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NHS Wales Dental Referral Management System
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Orthodontics is concerned with the appearance and functioning of teeth and covers a wide area of clinical practice from simple tooth position correction through to the management of people with cranio-facial abnormalities such as cleft lip and palate.

The British Orthodontic Society describe some of the common reasons for people wanting orthodontics as:

  • Protruding upper front teeth – one of the most common dental problems
  • Crowding – a narrow jaw may mean there is not enough room for your teeth, resulting in crowding. Conversely, some patients have significant gaps between their teeth.
  • Asymmetry – particularly when the centre lines of the upper and lower front teeth do not match, perhaps because the teeth have drifted or the position of the jaw has shifted.
  • A deep bite – when your upper teeth cover the lower teeth too much
  • A reverse bite – when your upper teeth bite inside the lower teeth
  • An open bite – when your front teeth remain apart when your back teeth meet; the tongue is often still visible between the upper and lower front teeth.
  • Impacted teeth – in some patients, secondary teeth come through in the wrong position or do not erupt at all. Orthodontic treatment can help bring these teeth into the correct position.

Being Referred to an Orthodontist

You should expect to have several appointments with your specialist – it is often complex care and there may well be several stages to plan your treatment before it begins. Orthodontic treatment may last over 2 years and require appointments every 5 – 6 weeks. It is not usually possible to schedule this at weekends of after school due to the number of patients and availability of appointments.

Care of teeth during orthodontics

Having braces on can make cleaning your teeth difficult and this can lead to an increased risk of decay and gum disease. There is no point having straight teeth if they are unhealthy or have swollen bleeding gums associated with them.

Orthodontists recommend the use of special toothbrushes that can help clean around braces and you should also ask if a fluoride mouthrinse might be used as well. There is also a special mouthrinse designed just for patients with braces – OrthoDefense, which is highly recommended.

If you are looking for orthodontic wax to help you manage with newly placed or adjusted brackets – you can get some here.






All specialists in orthodontics are registered with the GDC – and will have typically undertaken three years of specialist training and then sat an exam called the MOrth – this is run by Royal Colleges. Some orthodontists will have undertaken additional training to be Consultants – they may work in Hospitals managing complex cases or patients. Dentists have to undertake continuing education and ensure that they are up to date.

Key Terms

Brace – a device for straightening teeth – might be fixed to teeth (like the picture above) or removable

Ligature – a plastic or metal band placed around a bracket to keep a brace in place

Retainer – a wire fixed to, usually, the back of teeth or a mouth guard that is worn once treatment is complete – this stops teeth drifting – see a picture here

Head gear – a form of orthodontics that involves wearing a band around the head – see a picture here

IOTNa way by which the NHS decides who is eligible for orthodontics

Not everyone can have orthodontics on the NHS – you must be under 18 and have an assessment to determine if you are eligible.

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