NHS orthodontics

at One Smile Dental

NHS Orthodontic treatment is free for people under the age of 18 with a clear health need for treatment.

Reason for referral

Your dentist has referred you to us so that we can assess your potential need for NHS orthodontic treatment. This is because they believe that the alignment, function or health of your teeth may be improved by undergoing orthodontic treatment. To be eligible for NHS orthodontic treatment you will be assessed by our Specialist Orthodontist who will take some measurements to determine your IOTN score.


What is IOTN

IOTN is an unbiased and objective way to select those patients who will benefit most from orthodonctic treatment and aids the prioritisation of the NHS resources. Please see below a brief explanation of the IOTN grading system:

  • Grade 1 – Perfection or almost perfection and therefore no health need for treatment.

  • Grade 2  – Minor irregularities that do not impact function or health.

  • Grade 3 – irregularities which rarely require treatment for health reasons.

  • Grade 4 – More severe irregularities which require treatment for health reasons.

  • Grade 5 – Severe dental health problems.

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Private options

If your child does not meet the NHS criteria but you still wish to pursue orthodontic treatment, you can consider funding the treatment yourself on a private basis. This includes metal, ceramic and InvisalignⓇ treatments. We offer flexible finance options to facilitate funding private treatment should that be your choice.

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What to expect at the 1st visit

At your first visit the practice will request you to fill out some simple forms to ask about your medical and dental history. Our Specialist Orthodontist will carry out an examination of your teeth, most likely using a small mirror and a ruler. Occasionally scans, x-rays or photographs may need to be taken to aid in diagnosis. Once the Specialist has finished their assessment they will discuss their findings with you and most likely place you in one of the following categories:

  • Waiting List - Patients that are ready to start treatment. Only once patients are ready to start treatment can they be placed in this category.

  • Review - Patients who are likely to need treatment but are not ready to start or that need to be monitored over a period of time.

  • Discharge - Patients who do not wish to go ahead with treatment or who are not eligible due to not meeting NHS IOTN criteria, poor oral hygiene or being too dentally young (not having enough adult teeth).

  • Referral - Patients who need to be seen in a hospital orthodontic service setting to gain a second opinion due to the complexity their treatment may involve.

We would like to make all patients and parents aware that due to the limited NHS funding vs the demand for orthodontic treatment, there may be a waiting period before assessment or treatment can begin. We endeavour to work as efficiently as possible alongside NHS England to diligently manage our waiting times.

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NHS vs Private

If you are weighing up your options with regards to NHS vs Private treatment, this section is designed to give you all the information you may need to make the right decision for you.

NHS Private
Cost NHS set charge for replacement appliances only Charged on fee per item basis
Waiting time Potentially long waiting times No waiting times
Standard of treatment High standard of treatment that must follow NHS criteria and is regularly audited by NHS England High standard of treatment that does not have to adhere to NHS criteria and can therefore be more tailored to your particular concerns
Types of appliances used Only NHS approved appliances e.g metal braces and removable appliances Wider variety of appliances available that can be more aesthetically pleasing, discrete and streamlined for minimal discomfort
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