What is orthodontics?

Orthodontics is the speciality part of dentistry involved in the diagnosis and treatment of abnormal positional problems of the teeth and jaws eg crooked teeth, abnormal bites and small/large jaw sizes.

Who can provide orthodontic treatment?

Technically any dentist in the UK is permitted to ‘do’ orthodontics, provided they practice within the limits of their training and competence. However, undergraduate training only exposes dental students to basic orthodontic theory and simple techniques, so a detailed knowledge of orthodontics can only be obtained through three years of full-time specialist training in accredited university and hospital posts to become an orthodontist. Specialists are typically recognised by their MOrth RCS qualification (awarded by a Royal College of Surgeons) and inclusion on the General Dental Council's list of orthodontic specialists (www.gdc.org.uk).

A small proportion of orthodontists then undergo two further years of full-time training in specialised areas such as adult treatment, surgical management and cleft lip/palate care to qualify as consultant orthodontists, typically recognised by the additional qualification letters FDS(Orth) RCS.

The Priestgate Clinic provides consultant-level orthodontics.

A guide to our adult orthodontic options

Orthodontics produces better results than ever before and for a wide range of smile and bite problems. Indeed, adults can be treated at virtually any age, as shown below: the results of fixed brace results in a 60-something lady treated at the Priestgate Clinic. A range of brace options is available, but this may be confusing, especially if the details and effectiveness of some techniques aren’t accurately portrayed.

Before & after views of a retired patient who decided to have her teeth straightened after her children left home. This was accomplished with fixed braces, without the loss of teeth.

Fixed versus removable brace options

Fixed appliances use metal or tooth-coloured attachments on each tooth, and a connecting wire provides the momentum. They’re very effective at correcting tooth and bite positions, especially for complex 3D movements, but may feel cumbersome and require hygiene effort. Conversely,many adults find that there’s less to 'juggle' with a fixed brace compared to the self-discipline required for aligner treatment. Adult fixed brace treatment typically takes an average of 9-15 months for optimum benefits since they do much more than just align the front teeth. Therefore, be wary that advertised ‘6 month’ or ‘fast’ solutions aren’t as revolutionary as claimed!

Orthodontic aligners are transparent plastic braces, worn for 1-2 weeks, to straighten teeth by applying programmed pressure on them. InvisalignTM is the original brand, but there are many newer brands or ways of designing aligner treatment, e.g. cutting-edge 3D software to directly customise each individual’s treatment (shown below), rather than relying on a technician and standardised algorithms. In my experience, this also makes aligner treatment more cost-effective. Nevertheless, while aligners are good at treating a range of simple to moderate irregularity problems, independent research shows that there’s always a shortfall between the simulated and actual results, so always ask to see examples of actual cases treated by the dentist involved.


Every orthodontic treatment is followed by retainers to prevent relapse i.e. teeth becoming crooked again.This phase should be an integral and long-term consideration, not a brief after-thought. Quite simply, why pay for treatment for it to unravel afterwards?The quicker the treatment then the greater the relapse risks since the oral tissues have had insufficient time to adapt. Therefore, the best long-term control typically requires a combination of transparent removable retainers and bonded wires (shown on the incisors’ rear surfaces).

A bonded retainer on the rear surfaces of the upper incisor teeth

Examples of our 



68 year old with collapsed dental arches, treated with aesthetic fixed braces
Adult with collapsed bite, treated with aesthetic braces & then new incisor tooth fillings
Young adult with 4 months of upper aligner treatment
Adult patient who presented with missing upper lateral incisor teeth and problems with unaesthetic, fragile dental bridges
These pictures show on-going orthodontic treatment where the lower teeth were positioned first, to facilitate rapid closure of the upper tooth spaces (after removal of the bridges). The spaces were temporarily filled by tooth-coloured 'teeth' as the spaces were closed. This treatment camouflaged for the absent teeth, avoiding the long-term need for false teeth.
Teenage patient with an 'open bite', collapse of the width of the top teeth / palate & lower jaw size problems
This girl was treated, without the loss of teeth, using a combination of a expander brace on the top teeth, orthodontic mini-implants (anchors) and fixed braces.

Orthodontic fees

Orthodontics is a valuable investment and we aim to price this in a fair and transparent manner. In particular:

  • All treatment aspects are included in the quoted fees – we don’t believe in charging extra for essential items such as x-rays and retainers since your treatment can’t be done properly without them!
  • We don’t offer ‘free consultations’ – orthodontics requires a specialist clinical assessment, rather than a sales consultation for a specific commercial product or ‘quick-fix’. Indeed, professional regulations (www.gdc.org.uk) state that you should be given accurate information on all of your appropriate options, not just sold one form of treatment.
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Richard Cousley

Richard is regarded as a clinical innovator in the orthodontic specialty with a passion for achieving excellent clinical results, even in the most complex cases.

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