Key topics
When should children see an orthodontist?
The British Orthodontic Society recommends that children have an orthodontic assessment at around age 10, when most adult teeth have come through or are coming through. However, some issues — such as crossbites, significant jaw discrepancies, or problems with baby teeth — may warrant earlier assessment.
Most active orthodontic treatment for children in the UK begins between the ages of 11 and 14, when enough permanent teeth are present. Treatment started too early (while too many baby teeth remain) may need to be repeated.
| Age range | Typical stage | What may be appropriate |
|---|---|---|
| 7–9 | Mixed dentition — baby + adult teeth | Functional appliances for jaw growth issues; early crossbite correction |
| 10–12 | Late mixed / early permanent dentition | Orthodontic assessment; removable appliances; some early fixed brace starts |
| 12–14 | Most permanent teeth present | Standard timing for fixed brace treatment to begin |
| 14–17 | Full permanent dentition | Fixed or aligner treatment; all treatment options available |
| 18+ | Adult | Adult orthodontics — typically private; NHS rarely available |
How does NHS orthodontic treatment for children work?
NHS orthodontic treatment in England is available to children under 18 who meet the clinical need threshold. Eligibility is determined using the Index of Orthodontic Treatment Need (IOTN) — a scoring system assessed by a clinician.
IOTN DHC grades 4 and 5 — routinely eligible for NHS treatment
IOTN DHC grade 3.6+ — eligible; some grade 3 cases are borderline
IOTN DHC grades 1 and 2 — not eligible for NHS treatment (cosmetic cases only)
The typical NHS pathway is: dentist assesses teeth → dentist makes a referral to an orthodontic practice → orthodontist places child on waiting list → active treatment begins. Waiting times vary significantly by region — some areas have waits of around six months, while in many the wait is four years or more.
NHS orthodontic treatment for children is provided within the Band 3 dental charge structure (£332.10 in 2026), though all children under 18 are exempt from dental charges, so NHS treatment is free for every eligible child.
Types of braces for children in the UK
Fixed metal braces
The standard NHS appliance for children. Metal brackets bonded to the teeth connected by an archwire. Handles the full range of clinical complexity. Most children on NHS treatment will receive metal fixed braces. They require good oral hygiene compliance and some dietary care.
Removable functional appliances
Used primarily in growing children (typically age 10–14) to harness jaw growth and correct skeletal discrepancies such as prominent upper front teeth (overjet) or underbites. Common examples include the Twin Block, Herbst, and Clark Twin Block. Often used as a first phase before fixed braces. NHS-funded when clinically indicated.
Removable retainer-type appliances
Simple plastic plates with a wire clasp used for minor tooth movements or space maintenance. Less common now than in previous decades — fixed braces are more effective for most cases. May still be used for very specific early interventions.
Ceramic braces
Tooth-coloured brackets on the front of the teeth. Functionally equivalent to metal fixed braces but less noticeable. Not routinely available on the NHS — typically a private option for children/teenagers where parents want a more discreet appliance.
Clear aligners (e.g. Invisalign Teen, Invisalign First)
Custom-made removable plastic trays. Invisalign offers 'First' (for mixed dentition, younger children) and 'Teen' (designed with compliance indicators and extra replacement trays). Effective for suitable cases but require strict 20–22 hour/day wear and are not suitable for all case types. Private only — not NHS funded.
What does children's orthodontic treatment involve?
A typical NHS fixed brace course for a child involves:
Assessment and records — photographs, X-rays (OPG and/or lateral cephalogram), impressions or digital scans, clinical examination, and IOTN scoring
Treatment planning — orthodontist agrees a treatment plan; extractions may be recommended for crowding cases
Brace fitting — brackets bonded to teeth, archwire engaged; child given oral hygiene instruction and dietary advice
Regular adjustments — typically every 6–8 weeks for fixed braces; orthodontist changes wires and monitors progress
Debond (brace removal) — brackets removed, teeth polished; retainers fitted at the same appointment
Retention — retainers worn as prescribed to hold the result
Total active treatment duration is typically 12–24 months for most children's cases, though complex cases can take longer.
Private orthodontic treatment for children
Parents may choose private treatment for children for several reasons: the child does not meet the IOTN threshold for NHS treatment, the NHS waiting list is too long, or the parents want access to more discreet options such as clear aligners or ceramic braces.
| Treatment type | Approx. private cost (child) |
|---|---|
| Metal fixed braces | £1,500–£3,500 |
| Ceramic fixed braces | £2,000–£4,500 |
| Clear aligners (e.g. Invisalign Teen) | £2,000–£4,500 |
| Functional / removable appliance | £800–£2,000 |
Private orthodontic treatment for children follows the same clinical process as NHS treatment. The main differences are the absence of a waiting list and access to a wider range of appliance types.
What can parents do to prepare?
Ensure your child has regular dental check-ups — the dentist will flag if a referral is needed
Establish good oral hygiene habits before braces — orthodontists prefer to treat healthy gums
Discuss concerns with the dentist early — some bite issues are easier to address during growth than after
If the NHS waiting list is long in your area, consider whether private treatment timing suits your child's stage of dental development
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