Eligibility for free-of-charge NHS orthodontic treatment is based on the severity of the malocclusion measured using the Index of Orthodontic Treatment Need (IOTN), and on the age of the patient.

The severity of the malocclusion is measured using IOTN. This is a rating system consisting of 5 grades, ranging from ‘no need for treatment’ to ‘severe need for treatment’. In order to accurately grade a malocclusion using IOTN the clinician should be trained and calibrated to use the Index.

Not all dentists making referrals are calibrated to use IOTN so an orthodontic referral guide has been developed, to make the referral process easier for dentists not familiar with IOTN. This form can be laminated and kept in the surgery as a handy guide.

You can download your copy of the BOS referral guide using the link at the bottom of the page.

Most orthodontists working in primary care can only provide orthodontic treatment for patients under the age of 18. Patients over 18 with severe malocclusions may be eligible for orthodontic treatment in the Hospital Orthodontic Service (secondary care).

If you are not sure whether your patient is eligible for NHS orthodontic treatment you should make the referral and the orthodontist will make the final assessment.