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Align Technology Switzerland VAT Case – A Potential Opportunity for Dental and Orthodontic Practices

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John Rossiter · Posted on: May 20th 2025 · read

Who should read this

Dental practices and other dental professionals that supply orthodontic appliances, such as aligners, to patients. This insight summarises the recent First Tier Tribunal case, the potential impact that the decision could have, and the steps that you should consider taking.

Background

HMRC’s policy position has been that appliances such as aligners are not dental prosthetics for the purposes of VAT law and therefore do not fall within the exemption from VAT that applies to the supply of dental prosthetics by dentists and other persons registered on the dental care professionals register.

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As a consequence, HMRC have always considered the supply of aligners to be subject to VAT at 20%.

Align Technology Switzerland contested that aligners should be treated as dental prosthetics and the supply by dental professionals should therefore qualify for exemption from VAT.

The case

The First Tier Tribunal (FTT) determined that aligners do qualify as ‘dental prostheses’ within the meaning of the VAT law and should therefore be exempt from VAT when supplied by registered dental professionals.

In its decision-making process, the tribunal noted that there is no definition of ‘dental prostheses’ in the law. Following general jurisprudence, the term should be assessed by considering its usual everyday meaning, and the VAT treatment should be considered in the context of the purposes for which the VAT law was implemented.

The tribunal concluded that the ordinary meaning of dental prostheses would include appliances such as aligners. The tribunal also considered that the treatment of aligners as ‘dental prostheses’ was consistent with the purpose of the VAT exemption. Established case law had already determined that VAT exemption for the supply of dental prostheses made by dentists and dental technicians was intended to ensure that the supply of health-related products does not become inaccessible by reason of the increased costs of those products if their supply were subject to VAT. The exclusion of aligners from this would appear at odds with the purpose of the law.

Next Steps

Decisions at the First Tier Tribunal are binding only on the parties to the case and cannot be relied on more widely. It is possible that HMRC may appeal the case, but this has yet to be confirmed. For this reason, dentists and other registered dental professionals should continue to charge VAT at 20% on the supply of aligners.

If HMRC do appeal, a final determination of the position may take some time.

For this reason, protective claims for overpaid VAT should be submitted to HMRC now in respect of VAT that has been charged over the past 4 years on the supply of aligners, and top up claims for VAT charged going forward should be submitted periodically pending the final outcome of this case. This approach will ensure that no amounts fall out of time to be claimed if the final outcome of the case take time to be resolved.

In submitting claims, it will be necessary to take into account the impact of the now exempt supplies on VAT recoveries that have been made in the past, and this will need to be factored into the claim value.