NHS Orthodontics

It may be a possibility for some people to receive orthodontic treatment from the NHS. However, NHS orthodontics is limited to those that meet certain criteria on a scale known as the index of orthodontic treatment need. Cosmetic orthodontic treatments which include treatment with systems such as Invisalign, the Inman Aligner and cosmetic Damon braces will not be available on the NHS.

Who qualifies for NHS treatment?

Free treatment on the NHS is usually limited to people who are under 18 years of age, and require major dental corrections, which usually affect the health of the patient. Cases involving adults who require orthodontic treatment are analysed on a case-by-case basis, and generally only approved if the need for correction is great.

What kind of problems will the NHS treat free of charge?

A grading system is used to assess the teeth of the patient, to see if they are suitable for free treatment. This grading system is called the Index of Orthodontic Treatment Need (IOTN) There are five grades, grade 5 referring to patients who show the most severe issues. Below is an outline of each grade:

  • Grade 1 - the patient has near perfect teeth.
  • Grade 2 - the patient shows minor irregularities, such as the teeth not being symmetrical, a slight protruding of the teeth, and slightly irregular teeth.
  • Grade 3 - the patient shows more noticeable irregularities in the teeth, but these do not cause health problems. These irregularities can include, deep bite and upper teeth positioning issues (to an extent that they do not cause functioning problems), teeth that out of line or protrude 4mm or less than normal, and open bite (the back teeth do not meet when the mouth is closed).
  • Grade 4 - the patient's teeth show severe irregularities and treatment is needed for health reasons. For example: upper teeth which protrude more than 6mm, teeth that are more than 4mm out of line, the symmetry of the upper and lower teeth is out of line by 2mm (and function is affected), lower teeth protruding more than 3.5mm in front of the upper teeth, and deep bite which causes functioning issues.
  • Grade 5 - the patient shows severe problems which will affect dental health. These can include: a number of missing teeth, upper teeth which protrude more than 9mm, teeth are unable to come through due to an obtrusion, crowding, or additional teeth, problems with the development of the skull or jaw.

NHS treatment is not considered necessary for patients who fall into grades 1 and 2. Grade 3 patients are considered on a case-by-case basis, and treatment may be granted if the teeth appear particularly unattractive. Patients who are grades 4 and 5 will receive NHS orthodontic treatment.

Things to be aware of:

  • Depending on your location there may be a long waiting list for NHS orthodontic treatment and it may be a lot quicker to opt for the private route
  • Patients may have to wait from six months to two years for NHS treatment.
  • Patients may be charged to replace removable devices which have been damaged or lost.
  • The types of braces available on the NHS will be restricted to metal brackets and wires (i.e. traditional train track braces). Cosmetic braces, Invisalign braces, 6 month smiles and the Inman Aligner will not be available on the NHS.

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