae kiss a laud that's wearin braces an aa!"