Accessing orthodontics

Orthodontic treatment is a type of dental treatment used to improve the appearance, position and function of crooked or abnormally arranged teeth.

Orthodontic treatment, under NHS general dental services (GDS), is available where the patient has been assessed as having a clear clinical need for treatment. A system known as Index of Orthodontic Treatment Need (IOTN) is used as a means of assessing whether orthodontic treatment is required and can, therefore, be provided under GDS. The IOTN is made up of five grades, which are listed below.

Grade 1: almost perfect teeth.

Grade 2: minor irregularities with the teeth. For example, teeth slightly out of line.

Grade 3: greater irregularities with the teeth, which normally don't need treatment for health reasons. For example, upper front teeth that protrude slightly.

Grade 4: a more severe degree of irregularity with the teeth, that requires treatment for health reasons. For example, upper front teeth that protrude more than 6mm and missing teeth where gaps need to be closed.

Grade 5: severe dental health problems. For example, a large number of missing teeth and upper front teeth that protrude more than 9mm.

Cases assessed as Grade 1 are not considered as benefiting from orthodontic treatment and will not be available under GDS.

Cases assessed as Grade 2 will not normally be considered as benefiting from orthodontic treatment and will not normally be available under GDS.

Cases assessed as Grade 3 will be judged on a case-by-case basis, dependent on the appearance of the teeth. Treatment may be available under GDS.

Cases assessed as Grade 4 or 5 will be considered for orthodontic treatment under GDS.

Referral

Orthodontic treatment under GDS will only be considered where the patient has maintained a good standard of oral health.

If the dentist thinks that orthodontic treatment may be needed, you/your child may be asked to see an orthodontist to see if treatment is required. Being referred to an orthodontist for assessment doesn't mean that orthodontic treatment will be necessary or will be provided under GDS.