When Zach Greenway began orthodontic treatment, he was struggling with the appearance of his teeth at a time when his family was facing significant challenges. Born with a cleft lip and with a complex dental presentation involving a macrodont and a supernumerary tooth, Zach needed a carefully planned course of treatment. With the support of Dr Virginia Rootkin-Gray and her team at Orthodontic Excellence, he completed his treatment with a smile he no longer feels the need to hide. His experience has been recognised as a runner-up in the British Orthodontic Society’s Against the Odds competition.

“I don’t even think about my teeth anymore,” says Zach, now 19 and training to become a Chartered Surveyor. “When my braces came off, I went into school afterwards and my mates said I looked like a different person. I was showing everyone, and we even went clubbing! I felt like I didn’t have a care in the world.”

More than a concern about appearance

Zach’s dental journey began long before he met Virginia. Born with a cleft lip, he knew that his dental development was likely to be more complicated than that of many other children. He also had a macrodont tooth, which is larger than usual, and a supernumerary tooth, meaning an additional tooth beyond the normal number.

By the age of 12, Zach was becoming increasingly conscious of his smile. During the Covid pandemic, he spoke to his dad about how insecure he felt about his teeth. He worried about how he looked in photographs, when meeting new people and even when spending time with friends. The concern affected his confidence and made him self-conscious in everyday situations.

His circumstances became even more difficult when his mum died from cancer when he was 14. His dad was also seriously unwell and spent periods in hospital with heart failure. Alongside these profound family challenges, Zach was trying to manage the emotional impact of his dental concerns.

Zach explains:

“I was acutely aware of how my teeth looked. I was self-conscious in almost every situation, and it gradually wore away at my confidence.”

Zach says that having started orthodontic treatment during this period was important to him. He reflects that, without it, worries about his smile might have added to the emotional weight he was carrying. His older sister was also a great source of support following his mum’s death. His dad encouraged him to keep going, reminding him that the result would be worth the effort. That reassurance stayed with Zach throughout treatment.

A complex clinical challenge

Because of Zach’s cleft lip, macrodont tooth and supernumerary tooth, his orthodontic needs were more complex than a straightforward course of treatment. He had been waiting for care through the NHS cleft pathway, but his treatment had not progressed as he had hoped. Virginia contacted the hospital service and took over his orthodontic care.

Virginia, Zach’s orthodontist at Orthodontic Excellence, said:

“Zach’s case was clinically interesting because of the combination of his dental presentation and the movement required to achieve the final result. We needed to remove the macrodont tooth and move the supernumerary tooth across to take the place of a central incisor on the other side. It was a considerable distance for the tooth to travel, so the case required careful planning and a sustained commitment from Zach.

“He had been waiting a long time for treatment and was very aware of the appearance of his teeth. He was also dealing with the loss of his mum and significant challenges within his family. From the outset, he was keen to understand what we were doing and was fully invested in his treatment. He attended reliably and maintained a good standard of oral hygiene, which was important throughout the process.

“The reason I came into orthodontics was to make a difference to people and their lives. In Zach’s case, he was so invested in his treatment, and seeing his sense of achievement and the result at the end makes it all worthwhile.”

Zach remembers his clinical experience as straightforward and well supported:

“Virginia and the team at Orthodontic Excellence were so helpful and kind. They were always smiling and chatty, and appointments were easy to organise. Virginia put me at ease. She was informative, and her explanations were fantastic. Obviously, I know nothing about dentistry, so it really helped to understand what was going on.”

Seeing the difference

As treatment progressed, Zach began to see changes in his smile. What had initially felt like a long and uncertain process gradually became something positive to look forward to. The improvements were not simply about the position of his teeth; they also changed how he felt about himself.

The moment his braces were removed remains particularly memorable. He went straight to school afterwards, where his friends noticed the difference. He was excited to show people his new smile, and the sense of achievement was immediate. Zach believes that treatment also helped him feel more comfortable among his peers. He had worried about being teased because of his teeth, and improving his smile eased a concern that had followed him through his teenage years.

“Having my braces taken off was such a big moment. I remember it really well. My mates said I looked like a different person, and I just wanted to show everyone. It made such a difference that I don’t even think about my teeth anymore.”

Zach now has a bonded retainer in place to help maintain the result. His orthodontic treatment has given him a result he is delighted with, but he also recognises the significance of having had something positive to focus on during an exceptionally difficult period.

A lasting impact

Zach’s story illustrates how orthodontic treatment can have a significance that extends beyond dental alignment. For someone who has spent years feeling self-conscious about their smile, the opportunity to feel more comfortable in everyday situations can make a meaningful difference.

The British Orthodontic Society’s Against the Odds competition – sponsored by TOC –  recognises patients whose orthodontic journeys have made a difference to their lives, as well as the skill, commitment and care of the professionals involved. Zach’s experience is a reminder that behind every treatment plan is a person with their own circumstances, concerns and hopes for the future.

Pardeep Saini, Chair of the BOS Orthodontic Specialists Group, said:

“Orthodontic treatment can have an impact that goes well beyond the clinical outcome, influencing how people feel about themselves and their confidence in everyday life. The Against the Odds competition celebrates the dedication and expertise of our profession, while recognising the difference this care can make to individual lives. A smile that someone feels comfortable sharing can be an important step towards greater confidence and self-assurance.”