Preston Orthodontics
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NHS Braces

Orthodontics on the NHS Orthodontic treatment is only available free-of-charge on the NHS for young people who:

  • are under 18 years old
  • have a clear clinical need for treatment

NHS orthodontic care is not usually available for adults but may be approved on a case-by-case basis if the functional needs are great. A rating system, known as the Index of Orthodontic Treatment Need (IOTN), is used to assess the need and eligibility of individual cases. The IOTN consists of five grades, which are outlined below.

 

Grade 1

Grade 1 is used to describe almost perfect teeth.

Grade 2

Grade 2 is for minor irregularities with the teeth, such as:

  • slightly protruding upper teeth

  • slightly irregular teeth

  • the position of the upper and lower teeth is not entirely symmetrical, such as a mild overbite or underbite, but this does not interfere with the normal function of the teeth

Grade 3

Grade 3 is for more marked irregularities with the teeth that do not usually need treatment for health reasons. For example:

  • upper front teeth that protrude 4mm less than normal

  • the upper teeth are slightly out of position which only interferes with normal function to a minor degree (less than 2mm)

  • irregularly positioned teeth that are 4mm or less out of line

  • the back teeth do not touch each other when the mouth is closed (this is known as an open bite)

  • the lower teeth are overlapped by the upper teeth (this is known as a deep bite), but this does not interfere with normal function

Grade 4

Grade 4 is for severe irregularities with the teeth that need treatment for health reasons. For example:

  • upper front teeth that protrude more than 6mm

  • the position of the upper and lower teeth is more than 2mm out of their normal location in terms of symmetry and is interfering with normal function

  • lower front teeth protrude in front of the upper teeth by more than 3.5mm

  • irregularly positioned teeth that are more than 4mm out of line

  • deep bite that interferes with normal function

Grade 5

Grade 5 is for severe dental health problems, such as:

  • when teeth are unable to come through into the mouth due to an obstruction, crowding, additional teeth or any other cause

  • a large number of missing teeth

  • upper front teeth that protrude by more than 9mm

  • the normal development of the skull and/or jaw has been disrupted, e.g. by a cleft lip and palate (a birth defect where there is a split in the roof of the mouth, the top lip or both)

The British Orthodontic Society’s website has more information about the Index of Orthodontic Treatment Need (IOTN).

NHS treatment is available for grade 4 and grade 5 cases. Grade 3 cases are usually judged on a case-by-case basis. Treatment may be made available if the appearance of a person’s teeth is particularly unattractive.

Depending on your local primary care trust (PCT), the waiting time for orthodontic treatment can range from six months to two years.

"I have just had my braces off and I am so happy with my teeth, they are lovely and straight, and at school i got loads of nice comments. Thank you!"

British Orthodontic Society The Royal College of Surgeons of Edinburgh British Dental AssociationGeneral Dental Council