How to Get NHS Braces in England
NHS braces are free in England for under-18s whose teeth score IOTN grade 3.6 or above. Your dentist checks this and refers you to an NHS orthodontist, and waits range from about six months to four years or more depending on the area. Most adults do not qualify. This guide covers each step and what to do if you don't qualify or can't wait.
NHS orthodontic treatment is free (or low cost) for eligible patients under 18 in England. Understanding the process in advance means you can move quickly at each stage and avoid common delays.
Check whether you or your child is likely to qualify
NHS orthodontic treatment in England is available to patients under 18 who have a clinical need score — the IOTN (Index of Orthodontic Treatment Need) — of DHC grade 3.6 or higher. Adults do not ordinarily qualify except in specific surgical or clinical circumstances.
Use an IOTN checker tool to get an initial indication of likely eligibility
Signs of higher IOTN scores include: teeth that significantly protrude, are deeply overlapping, severely crowded, or cause bite problems
Cosmetic concerns alone (e.g. slightly crooked front teeth) typically score lower and may not reach the eligibility threshold
Register with a dentist and attend a check-up
NHS referrals for orthodontic treatment come from a registered dentist (or, in some cases, a doctor or school dental service). You must be registered with an NHS dentist and attend for a check-up before a referral can be made. Your dentist will assess your teeth and determine whether a referral is appropriate.
Register with an NHS dentist via NHS.uk/find-a-dentist if you are not already registered
Attend regularly — your dentist monitors dental development and can identify the right time for referral
For children, NHS dentists typically monitor erupting teeth from around age 7–10 and refer when the time is right
Receive a referral to an NHS orthodontic service
If your dentist agrees that you meet the IOTN threshold and NHS treatment is appropriate, they will make a referral — usually to a local NHS orthodontic department at a hospital, a community dental service, or a primary care orthodontic practice contracted by the NHS. The referral is typically made electronically or by letter.
Ask your dentist to confirm the IOTN score they have recorded
In some areas, practices accept direct self-referrals — ask whether an NHS orthodontist accepting patients near you can receive referrals directly
If you believe the clinical threshold is met but your dentist has not referred, you can ask for clarification or seek a second opinion from another NHS dentist
Wait for your triage or consultation appointment
After the referral is received, you will be triaged and added to a waiting list. Waiting times vary significantly by region. Areas with high demand and limited NHS orthodontic capacity can have waits of four years or more. The NHS has national guidance on waiting times, but provision is not uniform across the country.
You can ask for an approximate waiting time when the referral is made
If you move area after being referred, you may need to re-refer — confirm this with the receiving service
Some families choose private braces while waiting for NHS treatment to avoid delays, particularly for time-sensitive cases in growing children
Attend the orthodontic assessment appointment
At your assessment appointment, the orthodontist will take a full set of clinical records: dental photographs, X-rays (OPG and lateral ceph), and sometimes a 3D scan. They will confirm the IOTN score and whether NHS treatment is appropriate, and discuss the proposed treatment plan with you.
Bring any existing dental X-rays if available — it may save having to repeat them
Ask about the proposed treatment type, expected duration, and what is included
If IOTN is confirmed and NHS treatment is agreed, you will be placed on the active treatment waiting list
NHS treatment begins: fitting and active phase
When your position comes up on the treatment waiting list, you will be called in for the fitting appointment. NHS treatment typically uses fixed metal braces. The active treatment phase runs from fitting to debond — usually 12–24 months with 6–8 week adjustment appointments throughout. All appointments, archwire changes, and retainers are covered by the single Band 3 NHS charge of £332.10 (2026 rate in England).
The Band 3 charge (£332.10 in 2026) covers the full course of treatment, not individual appointments
Certain patients are exempt from NHS charges: under-18s in full-time education, pregnant women, and those on qualifying benefits
If you fail to attend appointments without good reason, the orthodontist may discharge you from NHS treatment
Retention phase
When the brace is removed (debond), retainers are fitted or provided as part of the NHS treatment. Consistent retainer wear is essential to maintain results. Most NHS orthodontists recommend nightly removable retainer wear long-term, and may also fit a fixed retainer bonded behind the front teeth.
Retainers are included in the NHS Band 3 fee
Replacement retainers may be chargeable if lost or damaged through non-compliance
Wear retainers as instructed — without them, teeth will drift back over time
IOTN at a Glance
The Index of Orthodontic Treatment Need (IOTN) is the clinical scoring system used to assess NHS eligibility. It has two parts — the Dental Health Component (DHC) and the Aesthetic Component (AC). NHS treatment is generally available to patients scoring DHC grade 3.6 or higher.
| IOTN DHC Grade | Description | NHS eligible? |
|---|---|---|
| Grade 1 | No treatment need | No |
| Grade 2 | Little treatment need | No |
| Grade 3 | Moderate need — borderline | Borderline (3.6+ only) |
| Grade 4 | Great treatment need | Yes |
| Grade 5 | Very great treatment need | Yes |
What if I don't qualify or don't want to wait?
If your IOTN score is below the NHS threshold, or if NHS waiting times in your area are too long, private treatment is the usual route. Private orthodontic treatment is available to anyone regardless of age or IOTN score.
No waiting list — appointments typically available within days to weeks
Wider range of treatments — ceramic braces, lingual braces, clear aligners
0% payment plans available at most practices — spread cost over 12–24 months
Photo-based assessments allow you to get indicative costs before committing to a consultation fee
Not sure where to start? Use these quick links to explore orthodontic treatments, typical costs, and helpful guides that explain what different options involve. Whether you're researching braces or clear aligners, comparing pricing, or just getting a feel for what comes next, you can browse at your own pace and come back when you're ready to request a quote.
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