Written question WQ92984

There are nationally agreed clinical criteria to determine eligibility for orthodontic treatment on a case-by-case basis. People must meet the requirements of the index of orthodontic treatment need (IOTN) and should be under 18 on the date of referral to be eligible for NHS treatment in primary care and normally 12 years of age when the adult dentition is formed.

There are historic complexities involved around the variation in waiting times for orthodontic treatment. In some instances, list sizes have been inflated through early, duplicate or inappropriate referrals and by other factors. Past inefficiencies in referrals have led to delays in orthodontic provision.

Wales is the first country in the UK to introduce electronic dental referrals across all dental specialities. The web-based system, funded by Welsh Government, allows general dental practitioners to refer patients to primary or secondary care for specialist care and further treatment electronically, including orthodontics. The system has replaced traditional paper referrals, minimising the risk of missing information or letters and tackling delays in patients’ treatment and enabling more people to receive care.

Inevitably, Covid-19 restrictions have led to increased waiting lists for many NHS treatments, including orthodontics. No new orthodontic case starts were able to commence from March to July 2020 and from July to December 2020 prioritisation of new cases was based upon whether delaying treatment would have a detrimental effect on the patient. Since December 2020, orthodontic providers have been asked to prioritise case starts for those people who have the greatest need, rather than use a ‘first come, first served’ approach. They have also been reminded to reduce the number of ‘assess and review’ cases, to ensure as much available capacity as possible is directed towards completions and prioritised case starts.

Finally, our latest stats release indicated that 2022-23 has the highest number of children undergoing orthodontic treatment on record. This shows that access to orthodontic treatment continues to be a priority.