If you’re wondering whether your child can have braces on the NHS, you’re asking one of the questions we hear most. The system is fair, but it’s also more nuanced than most parents expect — and understanding how it works helps you plan with far less stress. Here’s a clear explanation of who qualifies, why waiting lists build up, and what you can do if your child isn’t eligible.
How NHS eligibility is decided
NHS orthodontic treatment for children is funded for those who meet a defined level of need. Clinicians use a national framework — the index of orthodontic treatment need, often shortened to IOTN — to grade how significant a problem is. It works as a hierarchy, from minor issues that are largely cosmetic up to problems that affect dental health and function.
The principle is simple: NHS funding is directed to the children whose need is greatest, because there’s only a finite pot of money to go around.
Who qualifies
In broad terms, children whose problems fall into the higher categories of need (4 and 5) are likely to qualify. That includes situations such as:
- A tooth that hasn’t come through at all — for example, one stuck in the bone — which sits at the top of the priority list, because it needs resolving.
- Front teeth that protrude significantly, where there’s a real risk of damage.
- Other problems that meet the defined thresholds for dental health.
Milder crowding or concerns that are mainly about appearance generally fall below the cut-off and aren’t usually funded.
Why your friend’s child qualified and yours didn’t
This is a genuine source of frustration for parents, and it’s worth explaining. A child might look — to a parent’s eye — to have straighter teeth than a friend who did get NHS treatment. But eligibility isn’t judged on the front teeth alone. There may be a tooth further back that hasn’t come through, or another qualifying issue that isn’t obvious at a glance. The grading looks at the whole picture, not just the smile, which is why two children can look similar yet have very different eligibility.
Why waiting lists build up
Even for eligible children, there’s often a wait — and the maths explains why. A practice like ours might receive in the region of 70 new referrals a month, while our NHS contract funds a limited number of cases each year. When far more children are referred than can be treated under the contract, waiting lists naturally grow. It’s not a reflection of your child being deprioritised; it’s the reality of a finite system under high demand.
It’s also why a child can’t simply join a treatment waiting list at seven — not all of their adult teeth are through yet, so the right time to start hasn’t arrived.
If your child isn’t eligible: private options
If your child doesn’t meet the NHS threshold but you’d still like to go ahead, treatment is available privately — and it’s more accessible than many parents assume.
- Cost: our private children’s treatment is priced marginally lower than treatment for an average adult.
- Waiting times: there’s no NHS-style waiting list, so we can usually begin within around three months, or whenever is the right developmental moment for your child.
- Finance: we offer finance options to help spread the cost and make treatment manageable.
NHS or private — the same commitment to your child
Whether your child is treated on the NHS or privately, our commitment to the result is exactly the same: we genuinely want every child to get the best outcome. The main practical difference is choice. Privately, there’s a wider choice of appliances — more discreet, aesthetic brackets, or <strong>clear aligners</strong> where the case is suitable. NHS treatment uses a defined set of appliances within the funded contract. Either way, the clinical care and attention is identical.
Frequently asked questions
Is private treatment much more expensive than the NHS? Private treatment does carry a cost where NHS treatment is funded, but for children it’s priced lower than an average adult course, and finance options help spread it. We’ll always be transparent about costs up front.
Can we switch from the NHS waiting list to private treatment? Yes. If you’d rather not wait, or your child isn’t eligible, we can usually start privately within around three months. We’re happy to talk through both routes so you can decide what’s right for your family.
How is my child’s eligibility actually decided? Through the IOTN grading, which looks at the whole bite and dental development — not just the appearance of the front teeth.
Book a consultation
The clearest way to understand your child’s options — NHS or private — is a proper assessment. Book a consultation with our specialist team at No 1 Orthodontics in Derby and we’ll explain exactly where your child stands and the best route forward.
