Northern Ireland

Free orthodontic treatment for children could be about to end

Braces on teeth
Image caption Parents may now have to pay about £2,000 for their children's braces

Parents of children who require braces could be expected to pay for the NHS service under new proposals by the Department of Health.

They include introducing a grading system which will determine if a child's teeth are bad enough in order to be given free treatment.

If not, the child's teeth will remain untouched unless parents are prepared to pay for the service themselves.

That bill could be at least £2,000.

Last year more than 20,000 people in Northern Ireland had orthodontic appliances fitted. With slimmer bands now the norm - visiting the orthodontist is no longer taboo.

But new regulations could make it much tougher for young people to get that perfect smile.

In December last year, the health minister told the assembly that a number of measures could be introduced which would address the pressures on the dental services budget.

They included removing those treatments that are more cosmetic.

Looking at how often patients would have their teeth scaled or polished and introducing a scoring system to gauge whether or not patients were entitled to free orthodontic treatment.

The new arrangements would also include a scoring system based on an internationally recognised index which rates the severity of cases from one to five.

Grade one teeth would be rated as almost perfect.

By grade three a person would have some irregularities which would not create any health issues.

Grade four and five would show protruding, even crooked teeth, triggering severe dental health problems.

At the moment people who reach grade three are entitled to a brace - in the future people in Northern Ireland would have to reach grades four and five.

In England, however, young people have only to reach grade three.

Unfair treatment

Stephen McKenna runs an orthodontic clinic on Belfast's Ormeau Road. He said that inconsistency was unfair.

"The criteria for selection of NHS orthodontic cases in Northern Ireland is likely to be made more stringent," he said.

"These cases, over in Birmingham, for example, are likely to get health service funding. Similar cases in Northern Ireland will not. I don't think that's fair."

Orthodontist James Lundy runs a practice in south Belfast. He said the new assessments would disappoint some of those needing treatment.

"I think there is going to be a problem for a group of children who have moderate orthodontic problems.

"In the past they would have been eligible for treatment but under the new arrangement they no longer will.

"As a practice we expect these patients to be disappointed in the outcome of the assessment."

The chief medical officer was not available for interview but in a statement to the BBC said future changes would mean those in "greatest need being prioritised".

The statement added that there would be some discretions - but those cases would have to be approved before treatment can commence.

The move would also require legislation being introduced in the assembly.

The British Dental Association said the move would only discriminate against those children whose parents cannot afford to provide them with a healthy smile.