BOS raises concerns with Secretary of State re: VAT

A spokesperson for the British Orthodontic Society explains why thy are raising concerns about VAT on orthodontic dental appliances.

Following the British Orthodontic Society's deep concern about HMRC's decision to remove orthodontic aligners from the list of VAT-exempt dental appliances, Director for Clinical Practice, Matt Clover, has been in talks with the BDA, the Dental Laboratories Association and major appliance/aligner providers to voice collective concerns about the change in VAT status of orthodontic appliances.

In a letter dated 3rd August 2026, the BOS wrote an open letter to the Secretary of State for Health and Social Care, the Rt Hon Yvette Cooper MP, outlining a number of concerns. While it may appear to be a technical tax decision, this will have a very real effect on patients' lives.

The imposition of VAT on orthodontic aligners will increase the cost of providing this treatment.

As most dental healthcare supplied to patients is VAT-exempt, dental practices are unable to recover the VAT charged to them on the appliances they purchase. The additional tax therefore becomes a direct and irrecoverable cost of delivering care.

For private patients, this cost will either have to be absorbed by practices or reflected in higher treatment fees. Many providers, already facing substantial increases in staffing, laboratory, regulatory and operating costs, will be unable to absorb it.

The impact on the NHS will be even greater. NHS orthodontic treatment is delivered through contracts with fixed financial values. Providers cannot simply add VAT to a patient's bill or automatically recover increased appliance costs from the NHS. Where VAT is charged on appliances required to provide NHS treatment, that cost must therefore be absorbed within an already tightly constrained contract.

This will further erode the financial viability of NHS orthodontic services at a time when many providers are already questioning whether NHS contracts can be delivered sustainably in the face of rising costs and prolonged workforce pressures. Adding an additional, irrecoverable tax burden risks making more contracts financially unviable, leading to further contract handbacks and reducing access to treatment for children and young people.

The decision also has serious implications for the UK's dental laboratory sector. Laboratories will face additional VAT, administrative and compliance burdens, while practices may be encouraged to source appliances through alternative supply arrangements.

Matt Clover said: "We are asking the Secretary of State to work urgently with HM Treasury, HMRC and the devolved administrations to:

1. undertake an immediate assessment of the impact of VAT on patients, NHS dental and orthodontic providers, general dental services and UK dental laboratories;
2. introduce a clear VAT exemption for prescribed orthodontic appliances and other clinically necessary, patient-specific dental devices;
3. ensure that the wording of any exemption reflects modern dentistry and is not restricted to appliances that replace missing or damaged teeth;
4. protect NHS providers from irrecoverable VAT costs while that review is undertaken, including through appropriate contractual or financial support; and
5. engage directly with the British Orthodontic Society and representatives of dentists, dental technicians, laboratory owners and patients before any wider change to the VAT treatment of dental appliances is implemented.

He added: "We look forward to working constructively with the Secretary of State, HM Treasury and HMRC to find a solution that protects patients and secures the future sustainability of NHS and general dental services."

A copy of the letter can be found HERE.