A guide for parents
Many parents remember a time when it felt like almost every child had braces on the NHS. If you grew up in the 1990s or early 2000s, that may well have been your experience.
Today, NHS orthodontic care still plays a vital role in children’s dental health — but the rules around who qualifies are now much stricter. This can sometimes feel confusing or disappointing for families, so we wanted to explain how the process works and what your options are.
Our aim is always to be open, fair and supportive so you can make informed decisions for your child.
How the orthodontic journey usually starts
Orthodontic conversations often begin during a routine dental check-up.
At this visit, the dentist will:
- Look at how your child’s teeth are developing
- Check how the teeth meet (the bite)
- Identify concerns such as crowding, protruding teeth or crossbites
- Carry out a basic orthodontic assessment
If orthodontic treatment may be beneficial, we will discuss this with you and may move to the next stage.
Records and Treatment Coordinator visit
Your child may then be booked with our Treatment Coordinator for further records. This can include:
- Photographs
- Digital scans or impressions
These records allow us to carefully review each case.
Clinical review
The records are then reviewed by our dentist Jayne who has diploma in orthodontics.
At this stage, we determine whether your child:
- Qualifies for NHS orthodontic treatment, or
- Would be more suited to private treatment options
We always explain our findings clearly so parents understand the reasoning.
How NHS eligibility is decided
NHS orthodontic treatment in Scotland is provided based on clinical need, not cosmetic preference.
A national scoring system called the Index of Orthodontic Treatment Need (IOTN) is used. This measures how severe the bite problem is and whether treatment is necessary for dental health.
In simple terms:
- Only children with moderate to severe orthodontic problems qualify
- Mild crowding or cosmetic concerns alone usually do not qualify
- Good oral hygiene and commitment are essential. Because of these rules, fewer children now meet NHS criteria compared to decades ago.
If your child qualifies for NHS care
That’s positive news. We will:
- Explain the treatment plan
- Discuss likely timescales
- Offer an NHS orthodontic appointment when available
NHS orthodontics provides excellent clinical care, but waiting lists can sometimes be long due to high demand.
Why some families choose private orthodontic treatment
Even when a child qualifies for NHS orthodontics, some families still explore private treatment.
This is not because NHS care is poor — NHS orthodontics delivers very good outcomes — but because the system works within specific rules and funding frameworks.
For example:
- NHS treatment plans must follow set clinical guidelines
- In some cases, this can mean tooth extractions are recommended to create space
- Dentists providing NHS orthodontics must work within NHS regulations
- NHS cases are always reviewed and approved by an NHS orthodontic advisor, not by Jayne. Jayne will be able to tell you, based on her scoring, if it is likely, borderline or highly unlikely to be approved.
These safeguards ensure fair and consistent use of NHS resources, but they can sometimes limit flexibility in treatment planning.
Private orthodontics allows more freedom in how a case is managed. This may include:
- Exploring non-extraction options where appropriate
- A wider range of brace systems or aligners
- More choice around aesthetics and treatment approach
That said, private treatment is not “easier” or “lighter.”
It still requires:
- Excellent oral hygiene
- Regular attendance
- Motivation and cooperation from the child
The success of orthodontics depends far more on commitment than on whether it is NHS or private.
If your child does not qualify for NHS care
If your child does not meet NHS criteria, we will explain this clearly and honestly.
Some families choose to leave things as they are, while others consider private options. Both decisions are completely valid.
Private options can include:
- Tooth-coloured fixed braces
- Clear aligner systems
- More discreet aesthetic choices
Our role is simply to present the options and support you — never to pressure.
Our philosophy
We never “sell” orthodontics. Our role is to:
- Give honest, evidence-based advice
- Explain NHS rules clearly
- Outline private options where relevant
- Support families in making the right decision
Every child is different. For some, orthodontics is important for long-term dental health. For others, monitoring growth and development may be the best approach.
A final thought for parents
If you are unsure whether your child might need braces, the best first step is simply to ask at your next check-up. Early guidance can help you understand what to expect as your child grows.
Orthodontics is a journey, and we are here to guide you through it with clarity and care.
