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Adults – Common Questions

What is Orthodontics?

Orthodontics is the movement of the teeth within the jaw bones to straighten them and help them to bite more evenly together. Orthodontic treatment is about making the best of your teeth; it’s about improving the harmony of your mouth and jaws.

Who are Orthodontists?

Orthodontists are fully qualified dentists who have commonly completed a further period of training and examinations in order to specialise in orthodontics. A specialist orthodontist will have carried out at least 3 years of extra training after dental school becoming a qualified dentist. Only those dentists who have completed this training or equivalent can register with the GDC as a specialist orthodontist.

What should I expect from my Orthodontist?

A good Orthodontist will always…

  • Ask you about your concerns.
  • Outline all the different treatment options and their risks and benefits.
  • Explain about the different types of braces.
  • Estimate how long the treatment should take.
  • Explain about retainers at the start of treatment, and the possible need for lifelong wear if the teeth are to stay in their new place.
  • Explain how likely the teeth are to stay in their new position at the end of treatment (that is the stability of the final result).
  • At the start, explain what other procedures may be required as part of the treatment.
  • Give you thinking time to decide if you want to go ahead.
  • Give you a written treatment plan and fee estimate (if appropriate).

Do I need a dentist to refer me to make an appointment?

No you can make an appointment by contacting us on 020 7481 1013 or email

I been referred to the orthodontist, why?

Your dentist would like specialist advice about the position of your teeth. The orthodontist will advise on this and whether you would benefit from orthodontic treatment.

Am I too old for braces?

No, anybody can be treated at any age, as long as the gums and teeth are healthy. More and more adults are undertaking orthodontic treatment and achieving the smile they have always wished for enhancing their self-confidence, self-esteem and dental health.

Do all children need orthodontic treatment?

Orthodontics, the branch of dentistry concerned with the growth of the teeth, jaws and face, is in high demand. In excess of 200,000 children and teenagers in England and Wales have treatment within the NHS every year, with growing numbers of adults and young people seeking treatment on a private basis. Why? Orthodontic treatment is about making the best of your teeth; it’s about improving the harmony of your mouth and jaws. Once you can bite together correctly, you can eat more comfortably and care for your teeth and gums more easily. And your smile will benefit immensely!

What kind of braces (Appliances) are there?

There are fixed trendy metal ones with coloured elastics (for children), white and tooth coloured braces, invisible fixed braces and removable invisible ones. Please see different Braces under Our Treatments

How do I choose which type of brace to have?

Dr Cox will discuss in detail the alternatives available to you at the first consultation visit

What are Invisible braces

These look like small colourless thin close fitting gum shields, and are almost invisible. Treatment with them involves a series of thin, clear, precisely customised aligners that gradually move the teeth. Each aligner is worn for about 2 weeks, and a series of aligners are used until the teeth are straightened. The aligners are worn full-time, and taken out only for eating and brushing.

Invisible braces are suitable only in specific orthodontic cases.

What does orthodontic treatment cost?

Your first appointment/consultation is completely free of charge and without any obligation.

*Includes FREE Removable Retainers and Professional Tooth Whitening

Orthodontic Consultation 2017 Fee Schedule
Adult Orthodontics
Radiance Tooth coloured fixed Braces2 Arches – From £3950
Radiance Tooth coloured fixed Braces1 Arches – From £1950
INVISALIGN FULL Clear Aligners£3950*
INVISALIGN i14 Clear Aligners£2950*
INVISALIGN LITE i7 Clear Aligners£1950*
*Includes FREE Fixed and Removable Retainers and Professional Tooth Whitening
Children Orthodontics
AA Mini Fixed Braces (tooth coloured)From £3250
AA Mini Fixed Braces (metal)From £2950
INVISALIGN TEEN Clear Aligners£3950*
Functional (Growth) BraceFrom £925 – £1500
Removable Brace1 Arch – From £850 – £1200
General Orthodontics
Bonded Retainer£195
Removable Retainer Replacement£120
Teeth WhiteningFrom £250
Sports Mouth Guards SISU (professionally fitted)£75
Payment Options

1. We offer our patients an interest free payment plan over a 10 month period. We ask for an initial payment of 25% of the cost of your treatment to be paid by either credit or debit card at your records appointment and the remaining balance of your treatment is then spread over 10 months. Should your treatment be completed in less than 10 months any outstanding monies must be paid before the appointment where your braces are taken off.

2. Should you choose to pay in full for your treatment at the records appointment you will receive a professional WY10 Teeth Whitening home system with custom made whitening trays and full practical demonstration/instructions from Dr Cox.

Is the Orthodontic treatment worth the money?

YES. The cost of orthodontic treatment is well worth it when you consider the long term benefits it brings to the lives of patients, such as enhanced smiles, improved confidence and better health of the mouth, jaw and other related parts of the body. The 6 to 24 months wearing a brace is well worth the long term benefits.

What happens at the first appointment?

Please see Your Orthodontic Journey.

How often will I need an appointment?

Usually every 6-8 weeks. Please see Your Orthodontic Journey.

How long will I have to wear a brace?

Removable braces must be worn 24 hours a day except when eating, swimming or playing contact sports and fixed braces are worn at all times as they are glued directly onto the teeth. Braces are usually worn for a minimum of 6 months but may in some cases be worn for up to 2 years, this will depend on your progress under the treatment and also on how co-operative you are as a patient. We will give you a rough idea, but remember you can influence the length of treatment and the quality of the result by closely following the instructions, given for the care of your brace.

Is treatment painful?

A degree of discomfort is likely to start with. You can expect some aching and tenderness in the gums as the teeth start to move, but this mostly wears off after a few days.

Fitting the brace should not be painful. For a fixed appliance the brackets are simply glued to the faces of the teeth; metal bands may also need to be cemented round the back teeth. No anesthetic is needed.

As the biological processes get under way around the tooth roots to allow the teeth to move, you can expect some aching and the teeth will be tender to bite on. This usually settles down in a few days, although some patients do experience a degree of tenderness for a longer period. The amount of discomfort varies enormously from person to person. It may be helpful to take your normal painkillers for a day or two.

Some further discomfort may be experienced when the brace is adjusted subsequently, but this depends very much on what adjustments have been made.

Do I need to see my own Dentist during treatment?

Yes definitely; the orthodontist only looks after the braces. Your teeth are actually at greater risk during orthodontic treatment and it is particularly important that you keep up regular contact with your own dentist &/or Hygienist.

Will the brace affect my speech?

Fixed braces will not affect your speech. Removable braces can initially affect your speech but this will soon improve and return to normal. Lingual fixed braces may also need a period of adjustment.

Will my teeth stay straight?

At the end of treatment we provide you with retainers to support your teeth straight as they settle and firm up in their new position. You may be advised that this support should be continued at a lower level on a longer term basis. If you don’t wear your retainers as instructed your teeth may not stay straight.

What is a retainer?

Removable retainers should be worn for a minimum every night for 1 year each. It may then be possible to reduce the number of nights per week. Remember that the day you stop wearing retainers is the first day your teeth can move. Fixed retainers can be worn for a number of years (usually a minimum of 3). If you are happy with the position of your teeth after having worn a fixed retainer, you can have it removed, although there is always the risk that your teeth could move.

Do I have to have teeth removed?

There is no single answer to the question ‘Do I need teeth out?’. There is no doubt that in certain cases extractions are required to align crowded teeth or correct the bite.

Much depends on the sort of problem which needs correcting and a decision can only be reached on the basis of a detailed case assessment. Every course of treatment needs to be tailored to the needs of the individual patient. For some patients, in order to get the best appearance and long-term result, extractions will still be part of a ‘gold standard’ plan.

Any claims that treatment can be completed without extractions, especially before an assessment has been completed, should be regarded with considerable caution.

Are crooked teeth harmful?

Yes they could be because they are more difficult to clean and are therefore more prone to decay and gum disease.
The psychological effect of poorly aligned teeth is difficult to determine and will often depend on the individual.

When do you recommend that treatment should start?

Basically the sooner you start the sooner you will finish.

For children, a first appointment is recommended between the ages of 9 and 10. The best time for treatment to start depends on the problem. An early examination allows your orthodontic specialist to decide when treatment should begin for maximum improvement with the least inconvenience and expense to the patient. Early intervention can prevent later problems developing.

Treatment should start when the majority of the patient’s permanent teeth have erupted.

What is the difference between a general dentist and specialist orthodontist?

General dentists provide lots of different dental treatments, such as check-ups, fillings, hygienist appointments and teeth whitening. Whereas a specialist orthodontist only provides orthodontic treatment and associated teeth whitening and mouth guards.

Both dentists and specialist orthodontists can provide orthodontic treatment, but a general dentist will have undergone much less formal training and have less experience than a dedicated specialist Orthodontist.

Can teeth be straightened in 6 months? (6 month smiles)

While it is true that simple straightening of the front teeth can be carried out in as little as six months, this is not always a long-term solution. It often takes at least 12 months to get the teeth fully corrected, biting correctly and in harmony with the jaws and lips.

Dr Katherine Condren, President, OSI and Specialist Orthodontist, said “Orthodontics is a very specialised branch of dentistry. We have the required training to analyse and determine the causes of orthodontic problems and implement the most effective treatment plan to achieve the best and most cost-effective result. We understand that some people want a quick fix however specialist orthodontists who treat patients with crooked and overcrowded teeth everyday know that six month braces will only work for a small amount of patients (approximately 5%) and in those patients they usually only align the front teeth but do not provide a stable bite. Specilist Orthodontists have the expertise to recognize the difference and can give people straight teeth in harmony with their face that will last a lifetime.” Orthodontic Society of Ireland

Can I trust Quick fix Orthodontics?

Many of the treatments offered are heavily promoted and offered by dentists inexperienced in providing orthodontic treatment but who are claiming to give a beautiful smile in six months or less. This is much faster than the comprehensive individual treatment usually required to treat crowded and crooked teeth to get teeth fully corrected. Comprehensive treatment provided by specialist orthodontists ensures that following the treatment, the patient is biting correctly and the teeth are in harmony with the jaws and lips.

Always check qualifications, some dentists (including ‘cosmetic dentists’) who provide orthodontic treatment have only had a few hours training in procedures to straighten teeth. So it is advisable to ask the orthodontist/ dentist how much training they have had in orthodontics and with the type of brace they are proposing to fit.

Which Orthodontist should I trust?

ORTHODONTICS is an excellent way to achieve a healthy, happy smile but the British Orthodontic Society is growing increasingly concerned at reports of patients dissatisfied with the results of treatments used by some cosmetic dentists to straighten teeth. Many of these treatments are offered by dentists inexperienced in providing orthodontic treatment and claim to give a beautiful smile in six months or less – much faster than comprehensive treatment.

How the British Orthodontic Society can help you.

The majority of our members are fully qualified specialists who have carried out at least three years’ further training in orthodontics after becoming a qualified dentist. If you are considering having your own or your child’s teeth straightened, we would like to share the following advice to help ensure you get the best experience possible:

  • Consider all the options: Any good orthodontist will discuss the possible types of brace that can be used to correct your teeth. You should be wary if you are only offered one option or one type of brace.
  • Check qualifications: Some dentists have had as little as three hours’ training in straightening procedures, so it’s advisable to ask the orthodontist/dentist how much training they’ve had in orthodontics.
  • Don’t expect a quick fix: While it is true that simple straightening of the front teeth can be carried out in as little as six months, this is not always a long-term solution. It often takes at least 12 months to get the teeth fully corrected, biting correctly and in harmony with the jaw and lips.

For more information, or help in finding an orthodontist, please visit the British Orthodontic Society website

Correcting the bite is just as important as aligning the teeth.

What can go wrong with braces?

There are a number of things that may go wrong with brace treatment since the teeth are part of a complex biological system involving the gums, jaw bones and facial muscles.
Examples include:

  • Issues with the gums including gum disease or gum recession if the teeth are pushed out of the jawbone if there is not enough space for all your teeth.
  • The way the teeth bite together can also be affected
  • The teeth bite up into the gum of the roof of your mouth causing soreness.
  • The opposite can be true where the contact between your teeth is less, so reducing biting efficiency.
  • The top teeth can be pushed out to make them appear to ‘stick out’.

One of the most common problems that can occur is that teeth tend to return to where they came from once the treatment is finished – this is called ‘relapse’. This is often seen where there were spaces between teeth and very twisted teeth at the start. This particularly happens where the treatment is very quick or retainers are not provided appropriately (teeth can take at least a year for the jawbone and gums to settle).

Looking after your Braces

If you are thinking of having orthodontic treatment, you will need to know about the risks of treatment and how to look after your teeth and braces.

Patients should finish their orthodontic treatment with healthy teeth and gums. Unfortunately, some patients do experience problems during orthodontic treatment. Your orthodontist or dentist will talk to you about the common risks of treatment and about those that might particularly affect you.


The BOS has produced a range of leaflets for patients containing essential advice about looking after your teeth, gums and braces to ensure that the damage in the picture shown here does not happen to you. Links to these leaflets are at the bottom of this page so you can find about more about preventing damage and keeping your mouth healthy during your brace treatment.

How does orthodontic treatment affect sport?

There is more risk of cutting the inside of the mouth during contact sports with an orthodontic appliance in place. It is recommended that removable appliances are removed for contact sports, and that mouth guards should be worn over fixed appliances. We recommend the SISU range of mouth guards and these should be fitted professionally.

How does orthodontic treatment affect playing musical instruments?

Orthodontic appliances can certainly affect the playing of wind instruments. If the appliance is removable, its removal during playing may be advisable and the absence of the appliance for the limited periods in question will not normally have any adverse effect on treatment. Fixed appliances can cause some initial difficulty during playing especially for brass players; however, with persistence, most players find they can overcome any problems successfully. If necessary the orthodontist can provide soft wax or a guard to place over the appliance to help with the problem,

Fixed appliances

Conventional fixed appliances

Fixed appliances are the most commonly used appliances and are able to produce very precise tooth movement to achieve ideal results.

Lingual fixed appliances

Virtually invisible orthodontic appliances fixed to the back of the teeth

Removable appliances

Conventional removable appliances

Often used to correct simple problems, especially in patients who still have primary (baby) teeth in place.

Clear aligners

Clear removable aligners are a relatively new way of correcting milder orthodontic problems following a comprehensive assessment and discussion of the all the available options.

Functional appliances

Functional appliances (e.g. the Twin Block) are a popular type of reducing the projection of the front teeth in patients who are growing.

Orthodontic mini-implants (TADs)

A recent development in orthodontics – find out more about how and why orthodontic treatment might benefit from Temporary Anchorage Devices (TADs).

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Dr Shirley Cox

BDS(Hons), FDS RCS (Eng), MSc(Lond), M Orth RCS(Eng), FDS Orth RCS (Eng)
GDC: 68425

Shirley qualified in Dentistry from The Royal London Hospital in 1992, achieved her M Orth specialist qualification in orthodontics and registered on the specialist list in Orthodontics in 2000. Shirley was appointed as Consultant Orthodontist at Barts Dental Hospital in 2004 and now works as an Orthodontic Consultant at the new Royal London Hospital site.

As a Consultant Orthodontist with over 20 years training Dentists and Orthodontists and her additional training in children’s dentistry Shirley is equipped with the skills to provide the very highest standards of patient care. Having orthodontic treatment with her means that you will be in the best possible hands.

Shirley is able to offer the very latest treatments available, enabling her to treat adult and child patients who have simple, moderate and complex needs and to improve both the appearance and the function of their teeth.

Being an Invisalign Platinum provider, Invisalign Teen accredited and member of the Invisalign London Specialist Orthodontist group put Shirley in a unique position to offer Invisalign treatment for a very wide range of cases.

“Patients in my care receive my personal attention at all times and are treated solely by me. I love to treat patients and help them achieve and keep for life the beautiful, healthier and happier smiles they desire. I look forward to meeting you and helping however I can.”

Outside of orthodontics Shirley lives locally with her husband and two teenage children. For many years Shirley has been a Local School Governor and organises a local book club. Shirley enjoys active holidays whether its walking in Norfolk, skiing in the Alps or exploring further afield with her family.

Shirley Cox

Useful Travel Links

Please select a red marker to get directions.
  • Metro Orthodontics at Wapping Dental Centre is conveniently. Located on The Highway between the City and Canary Wharf.
  • Shadwell DLR is 200m and Wapping Station 500m away.
  • Bus numbers 100 and D3 stop within 50m.
  • Parking is available at Yellow Park multi storey Tobacco Dock. Wapping Lane 70m away.
  • The practice is a short taxi ride from the City and Canary Wharf.
  • Royal Wharf Dental is conveniently located at Royal Wharf in the Royal Docks off North Woolwich Road by the Thames Barrier Park.
  • Just 10 mins from Canary Wharf and 5 mins from both The Excel Centre and City Airport
  • Pontoon Dock DLR is 200m and Canning Town Jubilee line is 10 mins away.
  • Bus number 474 stops within 50m.
  • The practice is on a busy short taxi route and Ubers are readily available.
  • Parking locally in Royal Wharf street bays, free for 30 mins then pay via Just Park.
  • Uber Thames Clipper River bus stops at Royal Wharf
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