Orthodontics

Orthodontic treatment (usually with braces) is most often used to improve the appearance and alignment of crooked, protruding or crowded teeth, and to correct problems with the bite of the teeth.

Why orthodontics is used

The benefits of orthodontics can include:

  • correction of dental crowding and straightening of your teeth
  • correction of your bite so the front and back teeth meet evenly
  • reducing the chance of damage to prominent teeth
  • improving your appearance, including your smile

Many people have crowded or crooked teeth, or their teeth do not meet correctly when they bite. These problems can mean it's harder to keep the teeth and gums clean and the teeth are more likely to become damaged.

In some cases, abnormal positioning of the teeth and jaw can affect the shape of the face.

Orthodontics can also help in the treatment of other health problems, such as a cleft lip and palate.

Who can have orthodontics

Orthodontic treatment is usually only started after most of a child's adult teeth have started to come through.

This is usually when they're about 12 years old, but depends on how many of their adult teeth have come through and the growth of their face and jaws.

Orthodontic treatment for adults can begin at any age, but the treatment options are more limited.

Treatment will not begin unless you have a good standard of oral hygiene as orthodontic treatment can increase the risk of tooth decay and gum problems.

Types of orthodontic treatment

Orthodontics involves the use of braces to correct the position of the teeth. Your exact treatment will depend on the problem with your teeth.

In a small number of cases, you may have to wear headgear at night, or have small pins placed temporarily in the jaw as well as a brace. If your teeth are very close together, causing them to twist or overlap, you may also need to have some teeth removed as part of your treatment.

The length of treatment will depend on how complicated the problem is, but it's usually between 18 and 24 months.

When treatment finishes, you will need to wear a retaining brace. This is usually removable and needs to be worn every night for many years to keep your teeth in their new position. Sometimes, a thin wire may be permanently fixed behind your teeth to keep them in place.

Read about the types of orthodontic treatment.

Accessing orthodontic treatment

In most cases, your dentist will refer you to an orthodontist, although you may sometimes be able to seek treatment directly from your dentist.

Find a local dentist

If orthodontic treatment is recommended, you may have to decide whether to have treatment privately or on the NHS.

You can find a list of all specialist orthodontists registered in the UK on the General Dental Council (GDC) website.

NHS treatment

NHS orthodontic treatment is free for people under the age of 18 with a clear health need for treatment. But because of high demand, there can be a long waiting list.

NHS orthodontic care is not usually available for adults, but may be approved on a case-by-case basis if needed for health reasons.

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 (BOS) website has more information about the different grades used for the IOTN.

NHS treatment is available for grade 4 and grade 5 cases. Grade 3 cases are usually judged on an individual basis. Treatment may also be made available if the appearance of a person's teeth, jaw or face is of concern.

Private treatment

If you do not qualify for free NHS treatment or you do not want to wait for treatment to start, you may choose to have private treatment.

Private orthodontic treatment is widely available, but expensive. The fee can range from £2,000 to £6,000, depending on the complexity of the treatment and the type of appliances used, but fees can be higher.

After an initial assessment, a private orthodontist will talk to you about a possible treatment plan, how much it will cost and about any alternative options you have.

The BOS has an online service you can use to find orthodontic treatment in your area.

Taking care of your teeth

A common complication of orthodontics is white spots on the teeth, an early sign of tooth decay. You can get this when acid is produced from plaque, which builds up on your teeth and around your brace.

Cleaning your teeth and brace can be time-consuming, but it's needed to avoid permanent marks on your teeth when the brace is removed.

Many people with appliances find it difficult to keep their teeth and gums clean, so extra brushing is needed during treatment.

Your orthodontist may recommend using toothpaste with high levels of fluoride, or a mouthwash that contains fluoride, to reduce your risk of decay. You should also try to avoid sugary foods and fizzy drinks.

Read about how to take care of your teeth.

[Last reviewed 2017-02-17]