Fixed Braces for Children on NHS Waiting Lists or Ineligible for Treatments

11 July 2024

Fixed Braces for Children on NHS Waiting Lists or Ineligible for Treatments

The NHS reports that around one-third of children have misaligned teeth or problems with their jaw requiring orthodontic treatment.

As they become teens, a child’s mouth and jaw are still developing although they will usually have their adult teeth by then. The early teen years are therefore seen as the best time to correct bite problems.

This can give a child confidence in their smile, which in turn can boost overall self-confidence.

The NHS offers free orthodontic treatment to under-18s, provided they meet certain stringent criteria. The most common offering is traditional fixed braces. It is certainly worth a parent’s while to explore this offer.

However, there is another catch — and that is the current waiting times before your child can expect to receive their treatment from an NHS dentist.

When Your Child Might Require Orthodontic Treatment

Maintaining regular dental appointments is important for your child. This allows their dentist to monitor the development of their oral cavity and jaw.

The dentist can then refer the child to an orthodontic specialist if they detect any alignment issues. This could include crooked or protruding teeth, open bite, cross-bite or under-bite.

These symptoms indicate your child may require orthodontic treatment.

• Problems biting or chewing
• Teeth don’t meet properly when the mouth is closed or when biting
• Snoring
• Mouth breathing
• Impairment in speech
• Protruding teeth

Your first port of call when seeking orthodontic treatment for your child will likely be through the NHS. However, although the NHS offers free orthodontics to those under 18, they must meet certain medical criteria to qualify.

NHS Criteria for Free Orthodontic Treatment for Under-18s

The NHS does not have the resources to offer free fixed braces to every child with an irregular bite. Free treatment is reserved for those under 18 and considered to be the most in need of orthodontics.

This means there is a grading system in place designed to see whether a child fits these criteria. This is called the Index of Orthodontic Treatment Need and has five grades.

A dentist must assess your child as having grade 4 or grade 5 on the index to qualify for free braces on the NHS. These grades indicate a severe issue with a child’s bite that could result in further health problems if left untreated.

A dentist will also take into account aesthetics, using a 10-point scale. If your child scores 6 or above on this scale — and was graded three on the Index of Orthodontic Treatment Need — they will also be eligible for free fixed braces on the NHS.

If your child does not meet the criteria, they will be ineligible for free treatment on the NHS. However, even if your child meets the criteria there could be a lengthy delay before they can access their free orthodontics.

NHS Waiting Lists

Waiting lists have been in the news a lot recently and this can also apply to dental care. Even if your child meets the medical criteria for free orthodontic treatment they can be on a waiting list between 6 months and two years. In this time they could see their teeth shift even further.

Spotting bite issues early is key and why your child should be seeing a dentist from an early age. However, if a reference for orthodontic treatment comes in their mid-teens, your child may still be on the waiting list when they turn 18.

Through no fault of their own, your child can become ineligible for treatment overnight.

Why Are NHS Waiting Lists So Long?

A lack of resources and the Covid pandemic has led to an unfortunate perfect storm for NHS waiting lists. A drop in the number of dentists offering NHS treatment already meant there were fewer appointments available for those needing treatment.

The recent Covid pandemic added to the problem as so many appointments were cancelled or delayed. Enhanced cleaning routines brought about by Covid have been maintained — which also means fewer appointment slots at NHS dental surgeries during the working day.

Choosing to Go Private

A tempting option for parents whose children are on long waiting lists or who are ineligible for free treatment on the NHS is to go to a private dentist. According to one report in 2018, 20,000 children are ineligible each year for free braces on the NHS.

A primary reason parents opt for private dental care is so their child can receive their treatment immediately. Faster access to orthodontic treatment can reduce the risk of your child’s teeth shifting further while on a waiting list.

Your child will not require a referral and the more timely treatment can help prevent further oral health issues arising from delayed treatment. It could also prevent more costly treatment needed further down the line to correct the health issues caused by such a delay.

More Orthodontic Treatment Options

Another benefit of private dental treatment is you have more choices of orthodontic solutions. The free treatment offered by the NHS to qualifying under 18s is predominantly traditional fixed metal braces. Although effective, braces are not typically the aesthetic the average teen wants.

Private dental clinics can offer alternative orthodontic options, including:

• Ceramic braces – these are tooth coloured and are less visible than traditional metal braces.
• Lingual braces – fitted on the back of the teeth, making them far more discreet when fitted.
• Invisalign – clear aligners that are more discreet and are easy to remove when eating or when brushing.

The cost of going private can vary according to the treatment type and the provider. However, as orthodontic treatment can be best for your child before they reach adolescence, time can be of the essence.

Therefore, if your child is on a waiting list or is ineligible for free treatment on the NHS because they do not meet the criteria, private treatment can become a tempting option. The less conspicuous braces offered by private dental clinics can also encourage your teen to more readily accept their orthodontics, helping restore a confident smile.