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We understand that discharge before your treatment is complete can be a disappointment, but your journey isn’t necessarily over.

Here we’ll explain why you’ve been discharged and your next steps.

For patients who do not wish to go ahead with treatment or are not motivated and cooperative to have treatment:

Orthodontic treatment requires motivation, commitment and consent (permission). We cannot proceed with a treatment plan for those that do not wish to be treated. If you/your child changes their mind in the future, we are more than happy to see you to do a reassessment at a later date. This will require a referral from your dentist to the Dental Referral and you will be on the central waiting list.

For patients who do not qualify under IOTN grading:

The NHS has strict guidelines on the orthodontic treatments available according to your IOTN (Index Of Treatment Need) score. If your score means that your case is not severe enough to qualify for NHS treatment, we may offer you alternate options including no treatment or if you are keen, affordable private treatment options to help you correct your tooth alignment.


For patients with a very high caries risk diet and/or multiple decayed teeth:

If, during your assessment we’ve noticed that you are at high risk of tooth decay or already have cavities present it is not a good idea to start orthodontic treatment. Braces make cleaning more difficult and can provide a breeding ground for the bacteria that cause decay. We’d recommend visiting your dentist to obtain advice and treatment before having orthodontics. In these cases the risks often outweigh the benefits from possible orthodontic treatment.

For patients with very poor oral hygiene with or without permanent marks on teeth:

Wearing braces – especially fixed braces – can make cleaning tricky. Plaque and tartar can become a breeding ground for bacteria that cause tooth decay and for those patients that aren’t already up-to-scratch with their oral hygiene routine, this can lead to further problems. Your risk for developing permanent white or brown spots will be higher than the benefit of having orthodontic treatment. We’d recommend visiting your dentist/hygienist to obtain all the oral hygiene instructions required to build healthy cleaning habits so that you can return for a reassessment when stable. This will require a referral from your dentist to the Dental Referral and you will be on the central waiting list.

For patients that have significant additional needs that may not allow them to cope with treatment:

We understand that orthodontic treatment isn’t suitable for everyone, and occasionally it is ethically correct to discharge patients when distress outweighs the benefits of treatment. Please feel free to speak with our orthodontic specialists who will guide you as to any alternative options.

For patients that have significantly short roots of teeth may compromise the long term prognosis of these teeth:

During your assessment you will have had radiographs (x-rays) taken. These are used – amongst other things – to assess the roots of your teeth. If this has shown that you/your child have particularly short roots this can be an indication that treatment will not be suitable. Orthodontic treatment places a small amount of pressure on the teeth in order to move them into a new position. With shorter roots there is a chance of further resorption due to the movement and this may result in making those teeth wobbly. We will happily discuss this fully and will present you with any alternative options that are appropriate.

In the event of NHS discharge, we will inform your dentist securely via the Dental Referral Portal. If you/your child require follow up treatment with your dentist, it is your responsibility to make an appointment with them for treatment.

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