Request

I would like to request the following information under the Freedom of Information Act.

I would like to remind you that Section 16 of the Freedom of Information Act describes a duty to provide advice and assistance.

In this request "children" means the ages that NHS orthodontics are typically provided for: 0-18, and adults means patients that are not children: 18+.

In this request "treatment" means orthodontic treatment.

The date ranges for all questions are the years you have data for, i.e. 2015/2016 onwards. Please only include full years (i.e. not the present year).

Part 1: Basic Orthodontic Statistics

1. Per year: number and % of children receiving orthodontics by IOTN number 2. Per year: number and % of adults receiving orthodontics by IOTN number 3. Per year: number and % of child patients that started orthodontics that are on a second course of treatment 4. Per year: number and % of adult patients that started orthodontics that are on a second course of treatment 5. Per year: number and % of adult patients that started orthodontics that had orthodontics as a child 6. If you have statistics on the reasons for treatment beyond IOTN number:

a. Aggregated across all years: number and % of children receiving NHS orthodontics grouped by the reason for treatment

b. Aggregated across all years: number and % of adults receiving NHS orthodontics grouped by the reason for treatment

Part 2: Tooth Extractions

1. Per year: number and % of children having tooth extractions as part of their orthodontic treatment 2. Per year: number and % of adults having tooth extractions as part of their orthodontic treatment 3. Aggregated across all years: Per number of teeth (0-32): how many children start with these many permanent teeth missing before treatment began 4. Of children having tooth extractions as part of their orthodontic treatment:

a. Per year: Per number of teeth removed (0 - 32): number and % of children having this many teeth removed

b. Per year: Per each tooth: number and % of children having this specific tooth removed

c. Per year: number and % of children having 2 premolar teeth removed

d. Per year: number and % of children having only 2 premolar teeth and no others removed

e. Per year: number and % of children having 4 premolar teeth removed

f. Per year: number and % of children having only 4 premolar teeth and no others removed

g. Per year: number and % of children having any non-premolar teeth removed 5. Per year: number and % of children starting orthodontic treatment with 0 extractions on their FP17O form that had the below number of permanent tooth extractions on FP17 form(s) (even if it was at a different practice) within 2 months prior to starting orthodontic treatment

a. 1

b. 2

c. 3

d. 4

e. 5

f. 6

g. 7

h. 8

i. 9+

Part 3: FP17DCO Forms (Can be skipped if you don't process these; but please inform me if this is the case) 1. Per year: For each tickbox under "The following treatment is proposed" on the FP17DCO form: Number and % of children receiving orthodontics with the proposed treatment 2. Per year: For each tickbox under "Treatment appliances ("braces") to be used" on the FP17DCO form: Number and % of children receiving orthodontics with the proposed appliances 3. Per year: For each tickbox under "Retention appliances ("retainers") to be used" on the FP17DCO form: Number and % of children receiving orthodontics with the proposed appliances 4. Per year: total number and % of FP17DCO forms that have the "additional information" field filled out 5. Aggregated across all years: The top 100 words used, and how many patients' forms they appear in, used in the "additional information" field on FP17DCO forms.

Part 4: Incomplete Treatment

For this entire part, you should NOT consider treatments that are in progress and have yet to be concluded:

1. Per year: number and % of children that conclude treatment by the following method

a. abandonment by failing to show up

b. abandonment by request

c. discontinue treatment

d. completion

1. Per year: number and % of adults that conclude treatment by the following method

a. abandonment by failing to show up

b. abandonment by request

c. discontinue treatment

d. completion

1. Per year: number of practices where at least this many children abandon or discontinue treatment

a. 0% (i.e. this is the total number of practices that concluded any treatment)

b. 10%

c. 20%

d. 30%

e. 40%

1. Per year: number of practitioners where at least this many children abandon or discontinue treatment

a. 0% (i.e. this is the total number of practitioners that concluded any treatment)

b. 10%

c. 20%

d. 30%

e. 40%

1. Aggregated across all years: The number and % of patients by all combinations of (if they had tooth extractions), (how they completed treatment) and (if they were given a retainer before abandonment) as indicated in the following sub-questions. It is not clear to me exactly how Dental 9000 codes relate to FP17O forms (is one triggered when the relevant checkboxes are ticked on the form?), but receipt of a retainer might be indicated with 9406/9407 dental activity codes, in which case please treat presence of these codes as the patient did receive a retainer.

a. had tooth extractions, abandoned by failing to show up, with receiving retainer

b. had tooth extractions, abandoned by request, with receiving retainer

c. had tooth extractions, discontinued, with receiving retainer

d. had tooth extractions, completed, with receiving retainer

e. had tooth extractions, abandoned by failing to show up, without receiving retainer

f. had tooth extractions, abandoned by request, without receiving retainer

g. had tooth extractions, discontinued, without receiving retainer

h. had tooth extractions, completed, without receiving retainer

i. no tooth extractions, abandoned by failing to show up, with receiving retainer

j. no tooth extractions, abandoned by request, with receiving retainer

k. no tooth extractions, discontinued, with receiving retainer

l. no tooth extractions, completed, with receiving retainer

m. no tooth extractions, abandoned by failing to show up, without receiving retainer

n. no tooth extractions, abandoned by request, without receiving retainer

o. no tooth extractions, discontinued, without receiving retainer

p. no tooth extractions, completed, without receiving retainer

1. The top 10 reasons for abandoning treatment (beyond just "by request" or "failing to show up"), and top 10 for discontinuing of treatment. If this is not available, then provide any analyses or reports conducted or commissioned by you in the past 10 years, as part of your monitoring of dental treatments, for why treatment is abandoned and/or discontinued

The NHS Business Services Authority (NHSBSA) received your request on 25 May 2025.

On the 18 June 2025 you clarified your request as follows:

For the time constraints, please skip (Part 4 Question 5) that you estimate would take 1.25 days. This should bring the total down to less than 18 hours.

For whether to use treatment start or end date you should use the treatment start date for part 1.

Regarding your statement "Number of teeth or details of which teeth have been extracted/were missing are not captured by the NHSBSA." I assume you are referring to extractions that occur before treatment and not extractions that happen during treatment, because the latter would be captured in the FP17O forms and the former would require identifying patients by a unique identifier.

Regarding not capturing patients by a unique identifier, the FP17O form guidance shows on page 4 that NHS number is a valid field to be filled in and that "An NHS Number must be entered. If it not known or available then zero must be entered.". Am I to understand that for most patients this is zero? What about an identifier like (name and DoB and postcode)?

I would imagine that postcode is known and available more than NHS number.

FP17O Guidance: https://www.nhsbsa.nhs.uk/sites/default/files/2025-04/Guidance_for_Clinician_FP17O_20250401_England_V7.0.pdf

We have handled your request under the Freedom of Information Act 2000 (FOIA).

Our response

I can confirm that the NHSBSA holds some of the information you have requested.

Information Not Held

Part 1: Basic Orthodontic Statistics

Questions 3-5

Following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. . The NHS number is not a mandatory field and so we cannot successfully track patients with 100% accuracy.

Part 2: Tooth Extractions

Questions 3 - 5.

Following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. This information is unavailable as particular teeth or numbers of teeth extracted are not captured, only the quadrants of the mouth they are located in.

Part 3: FP17DCO Forms

Following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA but is held by the individual dental practices.

Part 4: Incomplete Treatment

Question 6.

Following a search of our paper and electronic records, I have established that the information you requested is not held by the NHSBSA. We only capture what is listed on the FP17O not the specific reasons.

Information Held

Part 1

Questions 1- 2

Part 2

Questions1-2

Part4

Questions 1- 4

I can confirm that the NHSBSA holds the information you have requested and a copy of the information and notes explaining it is attached.

Please read the attached data dictionary to ensure correct understanding of the data. This report contains the details from FP17s processed for the period stated reporting year 2018/2019 - 2023/2024 in English and Welsh Contracts. Activity by foundation dentists is excluded. The information within the report includes the data items and descriptions listed below. Please note that 2018/19 is the earliest held data due to our retention schedule.

Publishing this response

Please note that this information will be published on our Freedom of Information disclosure log at:

https://opendata.nhsbsa.net/dataset/foi-02868

Your personal details will be removed from the published response.

Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

Reusing the data and copyright

If you plan on producing a press or broadcast story based upon the data please contact communicationsteam@nhsbsa.nhs.uk. This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2025”. Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.