NHS braces for children: who qualifies?
The NHS funds orthodontic treatment for young people aged 17 and under, but only when their teeth meet the national criteria. Here's how that decision is made and what to expect if your child is referred to us.
Who can have NHS braces?
NHS orthodontic treatment is free for patients aged 17 and under whose teeth have a clear need for treatment. It is not available:
- if the problem is too mild, according to the IOTN score (explained below)
- to anyone aged 18 or over
- to anyone who has already had a course of NHS orthodontic treatment.
Your child will usually need a referral from their own dentist for an NHS assessment.
What is the IOTN score?
The Index of Orthodontic Treatment Need (IOTN) is the scale the NHS uses to make sure funding goes to the children who need treatment most. It has two parts.
Dental Health Component (1 to 5)
This looks at the single worst problem with the bite, such as missing teeth, teeth that stick out, crossbites, crowding or a deep bite. The scores are: 1 = no need, 2 = little need, 3 = borderline need, 4 = need, 5 = very great need.
Aesthetic Component (1 to 10)
For borderline cases, the appearance of the teeth is compared against a set of 10 reference photographs. Scores of 1 to 4 show little or no need, 5 to 7 borderline need, and 8 to 10 great need.
NHS treatment is normally only available with a Dental Health score of 4 or 5, or a score of 3 together with an Aesthetic score of 6 or more.
What happens at the assessment?
- Forms: you'll fill in a short medical and dental history.
- Examination: our Orthodontic Therapist will check your child's teeth and talk through any problems. This may involve X-rays, photographs or scans.
- Dental fitness check: your child may also see our Dental Therapy team. Before braces can go on, brushing needs to be good and any fillings must be done first. We'll help with this over a few visits, but we can't start treatment until oral hygiene is at a good standard.
- Treatment plan appointment: we explain the problem, whether treatment is needed and what kind. Your child is then placed on the treatment waiting list, booked for a review (if they're not ready yet), discharged, or referred to the hospital orthodontic service for more complex problems.
Good to know before you come
- A parent or legal guardian must attend with any patient under 16 until the consent forms are signed and the treatment plan is understood. We will need to rebook if a grandparent or another adult who can't give consent attends instead. Foster carers and other legal guardians will be asked to show proof of their status.
- Appointments alternate between school time and out of school time. This applies to everyone, regardless of age.
- Looking after braces matters. Poor brushing or repeated breakages can lead to treatment being stopped. See our guide to eating with braces.
What if my child doesn't qualify?
It isn't necessarily the end of the road. We'll offer a further appointment to re-check the score. If your child still doesn't qualify, options include:
- Self-funded braces: exactly the same treatment as on the NHS, with the same materials and conditions, at a reduced private fee. Payment plans are available.
- Invisalign: clear aligners are available for teenagers privately. See our Invisalign cost guide.
You can read the full details in our Orthodontic Welcome Pack (PDF).