A generation of British children will be left with crooked teeth under government cost-saving proposals. The Department of Health is planning to put a stop to the childhood rite of passage of wearing braces and tramlines to straighten teeth, The Observer can reveal.
Dentists warn that 50,000 children a year will be denied treatment, leaving them prone to bullying, low self-confidence, and oral health problems later in life. Only children with severely deformed teeth will still get free treatment on the NHS.
At present it is up to the general dentist or specialist orthodontic dentist to decide what treatment a child needs, if any. However, under the government plans they will be allowed only to treat children with such crooked teeth that they endanger their health - for example if they have buck teeth that stick out so far they are in danger of being knocked out.
All other children, who presently receive free treatment on the NHS, will have to go private, with the average cost of treatment being £3,000. The British Orthodontic Society estimates around half of the estimated 100,000 children who currently receive corrective treatment would no longer be entitled to it.
The cutbacks - outlined in a document called 'Modernising Orthodontic Services' - are aimed at controlling the cost of corrective treatment as parents become more insistent on their children having perfect teeth. The total cost of orthodontic treatments has doubled to £80 million in the past six years.
The rationing has caused fury among patient groups. Mike Stone, director of the Patients Association, said: 'It's very bad news for children with problem teeth. It's not just down to cosmetics - buck teeth lead to teasing and bullying. It's also short sighted. If kids aren't having teeth sorted, it will lead to greater problems later in life.'
Jonathan Sandler, spokesman for the British Orthodontic Society, said: 'For many families, the cost of private treatment is out of the question. Without a doubt there will be a reduction in treatment. There will be a large number of children who have to put up with disfiguring teeth. We are opposed to any form of rationing.'
British children are known for having wonky teeth. In the US - which is about 10 years ahead in the use of orthodontic dentistry - dentists refer to the condition of having crooked teeth as 'English mouth'. Sandler said: 'Any parent whose child has crooked teeth and is teased on a daily basis would want it done. There are going to be thousands of angry middle-class parents.'
The Government had planned to introduce the rationing in April 2001, but it is likely to be postponed for a year, giving time to train dentists to identify how crooked teeth need to be before they qualify. Britain has about 1,000 orthodontic dentists, with half the 16,000 general dentists also practising corrective treatment.
A Department of Health spokesman said the rationing of treatment was not about saving money, but about targeting resources more effectively. The rising demand for orthodontics had led to long delays, with children waiting up to two years for treatment.
The spokesman said: 'The proposals are aimed at ensuring resources are used more effectively and that waiting times for those most in need are significantly reduced. Clinical opinion within the orthodontic community is now questioning the health gain of treating some minor conditions.'
However, the department document makes clear the proposals will slow the growth in the cost of orthodontic treatment. It projects that by the third year, the rise in costs will be brought back in line with that of dental services as a whole.
