Braces during secondary school

Most UK children start fixed braces between about 11 and 15, once enough adult teeth have come through for the orthodontist to plan the whole bite. Assessment often happens earlier, from around 10, and an NHS referral usually goes through the family's general dental practice. Because waiting lists in many areas are long, being assessed early matters more than being fitted early. A smaller number of children have interceptive treatment before this, for example to guide an impacted tooth or correct a crossbite while the jaws are still growing.

Braces can be fitted during an exam year, and UK orthodontists do this routinely, but timing the appointments carefully reduces disruption. Tenderness after a fitting or a major adjustment typically lasts a few days, so most families avoid scheduling those in the week before GCSEs, mocks, performances or residential trips. Tell the practice about the exam timetable when appointments are booked, because routine adjustments can usually be moved by a week or two. Postponing the entire course is rarely necessary, and it is worth asking what a delay would mean for your place in the queue.

Teenagers can play rugby, hockey and other contact sports while wearing fixed braces, provided they use a mouthguard designed to fit over brackets. Standard boil-and-bite guards mould tightly to the teeth and fit poorly around a brace, so ask the orthodontist about an orthodontic or custom-made guard and expect to refit or replace it as the teeth move. After any knock to the face, check for loose brackets, bent wires or cuts to the lips and contact the practice rather than waiting for the next routine appointment.

Clear aligners can suit teenagers when the case is appropriate and the teenager will genuinely wear them for the hours required, typically 20 to 22 a day, removing them only to eat and clean. Being removable helps with sport, music and cleaning, but that same feature is the usual reason treatment stalls. Complex bite problems, teeth still erupting and inconsistent wear all point towards fixed braces instead. Aligners are also a private option in most cases, because NHS treatment for teenagers is normally provided with fixed metal braces.

NHS orthodontic treatment normally uses metal fixed braces, and ceramic brackets, lingual braces and clear aligners are not routinely provided. NHS funding exists to correct a clinically significant bite problem at no cost to eligible under-18s, not to pay for a more discreet appearance. Teenagers who want tooth-coloured brackets usually need to consider private treatment instead, and any arrangement an individual practice offers should be confirmed in writing before treatment starts. Coloured elastic modules around metal brackets are included and changed at every adjustment, which is how most NHS patients personalise their brace.

A small brace kit at school should include a travel toothbrush, an interdental brush, orthodontic wax, a mirror, spare elastics if they have been prescribed, and a rigid case for any removable appliance or retainer. Brushing after lunch keeps food out of the brackets and reduces the risk of white decalcification marks forming around them. Wax settles a bracket that is rubbing until the practice can see it. A named case matters, because a retainer wrapped in a tissue is very easily thrown away with a lunch tray.