NHS assessment criteria
If your child qualifies for treatment and is ready for treatment (i.e. have all adult teeth and do not need any teeth removed) then you will be placed on our waiting list. Once your child is ready for treatment, you will attend the practice for further scans and have the brace fitted. If your child does not qualify, we can still offer you treatment but this will be on a private basis.
The IOTN scale is split into two components: Dental Health and Aesthetic. To be eligible for free NHS treatment, the overall score must be 3.6 or higher. The first number relates to the Dental Health component and the second to the Aesthetic component.
Grade 1 – No treatment required
- Extremely minor malocclusions, including displacements less than 1 mm
Grade 2 – Little need
- Increased Overjet > 3.5 mm but <= 6 mm (with competent lips)
- Reverse overjet greater than 0 mm but <= 1mm
- Anterior or posterior crossbite with <= 1mm discrepancy between retruded contact position and intercuspal position
- Displacement of teeth > 1mm but <= 2mm
- Anterior or posterior open bite > 1mm but <= 2mm
- Increased overbite >= 3.5mm (without gingival contact)
- Pre normal or post normal occlusions with no other anomalies. Includes up to half a unit discrepancy
Grade 3 – Borderline need
- Increased overjet > 3.5 mm but <= 6 mm (incompetent lips)
- Reverse overjet greater than 1 mm but <= 3.5mm
- Anterior or posterior crossbites with >1mm but <= 2mm discrepancy between the retruded contact position and intercuspal position
- Displacement of teeth >2mm but <=4mm
- Lateral or anterior open bite > 2mm but <= 4mm
- Increased and incomplete overbite without gingival or palatal trauma
Grade 4 – Treatment required
- Increased overjet > 6mm but <= 9 mm
- Reverse overjet > 3.5 mm with no masticatory or speech difficulties
- Anterior or posterior crossbites with > 2 mm discrepancy between the retruded contact position and intercuspal position
- Severe displacements of teeth > 4
- Extreme lateral or anterior open bites > 4 mm
- Increased and complete overbite with gingival or palatal trauma
- Less extensive hypodontia requiring pre-restorative orthodontics or orthodontic space closure to obviate the need for a prosthesis
- Posterior lingual crossbite with no functional occlusal contact in one or more buccal segments
- Reverse overjet > 1 mm but < 3.5 mm with recorded masticatory and speech difficulties
- Partially erupted teeth, tipped and impacted against adjacent teeth
- Existing supernumerary teeth
Grade 5 – Treatment required
- Increased overjet > 9 mm
- Extensive hypodontia with restorative implications (more than one tooth missing in any quadrant requiring pre-restorative orthodontics)
- Impeded eruption of teeth (apart from 3rd molars) due to crowding, displacement, the presence of supernumerary teeth, retained deciduous teeth, and any pathological cause
- Reverse overjet > 3.5 mm with reported masticatory and speech difficulties
- Defects of cleft lip and palate
- Submerged deciduous teeth
Aesthetic Component
This is a ten-point scale, illustrated by a series of photographs which show the full range of grades through different levels of dental attractiveness. A rating is allocated for overall dental attractiveness, rather than specific similarities to the photographs.
The final value reflects the treatment need on the grounds of aesthetic impairment, and by implication the socio-psychological need for orthodontic treatment.
Patient testimonials
