Children dropping off NHS orthodontic waiting lists, going without treatment due to long waiting lists

Hundreds of thousands of children are waiting for NHS orthodontic assessments, but what happens when your child either doesn’t qualify for treatment or faces a lengthy wait?

The latest statistics published in the British Dental Journal show that over 350,000 children were waiting for an NHS orthodontic assessment in England, over 220,000 had been waiting longer than 18 weeks and over 140,000 had been waiting more than 52 weeks.

The longest recorded wait was 6.6 years and only one Integrated Care Board met the NHS 18-week standard for orthodontic assessments.

In addition, The British Orthodontic Society says that there is “a mismatch between demand and provision”, resulting in waiting lists in most areas because NHS funding is limited.

Beyond the impact on their oral health, how is the lack of treatment affecting their mental health and emotional wellbeing?

Dr Alex Seijas, from The London Orthodontic Clinic explained what he is seeing in-clinic: “I see first-hand every week the impact that long NHS orthodontic waiting times are having on children’s mental health and wellbeing. Many parents come into my practice feeling beside themselves with worry after years of waiting, watching their child’s confidence and self-esteem decline while they remain on a treatment list.

“We are seeing teenagers who are being bullied, teased and made to feel self-conscious about their teeth, and the emotional impact of this can be profound. A child’s smile is such an important part of their identity during their teenage years, and when they feel embarrassed to smile, speak or socialise, it can affect their confidence at a time when they are already navigating huge changes.”

“The latest figures are deeply concerning, with hundreds of thousands of children waiting for NHS orthodontic assessments and many waiting two to three years. I’ve heard of some teenagers waiting up to six years, by which point the child will turn 18 and they’re no longer eligible for help. These delays are not just a clinical issue; they are affecting real children’s lives.

“Many parents who come to see me have spent years on NHS waiting lists and often haven’t considered private orthodontic treatment because they assume it will be unaffordable or simply out of reach. In reality, there are now more flexible and accessible options available than many families realise. It’s important that parents understand they do have choices and seek advice early, rather than feeling they have to wait indefinitely while their child’s confidence suffers.”

When teasing at school caused Rebecca to hide her smile, her parents turned to early orthodontic care. What followed transformed far more than her teeth. When Rebecca came home from school in tears, her mother Nadia knew something had changed.

A classmate had joked that she did not need a costume for the school party because she already looked like a bunny. Her two front teeth were protruding and sitting apart.

“She came home crying, asking me, Mum, do I look like a bunny?” Nadia recalls. “Whilst I reassured she didn’t, we realised we needed to do something as she began hiding her smile, and she was only seven.”

Many parents will recognise the dilemma. Children become self-conscious, teased or bullied long before NHS orthodontic treatment is available. For Nadia and her husband, waiting years while she endured the painful comments was not an option.

When waiting is not the right answer
Rebecca’s jaw had begun to shift forward, and her two front teeth were noticeably misaligned. After the incident at school, the family went straight to the NHS. The response was familiar. She was too young.

It was considered cosmetic. Treatment could wait. “But she was clearly very unhappy,” Nadia said. “This was not about looks. It was significantly affecting her emotionally.”

A friend recommended the London Orthodontic Clinic and at her first appointment, Dr Alex Seijas, who has a special interest in treating young people with early intervention orthodontic treatments,asked questions that surprised them. Did Rebecca snore? Did she sleep with her mouth open? “We had noticed that,” Nadia says. “But we never realised it could be connected to her jaw or her teeth. We were shocked that something like that could affect her breathing.”

Dr Seijas explained that without early intervention, Rebecca might require jaw surgery as a teenager. Acting while she was still growing could guide her jaw development and avoid more invasive treatment later. Nadia says. “The clinic reassured us that this was the best course of action and we feltshe was in safe hands.”

A treatment journey shaped around a child
Rebecca’s treatment began with twin blocks, a functional appliance that gently guides the jaw. It was not the colourful braces she had hoped for and the adjustment was difficult. “At the beginning she cried at night because it hurt a little,” Nadia said. “But she is amazing. She went through it knowing we were trying to help her.” As her jaw position improved, fixed braces were added to align her two front teeth. This stage delighted Rebecca. She could choose the colours and finally felt she looked cool.

The next step was treatment – a system of clear removable aligners that gradually straighten teeth. The practical advantages became clear almost immediately. For Nadia, the contrast between braces and aligners was striking. “With the traditional braces I could see food hanging from her teeth at mealtimes,” she said.

“It was difficult for her to clean them properly with her little hands.”  Aligners removed that problem entirely. “You take them out, wash them and put them back in. It is simple and so much cleaner for a child.”

The clinical team also explained that aligners would move her teeth more quickly. Once Rebecca understood this, she embraced them. She kept her aligners in a pink case, reminded her parents when it was time to change to the next set on a weekly basis and checked her progress through an app, which allows patients to track their treatment journey. “We had the dates on our shared calendar and still forgot sometimes,” Nadia laughed. “But Rebecca never did!”

Dr Alex added: “Taking a phased approach is not unusual, however this treatment can now all be accomplished using the Invisalign system, as new innovations have been introduced since I treated Rebecca.

“Mandibular Advancement with Occlusal Blocks uses clear aligners with built-inblocks added to the soft polymer of the aligners to gradually move teeth while gently advancing the lower jaw at the same time. It’s designed to correct protruding teeth and improve jaw alignment without the need for traditional functional appliances. It is significantly more comfortable, and has all the benefits of a removable appliance”

Confidence returning one stage at a time
The change in Rebecca has been tangible. “Treatment has been a real boost for her confidence,” Nadia said. “Now when we take pictures she really smiles. She shows off her smile. She is proud of it.”

Teachers and other parents asked about her treatment throughout, and Rebecca happily explained it, showing the progress.” Her sleep also improved. Before treatment she slept with her mouth open and snored. Now she sleeps comfortably with her mouth closed. Nadia describes the change as remarkable.”

The family really appreciated the flexibility of the clinic. Appointments were arranged around school commitments, and if something unexpected happened, such as a brace breaking, Rebecca was seen promptly. “I do not think we would have been able to change dates like that on the NHS,” Nadia said. “The flexibility made life much easier.”

Rebecca is now 11 years old and wearing clear retainers while her final adult teeth come in. She may need a short second phase of treatment, but the major transformation has already taken place. She is no longer hiding her smile, and the confidence she lost as a seven-year-old has returned.

When asked what she would say to other parents, Nadia does not hesitate. “If you can help your child now, why wait? Rebecca’s jaw is aligned, she sleeps better, no longer snores, and she is smiling again. She is not hiding anymore.” For her family, early treatment changed far more than her teeth. It gave a little girl her confidence back.