East Coast Orthodontics Blog

In Ireland one of  the most confusing aspects of deciding Orthodontic treatment for your Children is wondering if treatment is covered by the HSE, because nobody wants to pay for private Orthodontic treatment if the the State is going to provide the same treatment for free. I do not work for the HSE so the following  information are my observations  over the years and if you want definitive answers contact the HSE directly.

As with all State schemes,resources are limited so therefore orthodontic care is rationed through the use of waiting lists and priority groups. In general HSE will provide treatment if you fall in to Grade 4 or Grade 5 category.

GRADE 5 TREATMENT REQUIRED

5.a Increased overjet greater than 9 mm.

5.h Extensive missing teeth or major dental anomalies such as amelogenisis imperferfecta.

5.i Impeded eruption of teeth apart from wisdom teeth due to crowding, displacement,presence of suppernumerary teeth,retained deciduous teeth,and any patholigical cause.

5.m Reverse overjet greater than 3.5,, with speech or eating problems.

5.p Defects of cleft lip and palate.

GRADE5 TREATMENT REQUIRED

4.B Reverse overjet greater tha 3.5mm.

4.c Anterior or posterior crossbites greater than 2mm .

4.dSevere displacement of anterior teeth.

4.eExtreme lateral or anterior open bite.

4.f Increased and complete overbite with gingival or palatal trauma.

4.l Posterior lingual crossbite.

4.m Reverse overjet greater than 1mm but less than 3.5mm with recorded masticatory and speech difficulities.

You may not fully understand all of it but I think you get the idea that only the most severe cases are accepted for treatment.I would say that 80% os cases are refused treatment.

So what are the practical implications?

1. Congratulations! you are accepted for treatment due to severity but HSE will not start treatment for 2 to 3 years if you are lucky! Any body who is in Grade 4 or 5 need to be treated as a matter of urgency, a two year wait time will only make a severe case even more difficult.

2 80% of Patients are eventually declined treatment ,attend private Orthodontist at 14 to 15 years instead of 11 to 12  and are not happy to have braces at 15 when thier friends are just finished not to mind the increased difficulty.

WHAT YOU NEED TO KNOW FROM HSE

1.Ask when your child will be formally assessed for Orthodontic treatment,and ask are they likely to be in Grade4 or 5.  The sooner you know the sooner you can plan.

2.Ask HSE will they provide retainer care  post treatment,I have seen quite a few HSE treated cases that relapse because no retainer care was provided.

2.Most private orthodontists want to see the child at 8 years to start planning treatment so treatment can start at the right time for the individual patient

3.HSE tend to formally assess children at 12 years of age which in my opinion is to late.

If you are in any doubt please consult your local private orthodontist,as you can be advised what is best for your child and when is best time to start treatment.

There are essentially three different methodd to provide fast orthodontics for adult patients.

1. 6 month braces,  these are modified clear fixed appliances with incisor tooth reduction to correct upper or lower incisor crowding. Probably the most effective  but the the disadvantage is that appliances are glued to the teeth and must be worn 24/7 with no break,best for moderate to diffficult cases.

2. Invisible aligners,  are very effective for incisor crowding  with no rotations of incisors. They are practicallly invisible to wear,most times nothing is glued to the teeth, and can be removed  for up to 2 hours a day. They are best used for mild to moderate crowding.

3. Inman aligners , are very effective  and fall somewhere in between 6 month braces  and aligners . They are more effective than aligners but not as effective as 6 months braces. They can be removed for up to 2 hours per day.

The Inman Orthodontic laboratory in Florida first designed the Inman aligner in 2001.It was originally designed to treat Adult relapse of incisors  after previous Orthodontic treatment. The appliances have evolved and are now used to treat patients that never wore braces to correct incisor crowding and rotations,anterior crossbites and extreme dental overlap.

The Inman Aligners achieve controlled and continuous movement of teeth by utilising NiTi coil spring, the forces are steady gentle and predictable. The Inman aligners are constructed in certified dental laboratories   only to consistently provide  a quality product.

6 month smiles is a popular term to describe the application of fixed appliances for a limited period of time to correct  mild to possible moderate crowding of Upper and Lower incisors.  Typically fixed appliances or orthodontic braces take approximately 24 to 30 months to complete,so how can  6 month smiles work in 6 months?  There are certain criteria that need to be met in order to complete orthodontic treatment in 6 months.

1. Upper and lower incisor crowding needs to be defined as mild to moderate.

2. A  reasonably good bite to start with.

3. No severe rotations of incisor teeth.

4. No severe gum disease.

5. Consent to reshaping or very slight narrowing of Upper and Lower Incisors to create space to resolve crowding.

6. Intact Upper and lower dental arches with no indications  for dental extractions.

If these criteria are confirmed on clinical examination, then with the use of very flexible wires it is possible to complete  this type of case in 6 months. The result is more predictable than aligner treatment and with the widespread use of clear braces ,appliances are almost invisible.