Adult braces on the NHS

funkygal · 8 August 2019 at 6:57PM

Hi,

I'm wondering if anyone could kindly provide me some information regarding braces for adults on the NHS.

I know only children can get this done on the NHS if they fall under grade 4 or 5 under the IOTN. But what about for complex cases?

I just went to a private orthodontist for a free consultation and they quoted me 5k for metal braces. However, they shocked me by saying that I need jaw surgery as well!

So I was wondering if I could get the braces and jaw surgery under the NHS? I have a very bad overjet and overbite. Or would I have to pay for the braces privately and then get the has surgery under the NHS. What if you're pregnant?

I would be grateful for any advice.

Thanks

Toothsmith · 8 August 2019 at 8:16PM

If that's the case, then you probably could get it all done on the NHS.

Get your general dentist to refer you to the orthodontic dept of your local hospital for a consultation.

Have you never discussed orthodontics with your general dentist before? He could probably have pointed you in the right direction anyway?

If the hospital do take you on, all treatment will be provided by them, and there wouldn't be a charge.

Having this sort of work done really wouldn't mix with pregnancy or a new baby very well (jaw surgery is similar to agreeing to a controlled car crash! Your jaw is broken & repositioned, often needing wiring together for a few weeks whilst everything heals) it is certainly not something to go into lightly.

For those who really need it though, the results can be life-changing. It is not without its risks '
& possible complications though, so make sure you're aware of exactly what you're letting yourself in for, and what the outcome is expected to be.

Often there can be a 'lesser' alternative which may get a bit of a difference to your smile without the surgery bit. If you opt for something like that though, as an adult, you would have to pay the full cost.

Think very carefully though

How much do you really want to change what you have at the moment?

If it's enough to sell everything you have and live in poverty for the rest of your life, just to have a better smile - then the jaw surgery the NHS would provide is probably the right thing to go for.

If paying £5k to get it done doesn't really seem worth it to you - then it's probably not serious enough to go through all that the surgery would entail!

mattvolatile · 8 August 2019 at 8:42PM

I had braces, complex maxillofacial surgery and surgical periodontics over the course of about 7 years, including various bits of exploratory surgery, all on the NHS and starting when I was 32. It's a very intense process, particularly the surgery, but it's changed my life and I wish I'd done it a decade earlier.

You need to get a referral to a dental hospital from your dentist if you think you qualify. The IOTN applies; it's much easier to get a referral if you're issue is mechanical (open bite, underbite etc.) rather than cosmetic.

mattvolatile · 8 August 2019 at 8:44PM

The difference between NHS and private treatment for braces is simply that you don't get the option of Invisilign etc. on the NHS. You're stuck with the train tracks! Didn't bother me at all but I know some people can be sensitive.

GlasweJen · 8 August 2019 at 8:58PM

I had a similar experience to you, went to a private orthodontist for a consult to be told too complex, I needed jaw surgery much more than I needed braces.

For context if I bit into a sandwich my teeth would indent the bread but not cut through it due to them not meeting at the front, I had a cross bite.

I went to an nhs orthodontic surgeon who agreed, surgery it would need to be but I'm too high risk and surgery wasn't in my best interest.

I went back to my private orthodontist and we worked out a plan to remove some of my molars and pull back some of my teeth to reduce crowding at the front of my mouth.

It hasn't changed my jaw shape, my palate is still too narrow and too high but I can bit into a sandwich now so that's progress.

I need a retainer at night to keep my teeth in place.

I paid almost £4,500 altogether. Not including the visits to the hygienist which are mega important when you have things attached to your teeth.

funkygal · 8 August 2019 at 9:40PM

Wow, thank you so much for all for your replies, I really appreciate it!

@Toothsmith
My dentist has never referred adults for braces on the NHS and was amendment that it could not be done. It was only when I told him I had met an adult who was getting braces on the NHS due to them requiring jaw surgery, hence the reason why I am only looking into this now.

My dentist made a referral to a central system and I chased it up myself. But it was rejected straight away due to me being over 18. They said my dentist needs to fill in an Individual Funding Request form (IFR). Perhaps as he has never done this before he is getting the referral procedure wrong?I will speak to my dentist again.

I have had a look into jaw surgery before and I think it would be beneficial for me in long term, and life changing.

@Mattvolatile
That's really interesting to read about your first hand experience, and how life changing it can be. It's both cosmetic and functional for me, I do have difficulty chewing. I am not bothered about how the train tracks would look, I just want my teeth to work normally!

@GlasewJen
I have the exact same problem as you, but I explained this to the orthodontist using a burger as an example instead, it can be difficult tearing food off, I have to use my molars instead! So perhaps I have a crossbite, not an overbite as previously mentioned. Why was it too high risk for you?

mattvolatile · 8 August 2019 at 10:01PM

I do understand that, as with many things, there's a real difference between areas of the country in terms of waiting lists. I was lucky to be in London, and got into the system in just a few months (7/8 years ago). I hear that it's not quite so smooth elsewhere.

Basic situation is that if your overjet and overbite are beyond the IOTN guidelines, your dentist should request a referral for you, specifically listing your deviations.

I had an open bite -- the IOTN classed 4mm+ as severe and qualifying for treatment; mine was 11mm. From the BOS website, if your overbite is greater than 3.5mm, you should qualify for NHS treatment -- though private might be quicker if you're not in London. I don't think you'll be able to get NHS surgery if you've had private orthodontics, though. https://www.bos.org.uk/Public-Patients/Orthodontics-for-children-teens/Fact-File-FAQ/What-Is-The-IOTN

I only got a referral when I moved house and registered with a new dentist who was obviously familiar with the procedure. Her first question to me at my checkup was "Why have you never gotten treated?". I'd had about 15 years of dentists in my adult life who'd never suggested that a fix was possible (and the problems were caused by bad orthodontics as a child, but that's another story!)

GlasweJen · 9 August 2019 at 9:42PM

funkygal wrote: »

@GlasewJen
I have the exact same problem as you, but I explained this to the orthodontist using a burger as an example instead, it can be difficult tearing food off, I have to use my molars instead! So perhaps I have a crossbite, not an overbite as previously mentioned. Why was it too high risk for you?

I've had a heart transplant so any additional surgery is a huge strain on the heart. Knocking me out for jaw surgery would be a big risk and it's not going to kill me to change how I bite things.

My weird shaped jaw and bite is to do with the heart problem, well they're linked but I think different jaw malformations can cause the same issues. If I clenched my jaw I could still stick my tongue out, still can a bit but it's improved a lot. I probably wouldn't qualify for surgery now.

20vt-rs · 12 December 2019 at 5:45PM

I know this is an old thread but stumbled accross it searching for something....

@Funkygal, have you made any decisions yet? My 5p's worth: I have had jaw issues since a very young age, never dealt with it when a tenager and throughout my 20's always had issues with my bite and nasal breathing, just lived with it... I addressed it again in 2011 with a referral from my NHS dentist. 4 years of treatment, 6 teeth extracted, top & bottom braces, upper / lower jaw surgey an a genioplastly and I was done.

I can honestly say it was the best thing I did and I wish I had done it earlier in my lifetime. Confidence boosting having straight teeth and no mis-aligned jaw. My face looks much better (well I think so anyway!), and I can eat now as my teeth line up, I could never eat a sandwich without the filling coming out, or ribs etc, I can breathe better through my nose, which I couldn't before (I had a resessed upper jaw which closed up my sinuses).

I have been wearing retainers since 2015 when I finished the treatment, and thats fine, every other day I wear them overnight. I do have some nerve damage on one side and the roof of my mouth, means I bite my lip or can burn easily as I cant' sense the pain. But you get used to this, it's not a big problem, I can even have a filling at the dentist now on my upper jaw without any anesthetic!

Anyway, enough rabbling, if it bothers you get it done else you might regret it later or be too old or unable to have it done, the end result is really worthwhile.

funkygal · 12 December 2019 at 10:29PM

Hey @20vt-rs

Thank you for your response, it's very insightful.

I've actually only just had a letter come through today for a referral to see a Maxillofacial! My first appointment will be set up soon so I haven't actually had a chance to speak to them properly yet. I completely understand what you meant with the sandwich as I have this problem too.

I will weight up my options when I have my first appointment, but to tell you the truth, jaw surgery sounds very daunting!

20vt-rs · 7 January 2020 at 6:09PM

funkygal wrote: »

Hey @20vt-rs

Thank you for your response, it's very insightful.

I've actually only just had a letter come through today for a referral to see a Maxillofacial! My first appointment will be set up soon so I haven't actually had a chance to speak to them properly yet. I completely understand what you meant with the sandwich as I have this problem too.

I will weight up my options when I have my first appointment, but to tell you the truth, jaw surgery sounds very daunting!

No worries, good luck with the referral, make sure you get all your questions written down on paper and take it with you (assuming you havent been yet), no chance of forgetting and remembering afterwards!
Happy to answer any questions you might have on here of in a PM. :wave:

Adult braces on the NHS

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