Children face four-year wait to see orthodontists

Children are having to wait up to four years for NHS orthodontic treatment in Norfolk, industry figures have said.

They said the lengthy waiting lists were due to a complicated picture, including a local shortage of orthodontists, Covid-19 backlogs and historical NHS funding changes.

Dr Gautam Sharma, who owns West Earlham Dental Practice in Norwich, said it could take "two to four years" for children to be seen in the county as "we already know Norfolk is what they describe as... a dental desert, but orthodontists are specialist dentists... so not any dentist can do orthodontics".

The Department of Health and Social Care (DHSC) has been contacted for comment.

Orthodontic treatment can be carried out on children usually aged 12 and over, as well as adults.

Orthodontists, who have undergone further training after qualifying as general dentists, will treat patients to improve the alignment and appearance of their teeth, as well as to create a healthy bite, normally through attaching braces.

They will also see people with health issues, including cleft lips and palates.

NHS orthodontic treatment is free for people with definitive problems and who are under the age of 18 when referred, according to the NHS website.

Speaking to BBC Radio Norfolk's Chris Goreham, Sharma said orthodontic work was "limited by the amount of practices offering it and that have a specialist, but trying to keep that workforce in Norfolk is quite hard".

He added: "Covid has caused some delays [so] they're still trying to cope with a backlog, but also they've had a change in workforce, so there's a bottleneck of trying to get kids seen."

He said that although a dental school was due to open in Norwich in 2027, there were only 25 places available per year and it would take years for orthodontic patients to reap the benefits.

Dr Matthew Clover, from industry professional body British Orthodontic Society, said any shortage "boils down to money and the amount of money that is provided for orthodontics in the NHS".

The society's director of clinical practice said: "There is no shortage of workforce. There are plenty of willing orthodontists out there."

He explained the situation was the product of historical changes dating back to 2006 when the NHS stopped commissioning any further orthodontic provision, with contracts issued based on the annual number of patients seen by individual clinics.

In 2019, UK contracts were put out to tender and recommissioned, but in some areas including the East of England, the process stalled and contracts were not given out.

"Effectively, at that point, the number of patients able to be seen in the East of England was frozen - and with an increase in population and an increase in demand for orthodontics - that has resulted in an increase in... waiting time," said Clover.

He said orthodontic services were commissioned by NHS integrated care boards (ICBs).

New contracts were now available and so ICBs needed to review current demand and provision levels which would now decide the amount of funding, which Clover said he hoped would increase.

Trade organisation Association of Dental Groups has blamed a lack of dentists and a skills shortage for the issue, which has seen children being referred for the specialist treatment in Norfolk at the ages of eight or nine in anticipation of joining the years-long waiting lists.

Its executive chairman, Neil Carmichael, said the solution to the problem involved addressing three areas: more dental school places, more consideration of recruiting international dentists and better teamwork across the industry.

"About six million children have scarcely seen a dentist at all and that is a real scandal," the former MP said.

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