The British Orthodontic Society is deeply concerned by HMRC’s recent decision to remove orthodontic aligners from the list of VAT-exempt dental appliances. This change has significant implications for both patients and orthodontic practitioners, and risks increasing the cost of orthodontic treatment at a time when affordability and access to care are already under pressure.
Orthodontic treatment is an essential healthcare service that improves oral health, function and wellbeing for patients of all ages. The removal of VAT exemption from orthodontic aligners will inevitably increase the cost of providing treatment. For practices that are unable to absorb these additional costs, patients will face higher treatment fees. This risks placing orthodontic care beyond the reach of some individuals and may widen inequalities in access to treatment. The British Orthodontic Society is also concerned that this decision may signal a broader reassessment of the VAT treatment of orthodontic appliances. Many laboratory-manufactured orthodontic appliances, including retainers and removable appliances, are integral components of orthodontic treatment. These appliances are not optional extras; they are clinically necessary devices used throughout the treatment process and in the long-term maintenance of treatment outcomes. Any extension of VAT to these appliances would further increase the cost of orthodontic care for both providers and patients.
Director of Clinical Practice for the BOS, Matt Clover commented, “Of particular concern is the potential impact on NHS orthodontic services for children and young people. NHS orthodontic contracts are already financially challenging to deliver, with practices operating within fixed contract values that have not kept pace with rising costs. If VAT is applied to orthodontic appliances required as part of NHS treatment, providers will be unable to recover these additional costs through NHS contract payments. This would further erode the already limited margins associated with NHS orthodontic care. The British Orthodontic Society is
concerned that increasing the cost burden of providing NHS orthodontic treatment may make some NHS contracts financially unsustainable.”
At a time when access to NHS dentistry remains a significant challenge across the UK, any policy change that undermines the viability of NHS orthodontic services risks reducing the number of providers willing or able to deliver care. The unintended consequence could be that more NHS orthodontic contracts are handed back, further limiting access to treatment for children who need it most.
The British Orthodontic Society has been actively engaged in discussions surrounding the VAT treatment of orthodontic appliances. The Society submitted evidence to both the High Court proceedings and the subsequent appeal relating to the VAT status of orthodontic aligners. In addition, a member of the British Orthodontic Society Board has met directly with HM Treasury officials to discuss the potential impact that the introduction of VAT on orthodontic appliances could have on patients, practitioners and the sustainability of NHS orthodontic services.
The Society urges HMRC and policymakers to consider carefully the wider implications of these changes. Orthodontic appliances are clinically necessary medical devices used in the delivery of healthcare. Tax policy should support, rather than hinder, the provision of high-quality and accessible orthodontic treatment. The British Orthodontic Society calls for meaningful engagement with the profession to ensure that future VAT policy does not adversely affect patients, practitioners or the sustainability of orthodontic services.
The British Orthodontic Society remains committed to working constructively with HMRC and government to protect patient access to orthodontic care and to safeguard the future of all orthodontic services.
