NHS question (Class III and had braces as a teen)

[windycitycassie]

Hello, everyone!

I have had fun with my mouth since I was a child. Retainer in grade school, braces in high school, and a retainer in college. Allmof these were to fix my underbite (Class III malocclusion and like 3-4mm...forgot the amount). However in the last 10 years my teeth have moved around and in now have an end to end bite and my teeth hurt from hitting together. When I bite down only some of my molars touch. On top of it all, my left jaw joint hurts off and on, pops sometimes, and occasionally gets stuck. It seems all the braces did was change the angle of the teeth but obviously did not fix the problem.

Saw a doctor a number of years ago and was told my malocclusion eas not in surgical range. Surely pain isn't a good thing? Oh and my bottom front teeth are all crooked but used to be straight.

Any suggestions? Seeing a different dentist next week and will ask for a referral...living in Shropshire sucks sometimes!

Thanks so much,
C

[windycitycassie]

Well I saw a dentist who isn't concerned at all and won't refer me. Then saw my GP who told me to see a dentist - so guess I'm not having any luck.

[HelenUK]

Book a consultation with a private orthodontist (you may have to pay a consultation fee). They will be able to tell you if you need surgery or just braces, and can refer you to the NHS hospital oral and maxillofacial department if needed.

[windycitycassie]

Thanks, Helen. That sounds like a reasonable course of action. Although I'll be a cynic and say they'll probably just want to use braces again since that's what they did when I was a teenager - but since that failed eventually, who knows.

[windycitycassie]

I hate bumping my own thread - this is almost a blog thread now.

Will be seeing some private orthos for checks. Anyone familiar with good orthodontists in Birmingham UK? Seeing Brackenwood anyway.

[keeponsmiling]

Sorry I can't recommend anyone, but any decent ortho should let you know exactly what your options are. It'd be pretty short sighted of them to recommend braces just to make a few quid if they can tell you need surgery - it wouldn't do their professional reputation much good. I saw a private ortho and a cosmetic dentist before getting treated on the NHS and both said they could give me braces as a cosmetic improvement (my top teeth were very wonky) but couldn't fix my open bite, and both said they were willing to treat me but only if I understood that they were only offering a partial solution to my problems, which in their opinions was pointless. Unfortunately, however, they also said that as private practioners they were unable to refer me to an NHS ortho and that I would have to get an NHS dentist to write the referral. That was five to seven years ago, so perhaps things have changed, but you may find you just have to keep trying different NHS dentists or pestering your current one. Don't let it drop though - my NHS dentist told me fifteen years ago that my case was too mild to need surgery but didn't warn me that my bite would get progressively worse. I'm six weeks post-op now and so far my only regret is that no one explained my options fully when I was a teenager - it would have saved me a lot of social embarrassment, heartache and pain.

[windycitycassie]

Thanks for the replies!

I saw a private orthodontist who then told me he wouldn't treat me until I saw a maxillofacial surgeon. He wants to make sure people are treated the correct way and just wants to make sure on this front - however, he said my Class III is very mild and may not be within the NHS range for treatment? Lastly, he told me he can't refer me and my NHS dentist has to, so I'm seeing my NHS dentist later this month.

Even if my Class III is mild (and other than slightly poor aesthetics in profile view due to this) due to braces having moved things around a lot from where they are, I assume a maxillofacial surgeon will see the real picture in terms of how mild or not it is, and then make a decision? I do not want to get braces again to fix my current bite and then have to wear a retainer forever at night AND still have to put up with how my lower jaw works. Plus, the ortho said he didn't even know if braces would (once finished) fix my mild lisp or any of my end-of-day TMJ issues.

[HelenUK]

Thats strange, I saw a private orthodontist who did then refer me directly to the NHS orthodontist and surgeon. He also sent my x-rays on so that I wouldn't have to have them done again.

[windycitycassie]

Thats strange, I saw a private orthodontist who did then refer me directly to the NHS orthodontist and surgeon. He also sent my x-rays on so that I wouldn't have to have them done again.

Lucky you! I phoned another private ortho and they said I had to see my NHS dentist for the referral. Oh well, I'm doing so late next week at least.

[miketaylor46]

Hi Cassie

I am 51 and in the same posittion as you, I went to a private orthodontist for a consoltation and he had a good look and said they would not be able to treat it with braces alone and referded me to the NHS hospital orthodontist who in turn referd me to a consoltant. I have had several xrays and scans and it has just been decided that i will have jaw surgery and braces which are due to be fitted next month. I would advise you do the same thing and as note the private orthodontist did not gharge me for his consoltation

Good luck

Mike

[windycitycassie]

Thanks for the info, Mike. Glad things are working out for you - always nice to hear happy stories!

I've had a few people who managed to get a private ortho to refer them, but none of the ones I've contacted will do that. They are just telling me to talk to my NHS dentist for this. Then again I live in the middle of nowhere (Shropshire) so maybe that is the problem!

[windycitycassie]

Just a bump for an update.

Saw my NHS dentist today and she didn't do a referral, either. She wants me to wear a mouth guard at night for a while and see if that fixes my jaw problems. Given that my teeth only touch on one side of my mouth when I chew, I fail to see how it will fix anything. Was basically told only 'extreme' cases get referred, whatever those are.

[midnight]

Sorry that you didn't get referred I know that in my area the NHS will only treat adult patients who are grade 5 on the IOTN http://www.bos.org.uk/orthodonticsandyo ... whatisiotn Might be worth finding out what the policy is in your local PCT to see if you would be treated if you did manage to get a referral from a dentist/ortho?