NHS Dental Treatment for Congenital Hypodontia

monkeyspanner

Thank you all for taking the time to reply and your tolerance to what must seem at least partially an illogical desire to begin treatment. I do realise that each patient will require a different level of communication and what is perfectly acceptable for many will be inadequate for some. Pitching communication at the right level must be a difficult task and unfortunately for the consultant we fall into the "some" category both by nature and experience.

There is also the difficult transition we must manage to allow my daughter to manage her future treatment herself. This often involves trying to explain to her things we don't fully understand ourselves because we do not have sufficient knowledge or information. Her early diagnosis by an excellent dentist means that she has lived with this problem for over a decade and she has been very patient up to now. Her desire now is to at least have the appearance of a normal smile.

Billiebob I will consider the first part of your suggestion but I would be extremely reluctant to involve PALS which is akin to swimming in custard.

welshdent

Monkey how old is your daughter now?

brook2jack

One last thing to consider. The treatment plan often evolves and only becomes fixed at the last moment. Many people would lose confidence in a consultant who answers truthfully that he doesnt know exactly yet what a treatment plan will be. There are thousands of permutations from jaw surgery to overdentures and until final restorations are immenent and choices have to be made by your daughter then its difficult to discuss. What is certain is if your daughter wants the best result she will have to be patient for a few more years. Even so if she has concerns about appearence there may well be compromises that can be made now.

dizzzy

Can't offer any advice but just wanted to say this thread has been very interesting to read. My ds has the same problem not quite as many missing teeth.

We are only in the very early stages though as he's only 13. He's already had some baby teeth removed, one was knocked out at school (by accident) and one was submerging back into his gum.

He has been seen at a dental hospital and have to say so far they have been great. The first time we went everything was explained to us and what treatments may be available but that nothing could be done untill he's older.

I think I worry more than my ds about how his teeth look. He's got 2 upper incisors missing and I worry about what other people must think. It doesn't seem to bother ds.

We do have to remember though how much things have moved on. My dad had the same problem and at 18 they just removed all the first halve of teeth and gave him dentures.

Monkeyspanner I hope your dd gets on well with any treatment that she has done and that the hospital starts discussing things better with all of you.

missypuff19

Hi, I know this is a few months since this topic has been active but I myself have a severe case of hypodontia at 19 years old. I have been receiving all sorts of dental treatment for this since I was 13. I have had 2 sets of braces and I have finally had my braces removed, in preparation for further permanent treatment in the form of implants and bridges. However, like the original post I have found that a breakdown in communication between my dentist, my orthodontist and a consultant I was referred to, has made it near impossible to carry on with any treatment as no one really has any clue as to what is going on. I cannot afford private treatment as I am currently a student at university so my only way to get a full set of teeth is through the NHS. I personally have felt quite insulted by some of the impersonal replies on here as a sufferer myself as I know how hard this situation can be. I don't tell anyone apart from family that I have hardly any teeth and have to wear dentures, as I feel embarrassed by this at such a young age. I feel as if they won't understand it is not actually my fault my teeth are missing and as I have not met anyone at the same age with the same problems I feel I have no one to really talk to about it. Thankfully my own mother has had the same problems so I can speak to her but due to the time differences, the treatments are different now so she can't always explain everything or make me feel better. Hopefully my treatment will be sorted soon and there will be one clear planned course of action, but at the moment I am stuck in limbo - just like monkeyspanner's daughter.

brook2jack

Where are you having treatment , at home or university? If you are getting nowhere and you have just started at uni and it has a teaching dental hospital it may be worthwhile asking for referral there. Most dental teaching hospitals have excellent units for treating thus sort of problem. However ,as you know, your treatment is still going to be long and complex so three years at uni may sort it ,but it's not worth changing over if you are in a final year.

I presume your orthodontist and consultant are at the same hospital as they will be the main movers in all of this? Have you no more appointments sorted yet?

19 is about the youngest you could even consider implants and some dentists would still want to leave it a year or two ,particularly if you have had alot of brace work as you need to allow time to see the way things are going to settle. This is particularly important in people with congenital hypodontia as often there is insufficient bone to put implants in and consideration has to be given to bone grafting etc and this again may need careful consideration with regards to age.

I know this is frustrating at your age but in the end you have to plan for the best treatment long term. Teeth prepared for bridges are teeth that are (unless front teeth) cut down . Drilling a tooth is an irreversible and destructive process and has to be done with care on a young person where the nerve inside the tooth is still large. For this reason implants are better but have constraints in terms of what age they can be done, where they can be placed, and how long it will take to place them.

Incidentally I have just had a young person I know start dental school their interest piqued by their treatment for hypodontia. They have just had their substructure for two front teeth placed and are waiting for this to heal for 8months before the teeth can be fitted. However they didn't have back teeth involved yet and have got canines which makes things more complicated.

brook2jack

Sorry can't edit on phone. Meant to say they have canines which makes things LESS complicated.

missypuff19

brook2jack wrote: »

Sorry can't edit on phone. Meant to say they have canines which makes things LESS complicated.

Haha sorry for really late reply!

From a quick google search, I have my canines too! I don't have my lateral incisors on the top but I do have my central incisors and the other missing ones I have are premolars on the top & bottom. (sorry if I've got the terminology wrong here)

My university doesn't have a dental school so no point transferring here, I'd just get put to the back of a waiting list anyway. My orthodontist and consultant aren't at the same place, not even in the same town! This is where the communication problems have occurred I think.

Anyway, I've been referred to a dental hospital now and I have an operation booked in July to remove the rest of my baby teeth & then onto possible implants (bone graft first).

It's strange you say 19 is the earliest, as my orthodontist always said 18 & this is when he referred me to a consultant. Anyway the consultant must not have read my notes properly and as I look a lot younger than I am, she must have assumed I was younger and told me that I had to wait until I was 17 to have implants! :rotfl:

brook2jack

There is no set age but implants are not placed in children. Also the orthodontists want a stable result and growth to have finished so most implants are not placed until late teens, early twenties or later.

As often in hypodontia bone grafting is involved again this is best done in adults.

missypuff19

Yeah I knew this obviously my mouth will have changed and ruined all the work! I've noticed this even with my denture that I have had since I was 14, which is quite tight!

I'm quite worried about the bone grafts to be honest... I don't really know what it entails in the UK? I have tried to google it but with no proper answer as a lot of it was from US sites.