Fixed Braces (Metal & Ceramic)
Fixed Braces (Metal & Ceramic) — Procedure, Risks & What to Expect
Quick answer
Fixed braces are free on the NHS for under-18s who score 3.6 or above on the IOTN scale. For adults paying privately, metal braces cost £1,500–£3,500, ceramic (clear) braces £2,000–£4,500, self-ligating (Damon) £2,500–£5,000 and lingual (hidden) braces £4,500–£10,000. Treatment lasts 12–36 months and is followed by retainers worn for life.
Key facts
- NHS: free for under-18s with IOTN ≥ 3.6 (free under 26 in Scotland)
- Private metal braces: £1,500–£3,500
- Ceramic (clear) braces: £2,000–£4,500
- Self-ligating Damon: £2,500–£5,000
- Lingual (hidden) braces: £4,500–£10,000
- Treatment length: 12–36 months
- Retainers required for life to prevent relapse
Fixed braces remain the most effective option for complex tooth movements. Metal braces are cheapest; ceramic (clear) brackets are more discreet but more expensive. Lingual braces are fitted behind the teeth and are completely hidden — the most expensive option.
What are fixed braces?
Fixed braces (metal, ceramic, self-ligating, or lingual) remain the gold standard for complex orthodontic cases. They are also the only orthodontic option routinely available free on the NHS — for under-18s scoring 3.6+ on the IOTN scale. Adult fixed braces are private only and range from £1,500 (basic metal) to £10,000 (lingual hidden behind teeth).
Who needs this treatment?
- Under-18s with significant alignment issues (IOTN 3.6+) — free on NHS
- Adults with complex bite problems beyond what Invisalign can fix
- Patients with severe crowding, rotated teeth, or open bites
- Cases requiring jaw alignment with surgery
What does the procedure involve?
Treatment takes 12–36 months. Consultation: photos, X-rays, study models or 3D scan, treatment plan. Fitting (60 minutes): brackets bonded to teeth, wire threaded through. Adjustment visits every 4–8 weeks to change wires and bands. Removal (60 minutes): brackets removed, teeth polished, retainers fitted. Total appointments: 15–25 typically.
Recovery time
Mild soreness for 3–5 days after fitting and each adjustment. Cheek and lip ulcers from brackets in the first 1–2 weeks — use orthodontic wax. Soft foods for first week. After removal, mild tooth sensitivity for days.
How long does it last?
Active treatment 12–36 months. Results last indefinitely if retainers are worn for life (nightly is acceptable after first year). Relapse is the main long-term risk.
NHS Coverage
Falls under Free for under-18s with IOTN ≥ 3.6.
In England the NHS charge is Free under 18, otherwise Band 3 (£332.10) (effective from 1 April 2026). Wales, Scotland and Northern Ireland each set their own rates.
NHS charges for all four nations compared →Going Private
Privately, fixed braces cost £1,500–£3,500 (metal fixed braces) across the UK, with central London typically 30–50% above that range.
Full price breakdown, option by option →What Affects the Cost
- Type of bracket
- Treatment length
- Whether retainers are included
- Whether you see a general dentist or specialist orthodontist
When is this treatment available on the NHS?
Free for under-18s who score 3.6 or above on the IOTN scale (Index of Orthodontic Treatment Need). The IOTN scores severity of crowding, overbite and alignment. Adults pay privately or, in rare functional cases, may receive NHS Band 3 treatment (£332.10).
How to save money on this treatment
- NHS orthodontics is free for qualifying under-18s — get your child assessed before age 14
- Metal braces are the cheapest private option (£1,500–£3,500)
- Self-ligating (Damon) braces shorten treatment by 4–6 months on average
- Avoid lingual braces unless visibility is critical — they cost 3–4x more
- 0% finance over 18–24 months is widely available
Does dental insurance cover this?
Adult orthodontic insurance coverage is limited. Comprehensive plans cover £1,000–£2,500 per year. Most basic plans exclude adult ortho entirely.
Risks and side effects
- White spots (decalcification) on teeth if hygiene is poor — permanent
- Root resorption (shortening) — usually minor
- Cheek and gum ulceration from brackets
- Bracket detachment requiring repair appointment
- Need for tooth extraction in crowded cases
- Relapse without retainer compliance
Red flags to watch for
- Quotes that don’t include retainers (mandatory after treatment)
- No discussion of underlying jaw discrepancies that might need surgical correction
- Promises of treatment in under 12 months for complex cases — usually unrealistic
- Orthodontic treatment by general dentists without specialist training for complex cases
Alternatives to consider
- Invisalign Clear Aligners — Clear aligners — less visible but unsuitable for some complex cases.
Frequently Asked Questions
Are metal braces faster than Invisalign?
For complex cases, yes — fixed braces give the orthodontist finer control. For mild to moderate cases the timings are similar.
How often do I see the orthodontist?
Every 4–8 weeks for adjustments. Each visit is 15–30 minutes.
Will braces hurt?
Mild soreness for 3–5 days after fitting and each adjustment. Most patients adapt quickly.
Can I eat normally with braces?
Soft foods for the first week. Avoid hard, sticky and chewy foods (toffee, chewing gum, popcorn) throughout treatment.
Are lingual braces worth the cost?
Only if visibility is a major concern (e.g. patients in customer-facing roles). Lingual braces are more uncomfortable and harder to clean.
Will my teeth move back after braces?
Yes if you don’t wear retainers. Lifelong nightly retainer wear is the only way to prevent relapse.