NHS Braces vs Private Orthodontics

Orthodontic treatment in the UK uses braces, aligners and other devices to move teeth into better positions. It can be used to correct crowding, spacing, protruding teeth and bite problems such as overbites or underbites.

Treatment is carried out by orthodontists - dental specialists who have completed additional postgraduate training beyond a general dentistry degree.

Types of orthodontic appliance include:

NHS orthodontics in England is mainly available to under-18s whose teeth score highly enough on the Index of Orthodontic Treatment Need (IOTN). Adults can access NHS orthodontics in limited circumstances, but eligibility is much more restricted.

Eligibility is assessed using the Index of Orthodontic Treatment Need (IOTN). This is a clinical scoring system that rates dental health need on a scale of 1 to 5. Grades 4 and 5 qualify automatically. Grade 3 qualifies only with an aesthetic component score of 6 or above - a bare grade 3 is borderline and does not automatically qualify.

IOTN grades are broadly:

An NHS-contracted orthodontist will carry out the IOTN assessment, usually following a referral from a general dentist.

Accessing NHS orthodontics usually follows these steps.

Your general dentist will assess your teeth and, if they think orthodontic treatment may be appropriate, refer you to an NHS orthodontist. You cannot usually self-refer for NHS orthodontics.

An orthodontist will assess your IOTN score. Grades 4 and 5 qualify automatically; grade 3 qualifies only with an aesthetic component score of 6 or above. If your score does not meet the threshold, you will be advised to consider private treatment if you wish to proceed.

NHS orthodontic waiting lists vary significantly by area. In some parts of England, waits can exceed two years. If your child is assessed young, ask about local waiting times - treatment often needs to start at a specific stage of dental development.

Once called from the waiting list, treatment typically starts with the fitting of braces. Most NHS orthodontic treatment takes between 18 months and two years to complete.

NHS orthodontic treatment is free for eligible patients under 18. For the small number of adults approved for NHS orthodontics who are not otherwise exempt, it is charged as an NHS Band 3 course of treatment - currently £332.10. This single charge covers all appointments, adjustments, and the first retainer, plus 12 months of supervised retention.

Private orthodontic treatment in the UK typically costs £1,500-£6,000 or more, depending on the type of brace and how complex your case is. Patients who do not qualify for NHS treatment, or who prefer not to wait, have a wide range of private options. Prices are indicative and vary by region, complexity and whether one or both arches are treated.

Fixed metal braces are the same type as those used on the NHS and are the most cost-effective private option, typically starting from around £1,500-£2,500.

Ceramic or clear fixed braces use tooth-coloured brackets instead of metal, making them less visible. These typically cost £2,000-£5,000.

Lingual braces are fixed to the back of the teeth and are barely visible from the front. They typically cost £3,000-£6,000 or above.

Clear aligners (such as Invisalign) use a series of custom-made removable trays to gradually move teeth. They are popular with adults who prefer a discreet option. Costs vary significantly by case complexity, typically ranging from £2,000-£5,500.

If your child is under 18 and has a genuine orthodontic need, it is usually worth pursuing an NHS referral first. Even if NHS treatment is available, some families choose to go private to access shorter waiting times or a wider choice of brace type.

If your child scores below the IOTN threshold, NHS treatment will not be available regardless of how their teeth look. If they do qualify, the main reason to consider going private is waiting time - a long NHS wait can affect when treatment starts, and timing matters for younger patients.

If you have a preference for a specific brace type, such as clear aligners, you will need to go privately. Most practices offer payment plans, which can make the cost more manageable.

This guide summarises publicly available information from UK health authorities. Sources consulted: