Grade 5 Orthodontic treatment

sinful07

Hi there,

I am a 22 year old live-at-home male with severe dental problems. I have an overbite that affects my confidence and self esteem, i have been single for a while and am not very confident with girls because of my smile. I can often start and continue conversation but i feel self concious when i laugh due to my overbite- it is so bad that my bottom teeth cant even reach my top front teeth. I also attribute this as it affects my career somewhat, i dont feel confident in an interview anyway, but not being able to smile really brings my confidence low...

I also have severe overcrowding on both top and bottom parts. I have been referred to an Orthdontics however the cost itself is quite expensive (£80) for something that im not entirely sure i can afford on the get go.

Currently my dentist has referred me to a private practice however i think that i can be referred to an NHS practitioner as well? I currently live at home and have a job, I pay part of the bills to my mum, help around the house and we barely can afford any extravagances such as forking out £2,000 for braces.

I just stumbled upon this referral from Barts and London which is an NHS Orthodontic hospital in london and i believe i qualify for it:


[FONT=&quot]Only those patients qualifying under IOTN grades 4 or 5 will be accepted for treatment. Occasionally lower priority patients (IOTN grade 1, 2 or 3) maybe accepted for treatment for teaching dental undergraduates. [/FONT]

[FONT=&quot]Patients considered high priority (Grade 5)
[/FONT]

• [FONT=&quot]Increased overjet > 9 mm[/FONT]

[FONT=&quot]Patients considered medium priority (Grade 4)
[/FONT]

• [FONT=&quot]Increased overjet > 6mm but <= 9 mm[/FONT]
• [FONT=&quot]Anterior or posterior crossbites with > 2 mm discrepancy between the retruded contact position and intercuspal position[/FONT]
• [FONT=&quot]Severe displacements of teeth > 4 mm[/FONT]
• [FONT=&quot]Extreme lateral or anterior open bites > 4 mm[/FONT]
• [FONT=&quot]Increased and complete overbite with gingival or palatal trauma[/FONT]
• [FONT=&quot]Patients requiring orthodontic treatment in conjunction with corrective jaw surgery[/FONT]

I think i qualify for the aspects above, however im not entirely sure- Which is why im here, i dont expect anyone around to be an Orthodontist that would be able to assess me, however someone with experience regarding NHS treatment or costs, or recommendations in South East Essex or in London would be great!


Although im very shy about it, i hope to remain annonymous and was brave enough to take some pictures for some assessment!

I have also taken some pictures but as a new user it wont allow me to post them, please do message me if you are interested in seeing the severity!



My Questions are:

1.) Do you think i have a chance for NHS treatment? Im prepared to wait as currently i cant afford treatment at all.
2.) Do you have recommendations on which Orthodontists to go for?
3.) Would my local dentist be able to refer me to another Orthodontist of my choosing? i dont really trust the one they recommended.

I am willing to do the leg work and research to make this happen, I just need a bit of help. Please and thank you!

-Sean Parker

brook2jack

No you are not eligible for nhs treatment as you are over 18. The only adults who will get ortho treatment on the nhs are those who are having it in conjunction with jaw surgery for severe abnormalities. The iotn scale you quoted is used to assess under 18 s only for nhs treatment.

You will only be able to have braces if you pay privately and £2000 is a good ball park figure for treatment. Most practices will charge £80 to £150 for an initial assessment.

No orthodontist who has a nhs contract is allowed to see over 18s , and only severe problems requiring surgery and braces will be seen at a hospital on the nhs.

welshdent

Its very rare for anyone over 18 to be able to get NHS orthodontic treatment. It usually only something available to someone with a functional problem not aesthetic or psychological.

Even if they did accept you you would not be able to get it in an orthodontic practice. It would only be something available in a hospital setting.
The waiting lists in my area run to a few years before treatment is likely to start then another few years in active treatment.

Can I ask why you do not trust the orthodontist? Your dentist can refer you to anyone you like but they will all be private unless it is the hospital. More often than not my hospital referrals are bounced back with a snotty letter

sinful07

Hello Brook2Jack,

Many thanks for your prompt reply, As dissapointing as that may sound, would you mind clarifying as to why this was not specified on the Barts and London website.. for example?

I found the acceptance form on the Barts and london website, under their acceptance forms. (i cant link as im a new member, sorry, but its pretty easy to find, dental services, orthodontics, scroll down to acceptance forms.)

And it doesnt limit/specify that its for anyone under 18- I dont mean to argue as i have heard that before, but do you have further advise regarding the matter?


Welshdent,

Thanks for your prompt reply too, i guess that saves me time from cold-calling NHS practices regarding! And im not sure, i just havent heard of them before and im just put off by the £80 for the assessment. That's at least a day and a half's work for me

Please and thank you to you both!

-Sean Parker

bluesnake

If you go to a teaching hospital, you may get treated very cheaply if you volunteer as a practice subject for students.

A friend had bone implant dentures fitted for £50 - cost of 4 titanium screws. Another friend of a friend got his mouth messed up so badly that it took the head of the dental school to step in and multiple visits.

Everybody makes mistakes and apparently you can evaluate the student beforehand.

welshdent

The 18 years old limit has been in place as long as I can remember as far as "general practice" orthodontics is concerned. Their contracts are specifically limited to under 18. We can not asess you personally as we can not see you but even then we are not qualified to do so anyway and would not wish to give you any false hope. Your own dentist MAYU be able to identify a functional issue as an indication for orthodontic treatment at the hospital and MAY manage put it succinctly enough in a referral letter to get you in the door past the screening staff, to which the consultants would be the deciding factor following an examination. However there really is no guarantee on any of it. I have never known anyone get orthodontics for cosmetic or psychological reasons post 18 years of age. If they were to do so it would open up major flood gates. Gates they have been trying to stem for UNDER 18s hence the IOTN in the first place. The IOTN was developed to stop under 18s having NHS orthodontics in practice settings.

Re the ortho practice you have been referred to - I wouldnt think many orthodontists have been heard of generally but for your own dentist to be happuy to refer you to them then they must have a degree of professional respect. It takes years to become an orthodontist. My best friend has just qualified as one and is deemed to have been quite quick passing through the pathway and he qualified as a dentist in 2005. Believe me, they are well trained. I woudl also say £80 for an ortho assessment is actually quite reasonable. I know many places that charge more. Dont forget it is a private exam which means the NHS gives zero funding to them. That means the practice must generate income somehow in order to pay for staff bills and equipment.... that money comes from the patient.

sinful07

Hello Welshdent,

Thanks again for replying- I think i'll have to save up my pennies for this assessment then, I'd like to keep this topic open for further input if that's ok with the moderators.

Thanks again- Any further advise is welcomed!

Kind regards
Sean

brook2jack

If you read link under acceptance criteria it says adults over 18 will not be treated unless they need multidisciplinary treatment e.g. surgery and braces http://www.bartsandthelondon.nhs.uk/our-services/dental-hospital/for-gps-and-gdps/your-referrals/

This is common to all hospitals they will not treat adults over 18 with braces even in teaching hospitals unless it is a very severe problem needing major jaw surgery as well.

Adult orthodontics (braces) have not been available in general nhs practice since 2006 when the criteria for children was tightened up (as per guidelines you found ) and adults removed entirely. http://www.bos.org.uk/orthodonticsandyou/orthodonticsandthenhs/whatisiotn

Toothsmith

bluesnake wrote: »

If you go to a teaching hospital, you may get treated very cheaply if you volunteer as a practice subject for students.

A friend had bone implant dentures fitted for £50 - cost of 4 titanium screws. Another friend of a friend got his mouth messed up so badly that it took the head of the dental school to step in and multiple visits.

Everybody makes mistakes and apparently you can evaluate the student beforehand.

Have you made up this entire post?

It's complete fantasy!

If you are accepted as a patient at a teaching hospital, the treatment, like all secondary NHS care is free at the point of delivery. You don't 'pay for the parts'! And anyway, 4 'titanium screws' are highly refined, precision engineered, coated, sterile surgical grade devices. They most certainly are not £12.50 each! I don't think I could buy titanium Allen bolts for my bicycle that cheaply!

Dental hospitals have such tightly squeezed budgets that they simply do not accept all and sundry for treatment anyway, and for orthodontics it is like brook and welsh said.

As for 'evaluating your student'.... How exactly would a member of the public be expected to do that? :rotfl:

When it comes to end of year professional exams for the students, all sorts of other tutors, lecturers and professors are brought in from other dental hospitals to give fair, objective and transparent assessment of each student.

You think it can be done like a brothel, where you just say 'I'll have that one'?

Peartree

On the cost front, I had orthodontic treatments as an adult and my orthodontist had a scheme where you could spread the cost with direct debit (no interest) across the treatment. I'm wouldn't have thought this was unusual and it means you don't have to find all the money up front.

Also, whilst schemes such as simplyhealth don't pay for the treatment they do pay for the consultation so that is worth looking at.

I thought my treatment was very good value for money.

As an aside, Toothsmith I am surprised by your comments about evaluation of students. I would not be at all unusual for some feedback from patients to form part of a well-rounded evaluation of a student in any branch of health or social care. Or don't you think dentists require people skills as well as technical skills?

Toothsmith

Peartree wrote: »

As an aside, Toothsmith I am surprised by your comments about evaluation of students. I would not be at all unusual for some feedback from patients to form part of a well-rounded evaluation of a student in any branch of health or social care. Or don't you think dentists require people skills as well as technical skills?

The comment was made as a response to the statement that members of the public turning up for treatment at a dental hospital can pick & choose which dental student treats them

They can't.

If a patient has an issue with a student, then that can be addressed, and how students get on with the public generally is looked at by the staff as they progress through their training.

(Although with some, you do wonder!)

None of this has anything to do with the question raised by the OP though. It's just that Bluesnake's post was utter rubbish.