Fixed braces problems

[autumnboys]

DS2, who is 14, has had fixed braces for about 18 months. He wore palate expanders top and bottom for about 6 months before that. He is being treated on the NHS.

We've been in for an appointment this morning and I went up with him, which I usually don't and the ortho told us both off, as he needed a repair. Apparently it is the 8th repair since he's had the fixed braces, the average is 2. He said that if DS breaks his brace again, they will take them off and discontinue treatment.

I will be watching DS like a hawk - I think he is generally quite careful about what he eats and drinks, but I will be doubling down and reviewing everything with him, to make sure we give him the best chance of getting to the end of treatment. I think he has been unlucky - one of the breakages happened within half an hour of the bracket being put on and they cheerfully admitted they'd probably been optimistic putting it on and took it straight off again. I didn't say this to the ortho, as he seemed too cross to argue with.

Has anyone else had this happen? Would it be possible to swap across to private care to get the job finished? Can the NHS discontinue orthodontic treatment? Any tips for helping DS get to the end of his treatment, please?

He has to be more careful. What is causing them to need repaired? In the nearly 2 years dd had hers she had 1 repair due to a bracket coming off.

It's all brackets. The back top molars, never anything on the bottom. Once I think he broke one when he fell off the climbing wall and knee-ed himself in the face.

He is pretty careful, but will obviously be hyper-vigilant from now on. It's just confusing to me, as he has other friends with braces, who appear to eat/drink/live similar lives to him and never have a breakage.

If you knew how expensive his treatment is costing the NHS and even the price per bracket and materials to replace it you would understand that 8 brackets off in 18 months is a lot to any orthodontist.

My DD has a brace and had to sign a form before treatment started and that did state that if there were too many breakages they would discontinue treatment (it is an NHS brace).

It has broken numerous times (bracket, elastic, wire - what else can go wrong) but has slowed down now! They did ask her to be careful after the last one tbh! If it is the upper brackets, is he biting anything hard with them because my DD was warned about that!

I try to ensure that he cuts everything up when he eats into quite small bits and he has a stopper glued to the back of his front teeth to stop him from closing his mouth too far. It’s a good thought though, thanks, I will watch him at dinner tonight.

20viona, I am well aware of the cost of the treatment, thanks. I had researched how much it would cost for us to pay privately. I wasn’t suggesting that his breakages were not a big deal. I just don’t understand why he has so many and I was interested that the NHS can withdraw treatment. I have, for example, nieces who wear glasses and are forever breaking or losing them. There’s never been any suggestion that they can’t have another set if they break/lose the new ones, or that the repairs would need to be paid for. I would be happy to pay for his repairs, but that was not offered to me as an option.

My DS has broken his around 5 times and none of them broke whilst he was eating! The first time it happened the orthodontist even admitted saying that she probably shouldn’t have put this type of bracket on as it is easily broken! Sometimes I think you can just be unlucky!

if it happens again, find another orthodontist and pay privately for the repair only, then return to the NHS orthodontist for the normal continuing treatment.

Mine has broken his brackets several times (twice in the hours after a tightening/check up), once from eating a forbidden baguette and the other times they randomly popped off. Nothing has been said. Though where I live they originally said they would just start charging us, never discontinuing so maybe you could suggest paying for the repairs?

My DS had braces for 12 months. He had one repair which wasn't a problem although I did take him once straight from school without cleaning his teeth due to lack of time. He had cleaned them in the morning so I thought it would be ok and they would understand but I was wrong.
The orthodontist refused to do whatever she was going to do saying he had to clean his teeth and that she had a duty of care etc.
I never made that mistake again.

Thanks everyone! I have made a list of questions to ask the orthodontist.

Magicmallow thank you for that suggestion. I’m going to make a few phone calls to the private surgeries in the local area and see if I can find someone who will do that.

Do some orthodontists only offer NHS? I bet if you asked you could finish the treatment privately where you are, but I wouldn't want to. DDs orthodontist is lovely and calm and never gets cross about her breakages. We are private (referred by NHS dentist but didn't meet criteria) but I can't

......imagine him getting annoyed with NHS patients either.

NHS orthodontics and private orthodontics are the same. It's just one the NHS pays for. You won't get braces that don't break privately.

NHS orthodontics costs 1000s and it's important that patients take care of the braces, otherwise it's a complete waste of NHS money. The NHS has the right to withdraw treatment from patients who arent taking proper care, or complaint. If he's not compliant with the braces chances are he's probably going to lapse on his retainer use, and he goes through years of treatment which is completely wasted. I don't really see the point in hiding the number of breakages from your orthodontist, that's not really fair.

Your orthondist was being fair. If it was something they were doing all their patients would have brackets coming off left right and centre. They don't, so it's clearly something DS is doing. Orthodontist deal with a lot of braces, they will know if a bracket is likely to debond or if it's something the patient is doing.

I don’t think I implied that I thought the orthodontist was being unfair, but in case I did, I should clarify that I share his frustration. I have to take time off work to take DS in and would also prefer the work to be completed in as few visits as possible. I'm also passionately in favour of the NHS, grateful for the treatment he's getting and keen to get to the end with as little further cost or inconvenience to the practise, as possible. I’m also aware that they're the same braces that the private ortho uses and that going private won’t change the rate of breakages.

Orthodontics has changed a lot since my fixed braces in my own teens. They seem almost to expect very little in the way of compliance - I mentioned my own head and neck straps and they laughed and said no teenager would wear them these days. As a result, after treatment, they glue a retaining wire to the back of the teeth and recommend it stays on permanently at the practise we're at.

Thanks to everyone for your thoughts and tips. DS is under surveillance and we are planning on a call to the practise to find out if we can find a solution with them, involving us paying for any further repairs, or indeed switching across to the private practise for the remainder of the treatment should that become necessary.

Just to add, it's extremely unlikely that another orthodontist (private) will be willing to take over treatment mid-way through. Unless within the same practice.

When I call there’s the option to press 1 for the private practise or 2 for NHS patients, so fingers crossed.