I'm curious to know if anyone has been treated, or understands clearly the referral guidelines of the NHS in adult orthodontics.
I believe I fit into the grade 5 category on the Index of Orthodontic Treatment Need (IOTN). Unfortunately, being aimed largely towards those under the age of 18, these guidelines are very unclear as to what qualifies an adult.
It vaguely states that if you have an NHS orthodontist in your area who is in possession of a contract which includes adult orthodontics, then the IOTN applies. It also states 'NHS orthodontic treatment to adults is not usually available'.
I'm confused.
I'm under the impression that these guidelines were introduced last year (2007). Can anyone shed any light?
After years of plucking up courage on a sensitive subject for me, I eventually, around 3 years ago asked my dentist about orthodontic treatment. I got a shrug and an excuse (I got the impression that I was eligible but he didn't want to do it). Being so sensitive to the issue my confidence was knocked and I was too scared/embarrassed to push it. It's taken 3 years to consider it again, but I need to know what the NHS has to offer me.
Adults and the NHS
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Thanks for the reply Meryaten.
The trouble is, my dentist is an orthodontist, and if he doesn't want to do it, then I'm screwed.
I could lean on him, but I have serious issues about my teeth (which also makes it difficult for me to talk about, even here) and I'm so sensitive that I'm likely to be paralyzed with fear and anxiety just at the thought of pushing the subject. And that's me skirting past the subject lightly, I'll leave the rest for if I ever go through therapy. And this really is the biggest problem for me. Bringing attention to an issue that I find essential to hide just to save my sanity, it isn't easy. I can't be dealing with people who won't treat it sensitively.
My current line of thinking is to change my dentist. It's difficult though because I'm usually sedated for treatment. Maybe I can brave my way around that one with a bit of positive self-talk, but the sedation thing limits my options heavily for finding a new dentist.
The Index of Orthodontic Treatment Need (IOTN) states anything over a 9mm overjet qualifies as Grade 5. I believe mine is around 11mm.
And I'm in the North East of England.
The trouble is, my dentist is an orthodontist, and if he doesn't want to do it, then I'm screwed.
I could lean on him, but I have serious issues about my teeth (which also makes it difficult for me to talk about, even here) and I'm so sensitive that I'm likely to be paralyzed with fear and anxiety just at the thought of pushing the subject. And that's me skirting past the subject lightly, I'll leave the rest for if I ever go through therapy. And this really is the biggest problem for me. Bringing attention to an issue that I find essential to hide just to save my sanity, it isn't easy. I can't be dealing with people who won't treat it sensitively.
My current line of thinking is to change my dentist. It's difficult though because I'm usually sedated for treatment. Maybe I can brave my way around that one with a bit of positive self-talk, but the sedation thing limits my options heavily for finding a new dentist.
The Index of Orthodontic Treatment Need (IOTN) states anything over a 9mm overjet qualifies as Grade 5. I believe mine is around 11mm.
And I'm in the North East of England.
I did some digging around on this last night and couldn't find a definitive answer - information varies depending on the Primary Care Trust involved. I did find lots of 'pieces' of information, though.
From April 2006, under the new contract, all patients must be assessed using the IOTN and only patients under 18 with a grade 4 or 5 malocclusion will be routinely accepted for free treatment. Adults will be accepted if they need orthognathic surgery.
You would need a formal assessment by an oral surgery/maxillofacial unit to determine whether you are a candidate for surgery. There are some patients who could have correction of a 11mm overjet through braces alone, in which case they wouldn't qualify for free treatment. If the problem is skeletal, however (i.e., a too-large upper jaw or recessed lower jaw), this can only be corrected with surgery and you would qualify.
If your dentist is an orthodontist and won't refer you, I believe you can self-refer.
If it helps, I am an adult, was referred by my normal dentist to a dental teaching hospital, and my treatment (braces and surgery) has been free of charge. There is a dental teaching hospital in Newcastle which runs MSc courses in orthodontics, so I would be very surprised if they weren't taking on adult patients as 'guinea pigs'. You could give them a ring as a starting point and see if they can offer any advice.
From April 2006, under the new contract, all patients must be assessed using the IOTN and only patients under 18 with a grade 4 or 5 malocclusion will be routinely accepted for free treatment. Adults will be accepted if they need orthognathic surgery.
You would need a formal assessment by an oral surgery/maxillofacial unit to determine whether you are a candidate for surgery. There are some patients who could have correction of a 11mm overjet through braces alone, in which case they wouldn't qualify for free treatment. If the problem is skeletal, however (i.e., a too-large upper jaw or recessed lower jaw), this can only be corrected with surgery and you would qualify.
If your dentist is an orthodontist and won't refer you, I believe you can self-refer.
If it helps, I am an adult, was referred by my normal dentist to a dental teaching hospital, and my treatment (braces and surgery) has been free of charge. There is a dental teaching hospital in Newcastle which runs MSc courses in orthodontics, so I would be very surprised if they weren't taking on adult patients as 'guinea pigs'. You could give them a ring as a starting point and see if they can offer any advice.
Braced May 2005
Bimaxillary surgery Aug 2007
Debraced Jun 2008
Bimaxillary surgery Aug 2007
Debraced Jun 2008
Hey Max it sounds like we have a lot in common. Im also from north east and have a 11m overjet. I have an extreme fear of dentists and always recieve sedation. It took me many years of hiding my mouth and refusing to discuss how I felt to request treatment, although I had been offered it as a child. Ive now been in braces since may and will be getting jaw surgery in November all through the NHS. I know it takes a lot to push the subject and its a difficult subject but its worth it
Kelly x
Kelly x
im 28 and having all my treatment on the nhs (ive had my braces on for 20months now and surgerys on monday)
i have a 13mm overjet and a few other odd concerns dentally and i had to almost pressure my dentist to refer me to the ortho, even tho id been told by an oral surgeon i needed braces and surgery.
I think in my experiance that some dentists, just do not bother referring adults to orthodontists as they dont believe the nhs will do the work. but
theres plenty of us on here the nhs has deemed "bad enough" to treat.
I spent 26 years being ashamed of my teeth, as im sure plenty of others on these boards have done too, and i dont regret starting treatment to fix that for a second.
Good luck
loulou
i have a 13mm overjet and a few other odd concerns dentally and i had to almost pressure my dentist to refer me to the ortho, even tho id been told by an oral surgeon i needed braces and surgery.
I think in my experiance that some dentists, just do not bother referring adults to orthodontists as they dont believe the nhs will do the work. but
theres plenty of us on here the nhs has deemed "bad enough" to treat.
I spent 26 years being ashamed of my teeth, as im sure plenty of others on these boards have done too, and i dont regret starting treatment to fix that for a second.
Good luck
loulou
Braces on 11th June 2006,~ BSSO and Wisdom tooth removal 11th February 2008,~ Plate Removal 14th May 2008,~ Braces off 28th August 2008.
http://adultwithbraces.blogspot.com/
Hey 
Well, i've got a way around it but its gonna cost about £50 to do it. You don't have to be referred as a private patient to an orthodontist practice. I had to pay to see one-my dentist was rubbish when i was a kid and i can remember countless times being asked to be referred (he said it was all in hand, pah!). Anyhoo, here i am about 9 years later sorting it myself. I was going to go for private treatment-i've hated my wonky teeth for years, so i booked in for an initial consultation. They took x-rays, and moulds (all included in the £45 fee-but bear in mind this was about 2 years ago so they may have risen). Then the ortho told me that actually, i could probably qualify for NHS treatment (which i did) and referred me to the hospital i'm being treated at now. Please don't let your own dentist wreck your dreams of sorting your teeth, at least if you shell out to see a private orthodontist once, you will know where you stand, and if you don't qualify then you can reconsider whether you want to go ahead privately or if you do qualify, then you can get the wheels in motion
It might just be the best 50 quid you spend (like it was for me)
Good luck,
Sarah
Well, i've got a way around it but its gonna cost about £50 to do it. You don't have to be referred as a private patient to an orthodontist practice. I had to pay to see one-my dentist was rubbish when i was a kid and i can remember countless times being asked to be referred (he said it was all in hand, pah!). Anyhoo, here i am about 9 years later sorting it myself. I was going to go for private treatment-i've hated my wonky teeth for years, so i booked in for an initial consultation. They took x-rays, and moulds (all included in the £45 fee-but bear in mind this was about 2 years ago so they may have risen). Then the ortho told me that actually, i could probably qualify for NHS treatment (which i did) and referred me to the hospital i'm being treated at now. Please don't let your own dentist wreck your dreams of sorting your teeth, at least if you shell out to see a private orthodontist once, you will know where you stand, and if you don't qualify then you can reconsider whether you want to go ahead privately or if you do qualify, then you can get the wheels in motion
It might just be the best 50 quid you spend (like it was for me)Good luck,
Sarah
NHS and adults
Hi skintz
Thanks for that info
Out of interest, how old are you?
Thanks for that info
Out of interest, how old are you?
I recently started treatment on the NHS at 24. This was because the waiting list was so long - I joined it at 20, when I was eligible as a student; and when I reached the front of the queue I was rated 4 out of 5 on the scale and the pre-2006 rules still applied.
I'm being treated in the NE as well and I know that my ortho is the only one in the County, which may explain dentists' reluctance, but don't let that put you off pursuing treatment.
I'm being treated in the NE as well and I know that my ortho is the only one in the County, which may explain dentists' reluctance, but don't let that put you off pursuing treatment.
It's all gone a bit dental...