Short answer
Can adults get braces on the NHS?
Usually not. NHS orthodontic treatment is free for under-18s who meet the clinical threshold set by the Index of Orthodontic Treatment Need (IOTN). Adults are only occasionally treated on the NHS, usually in hospital for severe problems, and NHS charges apply unless you are exempt. Most adults in London pay privately, from around £2,650–£3,650.
The Index of Orthodontic Treatment Need (IOTN) is the scale NHS orthodontists use to grade how much a person’s teeth and bite need treatment for health reasons. It decides who qualifies for NHS braces.
Many people assume braces are free on the NHS. For children with a real clinical need that is often true, but for adults the picture is very different. This guide explains who qualifies for NHS orthodontic treatment, how eligibility is assessed, what adults can expect, and the private options if you don’t qualify.
Key takeaways
- NHS orthodontic treatment is free for under-18s who meet the clinical threshold.
- Eligibility is assessed with the Index of Orthodontic Treatment Need (IOTN).
- Adults are only occasionally treated on the NHS, usually in hospital for severe problems, and NHS charges apply unless exempt.
- Most adults in London choose private treatment, from around £2,650–£3,650 depending on the appliance and location.
Who gets NHS orthodontic treatment?
The NHS provides orthodontic treatment where there is a health need, not for purely cosmetic reasons. To decide who qualifies, NHS orthodontists use the Index of Orthodontic Treatment Need (IOTN). It has two parts:
- The Dental Health Component grades the severity of problems such as overjet (protruding front teeth), crossbites, crowding, missing or impacted teeth, from grade 1 (little need) to grade 5 (great need).
- The Aesthetic Component scores how the teeth look on a scale of 1 to 10, by comparison with a set of reference photos.
In general, under-18s qualify for NHS treatment if they score grade 4 or 5 on the Dental Health Component, or grade 3 with an Aesthetic Component of 6 or more. Children who fall below that line can still have private treatment.
Next step
Get matched with a London orthodontist
Tell us what you are looking for and one vetted, GDC-registered practice will contact you to arrange a consultation.
Request a consultationCan adults get braces on the NHS?
NHS treatment for adults is limited. There is no automatic right to braces as an adult, and most adult orthodontic treatment in England is private. Adults may be treated on the NHS when there is a significant clinical problem, for example:
- A severe jaw discrepancy that needs orthodontics combined with jaw (orthognathic) surgery.
- Problems caused by injury, or certain conditions such as cleft lip and palate.
- Cases where orthodontics is needed to support other dental treatment.
These cases are usually seen by a consultant orthodontist in a hospital department after a referral from your dentist. If you are treated as an adult on the NHS in England, NHS dental charges apply (orthodontic treatment falls under the Band 3 charge) unless you are exempt, for example because you are pregnant, have had a baby in the last 12 months, or receive certain benefits. Check the current charge and exemptions on nhs.uk.
How long are NHS orthodontic waiting lists in London?
Demand for NHS orthodontics is high in many parts of London, and waits for assessment and treatment can be long, particularly for hospital-based care. Waiting times vary by area and by service, so ask your dentist or the orthodontic service for an estimate. Some families choose private treatment for a child who qualifies for the NHS simply to avoid the wait.
If your child just misses the NHS threshold
It is common for a child to be assessed as “borderline”. In that case, ask the orthodontist whether the need might increase as more adult teeth come through, and whether a review in 6 to 12 months makes sense. If the problem is mainly cosmetic and unlikely to change, private treatment is the alternative. Private fees for children in London start from around £2,500 for metal braces in outer London, based on published prices, and interceptive (early) treatment from around £1,200. A private consultation will tell you what is needed and what it would cost before you commit.
How do you find out if you qualify?
- See your general dentist. They can check your teeth and refer you if they think you may meet the criteria.
- NHS orthodontic assessment. An orthodontist assesses you using IOTN and tells you whether you qualify.
- If you do not qualify, you can ask for a private consultation to discuss options and costs.
Private options and costs
If you do not qualify for NHS treatment or do not want to wait, private orthodontics offers more choice of appliance, including discreet options like ceramic braces, lingual braces and clear aligners. One London orthodontic group publishes these adult “from” prices:
| Adult treatment (private) | Central London, from | Outer London, from |
|---|---|---|
| Metal braces | £3,650 | £2,800 |
| Clear (ceramic) braces | £4,000 | £3,150 |
| Invisalign aligners | £2,650 | £2,800 |
| Lingual braces | £9,870 | £4,800 |
Source: The London Orthodontic Group published fee guide (londonlovesbraces.com), checked 4 October 2026. "From" prices; your quote depends on your case.
See our London braces cost guide for what drives these prices and the extras to check, and our guide to adult braces for help choosing an appliance.
Paying for private treatment
Many London practices offer monthly payment plans, and some offer interest-free credit through a lender, subject to status. Check the total amount payable and what is included, especially retainers and any extra aligners.
NHS vs private: the main differences
| NHS | Private | |
|---|---|---|
| Who can have it | Mainly under-18s who meet the IOTN threshold; limited adult cases | Anyone suitable, any age |
| Cost | Free for eligible under-18s; Band 3 charge for adults unless exempt | Typically from about £2,650–£3,650 in London for adults; more for lingual |
| Choice of appliance | Usually metal fixed braces | Metal, ceramic, lingual or clear aligners |
| Waiting time | Can be long in parts of London | Usually weeks rather than months |
| Cosmetic-only cases | Not treated | Treated |
Beware of shortcuts
If NHS treatment isn’t available, it can be tempting to try cheap remote aligner kits with little or no in-person supervision. Professional bodies recommend an in-person examination before any orthodontic treatment, because moving teeth with undiagnosed gum disease or decay can cause lasting damage. Whatever route you take, make sure a GDC-registered clinician has examined you and is overseeing your treatment.
Ready to explore private options? Request a match with a vetted, GDC-registered London practice, or read more about orthodontists in London.
Frequently asked questions
Are braces free on the NHS?
Is NHS orthodontic treatment free for adults?
What IOTN score do you need for NHS braces?
Can I get NHS braces at 18?
Sources
Facts and prices in this guide come from the following sources (checked 4 October 2026):
- nhs.uk (nhs.uk)
- londonlovesbraces.com (londonlovesbraces.com)
Related guides
Next step
Get matched with a London orthodontist
Tell us what you are looking for and one vetted, GDC-registered practice will contact you to arrange a consultation.
Request a consultationThis guide is general information, not clinical advice. Treatment suitability, length and cost can only be confirmed by a GDC-registered dentist or specialist orthodontist after an examination.