Braces

There are many different types of braces, each suited to a particular type of problem. The best type of appliance for you will be advised by the Orthodontist. 

Removable appliances can be used for simple problems in younger patients (usually under age 11) or as part of a plan involving fixed braces. These are plastic plates with wires and clips and can be individualised for different patients. 

Fixed braces consist of small squares of metal or ceramic (brackets), bonded to teeth by dental adhesive. linked together by orthodontic wires. These wires are held in place by means of elastics (the ‘colours’ that you see on patients’ teeth when they have braces on) or mechanically by ‘doors’ on the brackets (as in self-ligating bracket systems such as the Damon system). 

Invisalign is a system utilising sequential clear removable aligners which gradually straighten teeth when worn 20-22 hours daily. They are less conspicuous than conventional braces, and it is easy to maintain good oral hygiene as the appliance can be removed to facilitate tooth brushing. Invisalign is a good alternative treatment modality for patients who are not keen to have fixed braces placed. 

Lingual braces are fixed braces which are attached to the back of the teeth (inner surface) and not the front. This means they are truly invisible so you can continue to smile with confidence throughout treatment. Because lingual braces are not visible they are ideal for adults or older teenagers who are concerned about the appearance of traditional fixed braces. Lingual braces are invisible when the patient smiles. 

Your Orthodontist will be the best person to recommend the appliance best suited to your lifestyle and mal-occlusion.

What are the Outcomes of Treatment?

Outcomes of braces/orthodontic treatment can be measured through objective assessment of the degree of improvement achieved using the Peer Assessment Rating (PAR). PAR is a widely accepted orthodontic index that is designed to evaluate improvement in alignment and positioning of teeth and jaws.

Scores are assigned to the pre- and post-treatment states, reflecting the deviation from an ideal alignment and bite for the patient. The difference in pre- and post-treatment scores will indicate the degree of improvement. A higher percentage difference reflects a higher degree of improvement in alignment and bite. As patient outcomes may be influenced by many factors, it has been recommended that 75% of completed cases should exhibit an improvement greater than 70%[1].

In NDCS, PAR is tracked on a yearly basis based on a sampling of cases. Results show that at least 90% improvement is achieved in 100% of completed cases evaluated. Year-on-year average is tabulated below.

[1] NHS England South Personal Dental Services Orthodontic Services Specification. Issued 19 February 2018.