Who is Eligible and How to Apply for Braces on the NHS?

Did you know a Dentist and an Orthodontist are not the same as one another?  Dentistry is a broad medical speciality that deals with oral health, specifically your teeth, gums, jaw and nerves in the mouth; Orthodontics however is a speciality within dentistry focusing on correcting your bite and how your teeth align.

Many Orthodontists up and down the country will take on new patients for private orthodontic treatment, including us here at Orthodontics For You.  Whilst private healthcare providers are independent from the NHS, they are still regulated and inspected by the Care Quality Commission (CQC).  Private patients are required to pay for the full cost of their orthodontic treatment, but can do so over a period of time (take a look at our Finance page for more info), and there isn’t usually a long wait list for treatment so you’ll be on your journey to a new smile before you know it!

NHS patients however will not be required to pay the full amount for their treatment which, naturally, is far more appealing, but because of this there is an exceptionally long wait list… we’re talking around three to five years!  But not everyone is eligible for braces through the NHS, only those who have a medical necessity are eligible for orthodontic treatment.  It’s also worth noting that although NHS patients don’t have to pay for the full cost of treatment, they will still be required to pay a contribution towards their care (unless exempt).

Who is Eligible for Braces on the NHS?

To determine if you are eligible for NHS braces in Birmingham, your Orthodontist will use the Index of Orthodontic Treatment Need (IOTN) rating system – typically this is used for children aged 17 years and under.  If you receive Grades 1 or 2 then unfortunately you will not be eligible for NHS funded treatment, but if you score a Grade 4 or 5 then you will automatically be eligible.  The assessment usually takes around 20 minutes so you won’t have to wait weeks on end for an answer.  Here’s a breakdown of each grade:

Grade 1 (almost perfection!)

Patients who score a Grade 1 will not have a sufficient health need for orthodontic braces as their teeth are considered ‘‘almost perfect.’’

Grade 2 (minor irregularities eg slightly protruding upper front teeth)

Patients who score a Grade 2 are also not eligible for braces on the NHS as there isn’t a justified health need. 

Grade 3 (borderline)

If you receive a Grade 3, you could still be eligible for NHS funding, but your case is borderline and so your Orthodontist will need to consider the appearance of your teeth too, giving them an aesthetic score of 1 – 10.  If you receive a Grade 3 and an aesthetic score of 6 or above then you will qualify for NHS brace treatment.  Irregularities of teeth which are less than 4mm out of line (e.g. open bites of less than 4mm) or deep bites with no functional problems will not qualify for NHS treatment.

Grade 4 (extensive irregularities)

Severe degrees of irregularity will qualify for orthodontic treatment on the NHS.  Examples include:

Grade 5 (severe irregularities)

If you score a Grade 5 then you will have a health need for orthodontic treatment on the NHS.  Examples include:

  • When teeth cannot sit within the mouth normally because of obstruction by crowding or additional teeth.
  • A large number of missing teeth.
  • Upper front teeth that protrude more than 9mm.
  • Lower front teeth that protrude in front of the upper more than 3.5mm and where there are functional difficulties too.
  • Cranio-facial anomalies such as cleft lip and palate.

The second part of the IOTN is the Aesthetic Component (AC) which we touched on earlier.  The NHS recognises that some patients need and benefit from orthodontic treatment on the basis of poor aesthetics. The Aesthetic Component of the IOTN is a scale of 10 colour photographs showing different levels of dental attractiveness. The grading is made by the Orthodontist matching the patient to these photographs.

What braces can you get on the NHS?​ Patients who receive orthodontic care through the NHS are usually issued with metal braces and will therefore not have the luxury of choosing their preferred brace type for themselves.  Metal braces are both efficient and cost-effective, and are made up of small metal brackets attached to each tooth which is controlled by a thin metal wire (it’s this wire that moves your teeth to the desired position and it will need tightening/adjusting approximately every 6 – 8 weeks throughout your treatment).

Unfortunately, orthodontic treatment for adults is only available on the NHS in very rare cases for those who require treatment for health reasons and is assessed/provided on a case-by-case basis (most adults seeking orthodontic braces will need to go private).

How to Apply for Braces NHS?

There are a number of reasons for seeking orthodontic treatment, but the process starts when you visit your Dentist for a check-up.  If you’re considering orthodontic treatment with braces then your Dentist will check the health and condition of your teeth and gums, plus the alignment of your jaw and bite before referring you to an Orthodontist.  You will need to visit the Orthodontist separately and they will assess your teeth for themselves.

Adults aged 18 and over can register for a complimentary, no obligation consultation with our Specialist Orthodontists at Orthodontics For You.  Consultation appointments are a fantastic opportunity for patients to meet our team and for us to assess their teeth including their condition and current (mis)alignment before recommending which brace types could work well for them (we specialise in Metal, Ceramic, Invisalign, Hidden Lingual, SureSmile and QuickSmile braces).  The consultation is also the perfect opportunity for prospective patients to ask us any questions they might have regarding the orthodontic options available to them, the associated costs and whether or not they qualify for orthodontic care on the NHS.  If patients qualify for NHS brace treatment, they will be added to our wait list, but be warned that the NHS waiting list is about four years with Orthodontics For You as the funding we receive for NHS treatment isn’t enough to meet the demand.  That said, adult patients who qualify for NHS treatment can still pay privately to have their brace fitted, jumping the queue… but that is a decision to be made by the patient themselves.

Pros and Cons of NHS Vs Private Orthodontics

NHS Pros:

  • Heavily reduced cost of treatment

NHS Cons:

  • Lengthy waiting lists
  • Metal braces only

Private Pros:

  • Choose your own brace (metal, ceramic, Invisalign, Incognito etc)
  • Jump the queue (minimal wait time)

Private Cons:

  • Must pay for the full cost of treatment

Hopefully the information within this blog provides an indication of whether or not you could be eligible and how to apply for braces NHS.  We appreciate there is a lot to consider and embarking on your own journey to a new smile can be a big step, but here at Orthodontics For You we want everyone to have the choice to undergo orthodontic treatment which is why we offer both private and NHS treatment services.  Our goal is to deliver the smile we know you deserve and to ensure you receive high standards of care, treated by the very best Orthodontists.


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