What is the

IOTN ?
The Index of Orthodontic Treatment Need
(IOTN) is a rating system that’s used to
determine whether under 18s qualify for
NHS orthodontic treatment.

During your NHS assessment,

your IOTN certified orthodontist
will look at two aspects of your
teeth: your dental health and the
appearance of your smile. dental health appearance

The dental health component

NHS orthodontic treatment is designed to help patients
who need treatment to improve their dental health.
To find out if you’re eligible, your orthodontist will use a set of
measurements to give your smile a grade of between 1 and 5.

do not qualify for NHS treatment borderline do qualify for NHS treatment

1 2 3 4 5
If your teeth are borderline your orthodontist will assess the appearance
of your smile to decide whether you are eligible for NHS treatment.

NOT
ELIGIBLE

GRADE 1
Good news! Your teeth are practically perfect.

NOT
ELIGIBLE

GRADE 2
You have a minor irregularity and you won’t
be eligible for NHS orthodontic treatment.

Examples include:

Mild to moderate Mildly crooked or Mild open bite

prominence (overjet) crowded teeth

BORDERLINE

GRADE 3
You have a moderate irregularity, which may
require treatment for dental health reasons.

Examples include:

Moderate prominence and Moderately crooked Moderate open bite

lips that don’t rest together or crowded teeth

ELIGIBLE

GRADE 4
You have a more severe irregularity and
are entitled to NHS orthodontic treatment.

Examples include:

Severe prominence of Moderately to severely Missing teeth that require

between 6 and 9mm crooked or crowded teeth pre-restorative orthodontics or
space closure

ELIGIBLE

GRADE 5
You have a serious irregularity, which requires NHS
orthodontic treatment for dental health reasons.

Examples include:

Teeth that don’t have space Extensive missing teeth, i.e. Severe prominence of
to erupt naturally due to more than one tooth missing more than 9mm
crowding (not including in any quadrant
wisdom teeth)

The aesthetic component

If you receive a dental health grade of 3, your orthodontist will then
look at the appearance of your smile and give you a second score
of between 1 and 10. This is done using a set of ten images as a
reference point for ‘attractiveness’.

If you are given an aesthetic score of 6 or above, combined with a

dental health score of 3, you will be eligible for NHS treatment.

1 2

3 4

5 6

7 8

9 10

If you are eligible for NHS care, you might need to join a waiting
list before you can start your treatment. This is because orthodontists
are only given a limited amount of NHS funding each year.

If you don’t qualify for NHS treatment, your orthodontist will be

able to discuss self-funded private options with you.

www.totalorthodontics.co.uk/IOTN