FAQs on accessing NHS orthodontic treatment for children
How has dental provision changed?
New NHS contracts for dentists in England and Wales were introduced in April 2006 to enable dental services to be funded and organised at a local level. Primary Care Trusts now have responsibility for commissioning services in their area. Only practices with contracts can provide NHS treatment.
What about specialist care, like orthodontics?
All orthodontists must also have an NHS contract in order to provide treatment and this is limiting availability, leading to longer waiting lists in many areas. Treatment criteria have been drawn up on the basis of the Index of Orthodontic Treatment Need to assess which cases should be treated on the NHS. Children who do not have a dental health need will not be treated
Why are there such long waiting lists?
The new contract was based on dentists’ earnings during a period between 2004 and 2005. Because orthodontic treatment typically takes one to two years the test period did not reflect the work the work that the practice was carrying out and would continue to carry out. This has caused problems for newer practices. The low contract value restricts the number of patients they can treat on the NHS and they have no option but to build the private side of their practice if they are to survive.
The British Orthodontic Society (BOS) would like all children who need treatment to be able to access it at the optimum time in their development, on average at about the age of 12. BOS would like new practices which are currently struggling with low contract values and long waiting lists to receive help and, in areas of shortages, additional services to be commissioned.
The Department of Health acknowledges that some orthodontic practices have had to carry out more treatment than they are being paid for in order to complete the cases started before April 1st. But it says it remains up to local primary care trusts to decide whether to allocate money to these cases.
So what does it mean for me if I want orthodontic treatment for my child?
It depends how badly your child needs orthodontics. According to the legislation, any child deemed by a specialist to need treatment is entitled to receive it. The criterion of need is based on the internationally recognised Index of Orthodontic Treatment Need (IOTN) although there is provision for individual cases falling below the official threshold to receive treatment if the treatment can be justified.
If your child is being refused treatment unfairly or placed on an unreasonably long waiting list, contact your Primary Care Trust. Use this link to help you find your nearest PCT:
http://www.nhs.uk/England/AuthoritiesTrusts/Pct/Default.aspx
So what do I do if my child’s treatment is no longer covered by the NHS?
If your child is not judged to have a dental health need, you may wish to seek private treatment. You can get recommendations from your dentist or the BOS website. It’s always a good idea to talk to others who have had orthodontic treatment and get personal recommendations too.
