NHS orthodontics

An Initial examination and assessment is available on the NHS for all patients under the age of 18. Orthodontic treatment for patients over 18 years of age is only provided under private contract. In order to justify NHS funding, there must be a definite benefit to the treatment in terms of improving dental health or appearance. Once referred Nicki will assess each patient in order to determine the need for treatment.

Please use our NHS referral form.

For more guidance please refer to the information below.

Referring patients for orthodontic opinion – extract from Avon Dental News, issue seventeen, December 2008

A frequent dilemma concerns the best age or stage to refer a young and growing patient to an orthodontist. Several factors may influence this decision.

    Dental factors. What adult teeth are present? What sort of problem is it?
    Psychological. Parents or patients may be anxious about teasing at school and may understandably press for early treatment
    Logistical. A long waiting list for orthodontic treatment may influence a decision to refer earlier than otherwise would be the case.

In a growing person, the large majority of patients are not ready for planning or carrying out treatment until almost all the adult teeth have come into the mouth. A good guide is to refer when the four first premolars have erupted.

The age for this varies but averages 11 years. A few specific problems are best dealt with at an earlier age: an incisor in crossbite with a mandibular displacement and an upper canine tooth which cannot be palpated at ten years of age are two good examples.

A particular problem can arise when orthodontic waiting lists are known to be long. Although the situation varies on a local and national scale most areas of the country have waiting lists.

This problem has no instant or easy solution, but one factor which can worsen the situation is inappropriate early referral. Referrers may feel that if there will eventually be a long wait, then early referral will get the patient in the pipeline and help them to be treated as soon as the dental development permits. However, this exacerbates the backlog by creating unnecessary consultations.

In addition, if the orthodontist decides to review the patient at intervals before they will be ready for planning and treatment, this can compound the problem. It also places the orthodontist in an awkward position when the patient comes back after several reviews and is indeed now ready for treatment, because the orthodontist has to explain that they must now wait to start because to let them jump the queue would be unfair to those patients who were referred at an appropriate age and now have to wait. The best way for the orthodontist to avoid this awkwardness and potential unfairness is to deal with early referrals by asking the refer to rerefer when the first premolars are through.