1. Referral from your dentist
- You will be referred to us if your dentist thinks you would benefit from orthodontic treatment, or they need a specialist orthodontist’s opinion. You will need to to be referred by your dentist to see us.
- Prior to Covid-19, anyone referred to us would normally receive notification of their first appointment within about 12 weeks from receipt of your referral. We cannot promise how long you will need to wait whilst the Covid-19 pandemic is still with us. Please be patient with us. Our Reception team will always be happy to give you a progress update whilst you are waiting for your first appointment.
2. Your first appointment (Consultation)
- We will assess whether you meet the criteria for NHS funded treatment and are ready to receive this.
- The NHS has strict rules for eligibility. Generally, less serious cosmetic issues are not eligible for NHS funded treatment. However, if you aren’t eligible, we can still treat you as a private patient. We also offer a Silver level of service, an NHS equivalent level for private patients who are under 18.
- You usually need to have all your adult teeth before we can begin orthodontic treatment. This typically occurs at around age 13 but it may be earlier, or later.
- If you are eligible and ready for treatment, we will place you on our waiting list. We have fixed quotas for how many patients we can start to treat in any year so, depending on when you are referred to us, we may be able to start your treatment sooner or not until later. Managing new treatment starts whilst we are living in the Covid-19 pandemic is quite complicated and it may be difficult for us to guarantee how long you will need to wait from going onto the treatment waiting list to actually starting your treatment.
- If your condition requires hospital treatment, we will refer you to the appropriate department.
- If you are not quite ready (e.g. you are waiting to shed some baby teeth), we will usually judge when we think you will be and review again at that point (often after 12 or 18 months).
- When we can start your treatment (after usually no longer than a few months), we will write to you with an appointment.
3. Your second appointment (Records)
- We collect clinical records so your orthodontist can determine how best to treat you.
- Your orthodontist will conduct a full dental assessment and listen to any concerns you may have. We will take photographs of the inside of your mouth and your face, and take x-rays. Impressions will be taken of your upper and lower teeth to produce a set of plaster models.
4. Your third appointment (Treatment planning)
- Your orthodontist will now have worked out the best way to treat you and will discuss your options.
- A treatment plan will be devised and we will ask you to consent to this by signing a form detailing the plan.
- If your dentist needs to carry out some dental work prior to the commencement of orthodontic treatment, we will write to them with instructions.
- At your next appointment, your orthodontic appliance will probably be fitted and your treatment will start.
5. Functional appliances
- Some patients need to wear a functional appliance. This is removable and works on the upper and lower teeth at the same time to correct specific issues, such as when your top teeth project too far in front of your lower teeth.
- Usually functional appliances are worn and then replaced by fixed braces.
6. Fitting your fixed braces
- Depending on your treatment plan, fixed braces may be fitted just to one arch or both.
- The brackets are fixed to your teeth using a special dental 'glue', and a wire passed through these. The wire exerts a force onto the bracket and this moves your teeth. For NHS patients, we use silver metal braces as standard.
- The small bands that hold the wire onto the bracket come in different colours so you can customise your braces.
7. Adjusting your fixed braces
- You will need several appointments throughout the treatment process as your braces need adjusting every 6-8 weeks and sometimes the wire is changed to alter the force acting upon your teeth.
- It is very important to brush your teeth thoroughly while wearing braces and you can use special small brushes to clean awkward gaps. You should also see your dentist regularly.
- Towards the end of treatment, we undertake some fine tuning to produce a perfect smile!
8. Removing your fixed braces
- When your teeth are nicely aligned, we remove the brackets and clean the dental ‘glue’ from your teeth.
- We will provide you with a retainer to stop your teeth moving back to their old position. This is usually similar to a thin, clear gum shield that fits snugly on your teeth to keep them in place. It is very important to wear your retainer as instructed.
- We take impressions of your teeth so we can make custom-made retainers and take more photos, so we have a record of the end result and can compare it to the start.
- The active part of your treatment has now finished, but we still need to see you a couple more times…
9. Keeping your teeth in line
- Approximately six months after your braces have been removed, we will want to see you again to check you have been wearing your retainers and all is well.
- Another appointment, six months later, will be your last. We will have got to know each other pretty well and, although we will be sad to see you go, we’ll be delighted you now have a beautiful new smile!
- Remember to keep on wearing your retainers – we won’t be seeing you again to check, but you must wear them as instructed (probably at night time only) to stop your teeth moving back.
- We are always happy to see you for new retainers. They will need to be replaced at some point.