Since when has referring a CHILD not been possible because they're not cleaning their teeth properly!!! If it was an adult maybe but not a child. And as the orthdentist said the overcrowding to the extent that it's a potential health hazard surely that could be why the teeth weren't as clean as they could be? It's difficult to get teeth properly clean if you can't get in between them. I'd complain - is there an institute of dentistry or something that dentists have to be a member of? If there is I'd complain to them as well as the local authority.