VAT and Orthodontic Aligners: What Dental Laboratories Need to Know

Dental laboratories that manufacture orthodontic aligners should be aware of a change in HMRC's approach to the VAT treatment of these products.

HMRC removed references to orthodontic appliances from its guidance on VAT exempt dental prostheses in February 2024. Its current guidance lists the types of dental prostheses that can be supplied VAT exempt by dentists and dental technicians, including dentures, crowns, bridges, plates, splints and other specially designed appliances. Orthodontic appliances are no longer included in the guidance.

Recent tribunal decision

The VAT treatment of clear orthodontic aligners has subsequently been considered by the tax tribunals in the case of HMRC v Align Technology.

The Upper Tribunal issued its decision on 7 July 2026, overturning the earlier First Tier Tribunal decision. It concluded that the clear orthodontic aligners in question were not dental prostheses for the purposes of the VAT exemption under Group 7 of Schedule 9 to the VAT Act 1994. The Tribunal therefore dismissed Align Technology's appeal against HMRC's decision that the aligners were subject to VAT.

What does this mean for dental laboratories?

Based on the information currently available, our understanding is that VAT registered dental laboratories supplying clear orthodontic aligners should treat these supplies as standard rated and charge VAT at 20%.

It is important to distinguish the supply of the physical aligner from the provision of dental treatment. The fact that orthodontic treatment provided by a dentist may be VAT exempt does not necessarily mean that a separate supply of an aligner by a dental laboratory is exempt.

HMRC's current guidance confirms that dental technicians can make VAT exempt supplies of dental prostheses, but the exemption depends on the item meeting the relevant definition.

Is this the case for all orthodontic appliances?

Not necessarily.

The Upper Tribunal decision relates specifically to the clear orthodontic aligners considered in that case. HMRC's current guidance continues to include splints and other specially designed appliances within its examples of exempt dental prostheses.

Laboratories should therefore consider the nature and purpose of each product rather than assuming that all orthodontic appliances have the same VAT treatment.

Important: the position may still change

The DTA is aware that the VAT treatment of orthodontic aligners is being challenged and there is currently no final outcome to that challenge.

This article reflects our understanding based on the information available to us at the time of publication and should not be regarded as individual VAT or tax advice. Dental laboratories that are VAT registered should discuss their individual circumstances with their accountant or VAT adviser before making changes to their invoicing arrangements.

Further information

HMRC: Dentists: Dental prostheses (VATHLT2490) 

HMRC: Health professionals and pharmaceutical products (VAT Notice 701/57) 

Upper Tribunal: HMRC v Align Technology Switzerland GmbH