Dentistry

How we help

We help children and young people with dentistry treatment at The Alex. The department of Orthodontics, Paediatric and Restorative dentistry has four fully equipped dental treatment areas as well as an orthodontic laboratory on site.

Paediatric dentistry (Children’s dentistry)

Paediatric dentistry aims to improve the oral healthcare of infants, children and young people through preventative, educational and treatment services.

The service provides multidisciplinary care, advice and treatment for children and young people with complex medical, dental and behavioural needs where treatment cannot be provided by primary and secondary dental care services. We work closely with other dental specialities and healthcare professionals in our dental clinic.

Getting ready for your appointment

Before your child’s appointment you will be sent a medical history form and patient questionnaire to complete with them and bring to their first appointment. It is important that you both complete all sections even if you do not think it applies to them. The patient questionnaire will help our team cater for your child’s needs if they require additional support. If your child uses alternative methods of communication please bring them to their appointment and any devices, toys or comforters that will help to make them feel more comfortable during the consultation.

If your child is under any hospital doctors please bring all letters and details of the team they are under to the appointment. If a dentist or orthodontist has taken any dental x-rays and / or moulds in the last 12 months please bring a copy of these to the appointment as this may reduce the need for these to be repeated on the day of the consultation.

Service overview

Our children’s dental service is limited to those children requiring Level 3 B complex care. We are an outreach specialist regional centre for cleft lip and palate services.

Outpatient treatment clinics (local anaesthetic and inhalation sedation) are for children with complex dental trauma, dental defects and oral mucosal diseases.

Children with complex medical problems are seen on the request of their consultant paediatrician and dental care is shared with their local dentist.

We provide dental care under general anaesthetic on a day case and inpatient basis.

We do not accept walk in patients, only referrals through DERS. If your child has just injured their teeth or has a facial swelling please contact their regular dentist urgently, call NHS 111 or the on-call maxillofacial team at the Royal Sussex County Hospital.

Conditions treated

We treat children requiring Level 3 B complex care this includes children with the following:

Complex medical and behavioural conditions.
Soft tissue conditions (eg problems with the lips, gums, cheeks or tongue).
Dental anomalies (teeth with an altered structure, shape, size or form, and children with missing or additional teeth).
Complex dental injuries requiring multidisciplinary care.
Craniofacial conditions (such as cleft lip and palate).

We may also treat children who need:

Surgical removal of teeth that have failed to come through (“erupt”).
Investigate disorders of tooth eruption and loss.
Genetic conditions related to teeth and dental structures (eg amelogenesis imperfect and dentinogenesis imperfect).

How to refer

We’re currently not accepting paediatric referrals at present.

Orthodontics

Orthodontics is a type of dentistry related to the growth of the face, jaws and teeth. Orthodontists are dental surgeons who have had further specialist training.

The key areas of orthodontic provision at The Alex include:

Consultant advice: providing specialist orthodontic advice for patients who are referred from general dental and specialist orthodontic practitioners as well as other medical and dental consultants.
Consultant led treatment: treatment for patients with severe malocclusions (misalignment of teeth), and/or complex medical conditions with a high need for treatment. This includes patients with buried and malformed teeth, hypodontia (care for patients with multiple missing teeth), orthodontics and jaw surgery, obstructive sleep apnoea and cleft lip and palate care.
Multidisciplinary treatments: working jointly with other specialist services to provide the appropriate care when treatment cannot be carried out by braces alone.
Education, training and research: providing post graduate education and clinical training for future orthodontic specialists and consultant colleagues.

What happens at your appointment

At the first appointment your child will be seen in the orthodontic new patient clinic. We’ll ask you and them about any concerns and assess the need for treatment. Your child may have X-rays and putty moulds (impressions) taken of their teeth.

If your child is accepted for treatment, we’ll arrange a treatment planning appointment to discuss the treatment options, any other procedures needed and explain the types of braces available. You’ll not have any orthodontic fixed or removable braces fitted at these initial appointments. We may decide that your treatment is better treated by a local primary care specialist in orthodontics and if the position of your teeth is very mild you’ll be discharged back to your dentist.

How to refer

Patients referred to our department must have:

Significant malocclusions with an Index of Orthodontic Treatment Need (IOTN) of 4 or 5. Further guidance can be found here on the British Orthodontic Society website.
The complexity of the malocclusion must be level 3b, to justify treatment within secondary care. Further information can be found on here in this NHS England orthodontic information.
Excellent standard of oral hygiene and dental health. Patients who are not dentally fit will not be accepted.

All referrals must be made via the Dental Electronic Referral Service (DeRS). Please include any relevant X-rays taken within the last 12 months with the patients’ details and date of exposure clearly visible. We’re unable to accept orthodontic referrals from primary care via the post.

Restorative dentistry

Restorative dentistry provides planning advice for patients with many dental needs including orthodontics, paediatric dentistry, oncology, oral and facial surgery and ear, nose and throat.

It also provides complex restorative dental treatment for patients with head and neck cancer, cleft lip and palate, severe hypodontia (teeth that are missing or not developed) and facial trauma.

Getting ready for your appointment

Before your appointment you’ll be sent a medical history form to complete and bring to your first appointment. It’s important that you complete all sections, even if you don’t think it’s relevant to your teeth or mouth.

If you’ve had any X-rays and/or moulds of your teeth in the last 12 months then it would be helpful to bring a copy of these to your appointment or check these have been sent with your referral.

One of the criteria for accepting patients for treatment is excellent oral and dental health. Before attending your appointment, it’s essential that your teeth and gums are clean with no active dental decay.

What happens at your appointment

The restorative dentistry consultant works closely with other colleagues so after being seen you may be referred to our joint orthodontic – restorative clinic, maxillofacial-restorative clinic or the oncology clinic.

Most patients are discharged back to their referring clinician or dentist with a written plan for care. A small number of patients are provided their complex restorative dental care in the hospital.

Private treatment is available in selected cases, you can ask about this at your first appointment.

How to refer

Conditions treated include maxillo-facial defects following surgery or trauma, severe hypodontia, cleft lip and palate. There are no pre-referral requirements. Patients can be referred through a written referral.