Orthodontic FAQs

The team at Orthosmile in West London understand that orthodontic treatment can be daunting, and welcome questions from patients to help make an informed decision about what to expect from their treatment journey. They have prepared some answers to the most commonly asked questions about orthodontics.
As orthodontist, we specialise in the correction of “malocclusions” or “bad bites”. Many people have teeth that are crowded or crooked, some people have upper teeth that stick out and look unsightly. Orthodontic treatment can be used to straighten these teeth and improve appearance. Orthodontic treatment is always a change for the better regardless of your age. The biological process involved in tooth movement is the same in both adults and children. The health of your teeth, gums and supporting bone is the most important factor in determining the prospects for improving your smile. Modern tooth-coloured (ceramic) braces, lingual (hidden behind-the-teeth) braces and invisalign (invisible braces) have all encouraged adults in increasing numbers to take on treatment. However, they are not suitable for all cases and most appropriate type of brace will be recommended after consultation.
NHS orthodontic treatment is available on the NHS for people under the age of 18 who have been identified as having a definite need for treatment. You will need to be referred by your dentist for an orthodontic assessment. A rating system known as the Index of Orthodontic Treatment Need (IOTN) is used to assess your eligibility for NHS treatment. The British Orthodontic Society’s website has more information about the different grades used for IOTN. If you do not qualify for treatment on the NHS, we will discuss with you about having treatment privately so that you are able to make an informed choice. Patients who are 18 and over will only be seen on a private basis. The cost of treatment will depend on the severity of the problem and the type of appliance required.
The Initial Consultation involves a full examination of the teeth and the jaws and is followed by X-rays, photographs and impressions (moulds) of the teeth. These pre-treatment records enable your orthodontist to make a correct assessment of your teeth, and devise a treatment plan to address the problems. In our clinic both dentofacial orthopaedics using custom-made removable and functional appliances to modify the pattern of jaw growth and orthodontics using fixed appliances to correct dental irregularities are used to achieve the best result.
A report will be sent outlining the problems, suggested treatment plan and the cost and payment plan. If as part of your treatment plan any dental treatment needs to be carried out beforehand, we will remind you to contact your dentist for this to be done (a letter will have already been sent to your dentist).
Fitting braces does not hurt! Different patients require different types of brace. Some people, for example, need removable braces. These simply fit over the teeth. Those patients who require fixed braces will usually need 1-3 appointments to have their braces fitted. (Occasionally, 4 appointments may be needed to fit some types of fixed braces).
You are then usually seen about once every 6 weeks to have your braces checked and adjusted. Whilst every effort is made to accommodate your preferred appointment day and time, appointments during school holidays, and those at the end of the day or early morning are popular with most people, and we cannot guarantee that you will be able to get any particular day or time of the day. If the available appointment time is not suitable, your preferred appointment time may only be available 1 to 2 weeks later. You must continue to see your own dentist for check-ups.
We respectfully request those accompanying the patient (especially parents with other younger children) to remain in the waiting room while treatment is being carried out. We find that in this way, the clinic runs more smoothly without the orthodontists and their patients being distracted, and so without the treatment being compromised. It also means that our nurses are able to move about the clinic more freely, and do their job more effectively. If you would like to speak to the orthodontist at any stage, you are of course welcome to ask the receptionist to do so either before or after the visit.
The duration of orthodontic treatment varies, depending mainly on the type of case, type of brace and on how well the brace is looked after. Average treatment time is usually 14-18 months. However, with modern techniques, treatment time can in some cases be reduced to as little as 6 months. Treatment always finishes sooner for those patients who have taken good care of their braces as advised by their orthodontist.
All patients wear retainers after the completion of treatment. Your orthodontist will decide which type of retainer is most suitable for you. Removable retainers are fitted over the teeth and are worn initially full time followed by a period of night-time wear and in general we advise children to wear them until their growth is finished. Fixed retainers are made of closely-fitting thin wires that are fitted on the inside of the front teeth. These retainers are generally used in combination with clear removable retainers.
Jaw (or orthognathic) surgery involves the combined effort of the orthodontist and an oral and maxillofacial surgeon. In some cases, the jaw bones are positioned in a way that makes it difficult, if not impossible, to obtain good results with orthodontics alone. The most common problems corrected with jaw surgery include a protruding upper jaw (which sometimes causes a “gummy smile”), a protruding lower jaw, or a recessed lower jaw. Dramatic improvements in facial features, as well as straight teeth, can be obtained when surgery is done in conjunction with orthodontic treatment.
Orthodontics is for adults too. Since the biological process in tooth movement is the same in both adults and children, you’re never too old to be at your best. Our oldest patient so far has been 76 years young! About 40% of our patients are adults, and the number is growing.
The rule of thumb is to see an orthodontist as soon as a problem is noticed. It’s a big advantage if we see younger patients for the first time at about age 7. This is the opportune time to begin a guidance program. Sometimes removal of baby teeth can prevent improper eruption of permanent teeth.
Children under the age of 18 with complex malocclusions are offered NHS treatment. Cases that are not covered by NHS, or those children who wish to have more aesthetic types of braces and adults are offered private treatment. Our fees vary according to the complexity and time involved with each case and type of braces (appliances). We offer several payment options to fit your budget. Your orthodontist will be happy to discuss these options with you at the initial consultation. Orthodontic treatment will make your smile look fabulous. Think about how a fabulous smile will improve your life.
In order that practice is run efficiently we request that patients keep to the appointed time. If you are unable to keep your appointment please let us know as soon as possible so that we can use the appointment for another patient on our waiting list. Failure to attend appointments or giving us less than 24 hours notice may result in discontinuation of the treatment and discharge from the clinic.
Whenever possible, please contact us about emergencies during normal surgery hours. If you need to be seen the same day, please get in touch as early in the day as possible. In case of emergency out of our opening hours, please call the practice on the normal telephone number and a message will explain how to contact the out-of-hours service or just call NHS Direct on 111.
We want to provide the highest standard of care and we are sorry if you are not completely satisfied with the service you received. We hope we will be able to put things right. A formal complaint should be made in writing to the Practice Manager of our clinic. Read more details about our complaints procedure here.
We can only keep and use information for specific reasons set out in the law. If we want to keep and use information about your health, we can only do so in particular circumstances. We hold personal information about you including your name, date of birth, NHS number, address, telephone number and email address. This information allows us to fulfil our contract with you to provide appointments. We will also use the information to send you reminders and recall appointments as we have a legitimate interest to ensure your continuing care and to make you aware of our services.
Your orthodontic records will remain confidential and secure. However from time to time we may need to release these to The NHS Business Services Authority as part of our ongoing clinical review process. We will try to contact you before releasing your dental records to another organisation.

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If you have further questions regarding orthodontic treatment, the specialist team at Orthosmile are here to help. Book a free consultation today and we'll go through each of your questions and concerns, one by one.

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