Underbite treatment for 11 year old.

mrscb

Have seen orthodontist for initial assssment of my 11 year old DD..he has said that her underbite is caused by the way she is growing(and obviously they cant change that)..it is causing excessive wear on her upper teeth..in particular the front two..he asked us to go back next month to take xrays and get her records and will then discuss what treatment she may be able to have.As all her teeth arent through yet i just wondered what is likely to happen..otherwise i will spend the next few weeks googling!
Thank you

welshdent

Only they can really say as it would vary from patient to patient, orthodontist to orthodontist. I shouldnt imagine any wear would be THAT severe in a couple of monitored years. Just follow the advice of the orthodontist who will manage how they feel is most appropriate. I would say 11 is normally a little short of the normal time of intervention especially as she still has baby teeth so they may just monitor for the time being.

brook2jack

Actually there are many, many different ways of treating this sort of jaw relationship which way depends on the detailed measurements and records the orthodontist is making. At 11 a girl is just before the prepubertal (teenage) growth spurt and for some problems this is a good age to wear a functional appliance (brace). However as Welshdent said they may just decide to wait until all the baby teeth are out.

The problem with googling any medical problem and particularly dental is you get every opinion including the wild and wacky all with the same weight of "evidence". You will read and be convinced that they need jaw surgery, braces for twenty years and a head transplant. There are no hard and fast rules in dentistry that for problem x the solution is y, the solution is normally completely different for every patient and quite often every orthodontist will have a different approach.

So unfortunately you'll have to be patient and wait to hear options from the only person who can accurately say what your daughter needs..., your orthodontist.

Kazipoo

My daughter has been told that she has needed a brace for several years by the dentist, yet when we were refered to the orthodontist he refused to give her one under NHS and told us we could pay £3k for one fitting privately instead. My friends daughter had near perfect teeth and was refered to a different orthodontist at the request of her mother (who has perfect teeth) and she was given a brace almost immediately. I really think treatment varies from practice to practice, although there are guidelines that the NHS follow, it is down to the individual practice to determine the course of treatment.

At the request of our dentist, my daughter was re-refered to a different orthodontist who we have waited two years to see, maybe she will strike lucky this time.

brook2jack

There is really very little leeway in assessing cases for nhs treatment. Orthodontists have to stick to iotn guidelines and are not allowed to treat cases that are not graded high enough http://www.bos.org.uk/orthodonticsandyou/orthodonticsandthenhs/whatisiotn.

Someones teeth may look good from the front but they may have serious problems with the bite not obvious to the lay person. Perfect or near perfect teeth would not qualify for nhs treatment no matter who the orthodontist is.

Unfortunately if your child is not at least iotn 3 With severe problems with the look of the teeth ,then they will not be treated and in certain areas eg NI the cut off is likely to be iotn 4 soon.

Kazipoo

I am aware of the nhs guidelines, but I really think it had more to do with the fact that I asked him to clean the dribble off the chair from the previous patient.

My dentist was the one to re-refer her. Surely if he didn't think it was necessary he wouldn't have bothered?

abbecer

My son age 9 was told he had under bite around 8-9 months ago and was referred to the orthodontist. Saw orthodontist within 2-3 weeks and was fitted for a brace immediately to correct his bite. To date he has had two different braces (removable) and his top teeth are now slightly in front of his bottom teeth. They have said it is likely he will need a fixed brace in the next few years to straighten his teeth when all his baby teeth have gone and adult teeth are through. Very impressed with his treatment so far which has all been NHS funded.

Rebecca

Toothsmith

Kazipoo wrote: »

I am aware of the nhs guidelines, but I really think it had more to do with the fact that I asked him to clean the dribble off the chair from the previous patient.

My dentist was the one to re-refer her. Surely if he didn't think it was necessary he wouldn't have bothered?

There are obvious cases that will qualify and there are obvious cases that won't.

Then there are the cases in the middle.

Being a general dentist rather than an orthodontist (And also not having a vast amount of kids on my list) I am not an expert on the IOTN system. I would suggest that most general dentists could not give definative classifications of orthodontic need based on that scale, it's quite complicated.

So I still refer kids who I think might get through - so long as the kid (The kid, rather than the parent) wants to investigate treatment options. I must admit, if I think it's borderline, I do warn parents that it might not qualify for NHS funding.


As for the 'dribble' bit - can you be sure it was dribble?

Something I find commonly happens is that whenI'm rubbing disinfectant hand gel over my hands, sometimes that 'escapes' and can make a clear fluidy pool where it lands. I'm just saying that there are several fluids used in the process of wiping down surgeries between patients, and without forensic analysis I would struggle to identify saliva just on looks alone.

brook2jack

We've changed the stuff we wipe the chairs down with and it takes an age to dry . It's different stuff to what is squished around the spittoon and areas, different again to what's used to clean down the bracket tray ,pipes and couplings. The hand rub is now alot "gloopier" than it used to be as it now has some moisturisers in it and as we have automatic dispensers that are motion sensitive it can end up being squirted all over the place.

All of this stuff is squirted and wiped on chairs, tubes, lights, bracket tables, hands, safety glasses after every patient and takes an age to dry so it is not unusual to have bubbly streaks somewhere.

What that doesn't negate is that for a nhs orthodontic exam there are a mountain of forms to be filled in detailing the exact classification of a Childs teeth. There is simply no leeway to allow someone with minor problems to get treatment. However there is a small amount of movement in very borderline cases where there is little health benefit in treatment but assessment of the "aesthetic" (looks of teeth) component can be somewhat subjective. However many children who would have had nhs orthodontic treatment in the past are no longer eligible, and this has been difficult when pre 2006 you warned parents their child would need a brace when they were older to find post 2006 the nhs would no longer provide it now the children were of an age to start treatment.

Kazipoo

Lol, no I have no idea whether it was dribble or not, but even if it was not, it was a glob that had made its was from the head area of the chair to the crease of where the next goes and sort of pooled there. I didn't actually see it at first, my daughter mentioned it to me and I asked the orthodontist if he could wipe the chair because she didn't want to get the offending 'dribble' on her clothes or in her hair.

My daughter is desperately shy and very self conscious about her teeth, I think she has lovely teeth (although some are a little wonky), but her top teeth angle inwards and I believe it is because of this the dentist has refered her. He did mention that the criteria is quite tight but because of her lack of confidence he wanted to get a second opinion.

Toothsmith

If the teeth slope inwards, then it might (Might - I'm just guessing here) be what's classified as a Class 2 Div II.

These patterns are actually very hard to treat successfully, and have a tendancy to relapse after treatment. Plus - there's not actually much 'improvement' in the way things look at the end of treatment anyway, it's just the teeth are in different places!

The dentist sounds like he did the right thing in asking the question - the orthodontist seems to have answered it in that it doesn't qualify for NHS funding. Your decision now is given the information you've had from the orthodontist on outcomes, given your daughters feelings about her teeth, given the family budget, do you want to go ahead with treatment?

'No' is a perfectly acceptable answer.

With my eldest son, (Although he did qualify for NHS) there was a phase 1 to treatment, and then an optional phase 2 which required another 2 years of braces just to fiddle a few teeth into a slightly better position, and make the result a bit more stable.

My son decided that he didn't want to go through that, so we stoped after phase 1. Since he's finished, a couple of teeth have gone a bit more squiffy than they were at the end of treatment, but they're still better than they were at the start, so we're all still happy enough.

There is no need to have perfectly straight teeth. Personally, I always think it looks too false anyway.