NHS & Private Dental Charges Explained

NHS Dental Charges Explained

Whenever you go to see the dentist, you should expect to pay, whether that is for emergency care, checkup, or for treatment. 

The cost of seeing a dentist will depend on whether you are receiving NHS care or private care. 

NHS dental charges tend to go up slightly every year, typically by 5%.

If prices increase during your course of treatment, you will pay the charge that applied when you started treatment, and this should be discussed at your first appointment.

Overview of NHS costs

NHS dentistry is subsidised by the Government, so you do not pay the full price to the dentist.

The cost of NHS dentistry also varies depending on whether you are in England, Wales, Scotland, or Northern Ireland. 

Some people are also entitled to free NHS dental care – NHS dentistry exemptions, or help paying for NHS dentistry with the Low Income Scheme.

Not all dentists provide NHS dental care, and even though you are eligible for it, you will still need to find a dentist to provide the treatment for you.

• England and Wales have bands of payment and all treatment will come under:
  • Band 1: £25.80 / £14.70
  • Band 2: £70.70 / £47.00
  • Band 3: £306.80 / £203
• In Scotland and Northern Ireland you pay a percentage of the dentist’s fee, up to £384.
• Some people are entitled to free NHS treatment or help with the costs of NHS dental treatment.
• NHS treatment will provide treatment you clinically need, but will not cover cosmetic or aesthetic work.

In the UK everyone is entitled to NHS dentistry. There are NHS dentists available throughout England, Wales, Scotland, and Northern Ireland. 

NHS dentists are there to provide you with treatment that you need to keep your mouth healthy. They also provide routine check-ups to prevent any problems going unnoticed. 

You are charged a contribution towards the cost of your dental care. 

If you need specialist treatment that your general dentist is unable to offer, they also have the option to refer you to hospital for some types of NHS dental care. This might include for second opinions about lumps and bumps, or for extraction of wisdom teeth.

The price you are charged for NHS dentistry will vary depending on the treatment that you have, and where you go to see the dentist – the cost of a dentist varies between England, Wales, Scotland, and Northern Ireland. 

Sadly, in some areas, there are not enough dentists for the number of people living in that area, where this is the case, you may experience difficulty accessing NHS dentists for routine care and check-ups. 

However, there are always procedures in place to help you access emergency NHS dental care, even if you are not registered with a dentist. 

For some people, NHS dentistry may be provided free of charge  if you are eligible for NHS dental charge exemptions.- and I will cover this in more detail in the section on Free NHS dental treatment.

Who is entitled to NHS dental treatment?

According to Citizen’s Advice, everyone is entitled to NHS Dental Care:

“A patient doesn’t need to be “ordinarily resident” in the country to be eligible for NHS primary medical care”.

However, if you are not normally resident in the UK, then a dental practice doesn’t have to register you permanently. This may be the case if they have long waiting lists. They will, however, ensure you are seen for emergency dental care to get you out of pain.

Overview of Private costs

Private dentistry is an alternative to NHS dentistry, and is not subsidised by the Government in any way.

You will need to pay the full cost of the treatment, although there are also payment schemes available to help you with this.

Private dentistry charges can also vary depending on the location of the practice, and even whether it is a chain (corporate) practice or an independent family practice.

When you pay for private dentistry, you are paying the full charge. There are no benefits that entitle you to free private dentistry. It is worth shopping around because prices can vary greatly.

You may also choose to sign up for a monthly payment scheme for priate dentistry. There are different schemes available, but they broadly fall into two categories: 

1. Those that include only checkups and hygiene treatment, which have a lower monthly cost. These often provide you with a discount when you do need further treatment, such as a filling.
2. Those that include the cost of all treatment. These normally have a higher monthly fee, but will include almost all treatment. Often, if you require any lab work such as a denture, or a crown, you will still need to pay the lab bill. But you will not pay for the dentist’s time.

I will discuss more about your options for private dentistry below. However, private dentistry is dental care that is provided by a dentist or other dental care professionals (DCP), but not on the NHS.

Private dental care is not subsidised by the government, and so you will pay a price set by the dentist for the treatment they will provide.

Private dentistry may be an option for faster treatment, or treatment options that the NHS does not provide. Private dentistry can also be used if you wish to join a monthly payment plan, or even because you like a particular dentist.

In most cases, private dentistry will be more expensive than the equivalent NHS treatment. There are some key points which pricing up private dental treatment:

• Costs of private dental care are set by the practice but can be modified by individual dentists.
• Payment can be pay-as-you-go, via a capitation based dental plan, or claimed back via dental insurance cover.
• Private dentistry offered the widest range of treatments, including cosmetic and aesthetic work.

The cost of a private treatment can vary greatly. This is because the price is set by the practice and is not regulated by the Government (unlike NHS treatment).

When you pay for private dentistry, you are paying the full charge. There are no benefits that entitle you to free private dentistry. It is worth shopping around because prices can vary greatly.

The treatment is normally more expensive than a standard checkup appointment.

One of the reasons for this is because the appointment is often longer to give you more time to discuss any problems or concerns, and to use different techniques.

Some things to consider when you are looking at the cost of a private appointment:

• Corporates or chains or dental practices can be cheaper than an independent practice (but not always). With these types of practice the price is normally the same no matter where you are in the UK.  Some common chains of practice include myDentist, Bupa Dental Care and Rodericks (although there are others available).
• Independent practices set their own fees, so even in the same town prices can vary greatly. If you are looking for a dentist and it does not have a corporate logo, it may be an independent practice. It is worth looking at different practices in the same town to compare prices.
• Prices can vary depending on where you are located in the UK, with the South of England often being the most expensive. If you commute for work, it might be worth comparing the costs of dental practices between your hometown and where you work.
• Considering whether you want to pay as you go (where you pay a fee per item for treatment completed) or whether you want to join a monthly payment scheme – which I will discuss a bit more later on.

Why private dentistry?

Private dentistry may be an option for faster treatment, or treatment options that the NHS does not provide.

Private dentistry can also be used if you wish to join a monthly payment plan, or even because you like a particular dentist.

Some people may choose to have private dentistry. The reasons are varied, but this may be because you are struggling to find an NHS dentist, or it may be because you like the treatment you receive with a private dentist.

Some treatments are not available on the NHS, so you may choose to have a combination of NHS and private treatment.

Your dentist must clearly explain to you any charges – NHS and private – before starting the treatment, and can provide you with a breakdown of these costs.

Having private treatment does not mean you will lose your eligibility for NHS dental treatment place at a practice.

NHS Dental Charges

When you receive NHS dental care in the UK, you pay a contribution towards the total cost. You do not pay the total cost of the treatment. 

The cost of treatment with an NHS dentist is subsidised by the government. It is a complex system, but the money you pay does not go directly to the dentist treating you. The system also varies depending on where you live in the UK.

There are two different ways charges are done. This is split geographically; Scotland and Northern Ireland still follow an older style of dental contract. 

In Scotland and Northern Ireland, NHS Dental Charges vary and you will pay 80% of the dentist charge, up to a maximum of £384.

England and Wales moved away from this scheme in 2006, although there are ongoing trials to change this scheme again in the future.

In England and Wales, NHS Dental Charges follow a basic system of banding the charges. You will be charged once per course of treatment, and it will be one of three charges.

NHS Dental Charges in England and Wales

NHS Dental Charges in 2023 are varied, depending on whether you are being seen in England or Wales.

In England and Wales NHS Dental Charges follow a price band system. Basically there are three bands of NHS dental treatment.

The type of treatment you have will fall into one of these three bands – this applies to all treatment that is clinically necessary. 

Any treatment for cosmetic or aesthetic purposes will not normally be provided on the NHS and you would need to pay privately for this. The cost of each of the bands is different depending on whether your dentist is in England or Wales.

Band 1

A basic checkup is a Band 1 treatment. Band 1 will also include x-rays and a scale and polish if it is clinically necessary – I have discussed about how this may not be the case in this article about having a scale and polish. 

A Band 1 charge will also cover preventative treatment such as the application of fluoride varnish. 

Band 1 is also the price you will pay for emergency treatment with an NHS dentist. This does not include a checkup, but will treat a problem causing you pain, sometimes in up to 2 teeth. There are specific rules around this, which I will talk about later.

The charge for a Band 1 in England in 2023 is £25.80 and in Wales the Band 1 charge is £14.70. 

There are some exceptions to this Band 1 charge:

• In England and Wales, dental charge exemptions – more on this later, but briefly this will apply to you if you fall into one of the following categories:
  • Age: Under18, or under 19 and in full time education.
  • Pregnant or given birth in the last 12 months
  • Tax credit exemptions.
  • In receipt of income-based benefits.
  • Recieve help with dental charges as part of Low Income Scheme.
• In Wales – for under 25s checkups are free. Even though the examination is free, if you are aged 19-24 you will be charged a Band 1 charge for any x-rays, scaling, or fluoride varnish application. You will also pay for any treatment that is provided (i.e. Band 2 or 3).
• In Wales – for the over 60s checkups are free. Even though the examination is free, you will be charged a Band 1 charge for any x-rays, scaling, or fluoride varnish application. You will also pay for any treatment that is provided (i.e. Band 2 or 3).

Band 2

A Band 2 Dental Charge in 2023 is £70.70 in England, whereas a Band 2 Dental Charge is £47 in Wales. This charge includes the checkup and any treatment Band 1 Dental Charge, and is the total price you will pay.

A Band 2 is the total price for the whole course of treatment. That means if you come in for your checkup and the dentist advises that you need to come back for treatment, you will only pay one total charge. 

This applies whether you come back for one appointment or for a few further appointments. It is one price for all the treatment, whether you have one tooth treated or multiple teeth treated.

A Band 2 Dental charge applies for courses dental treatment that includes:

• Treatment for gum disease.
  • A simple scale and polish may be completed under a Band 1 charge (as explained here), however more complex treatment and deeper cleaning, which takes more time, will be charged as a Band 2 Dental Charge. This would include preventative advice and cleaning, as well as a more thorough examination if required.
• Treatment for tooth decay – fillings.
  • Whether this is a front tooth or a back tooth. And whether metal filling or white filling is placed. It is worth noting that because this is NHS treatment it is only for treatment that is clinically necessary. Usually a back tooth will have a metal filling, but more on that later. 
• Root canal treatment – also known as root treatment, or endodontic treatment.
  • A Band 2 charge will cover a root filling and filling on top to protect the tooth. Manny dentists will also recommend a crown to go on top of a root filled tooth, which would then require you to pay a Band 3 Charge instead.
• Removal of a tooth – extractions.
  • Simple extractions that can be done by your general dentist will be covered by a Band 2 Dental Charge. Complex extractions may need referrals, this includes buried teeth, broken teeth, and most lower wisdom teeth. If you are referred for NHS treatment, the most you will pay is the Band 2 charge wherever you are treated. In some cases, you may not need to pay.
• Additions to dentures such as adding a tooth, adding a clasp, or a reline.

As you can only be charged once for a course of treatment, any treatment plan that involves one or more of the above will only cost you a maximum of £70.70 in England or £47 in Wales. 

Band 3

In England in 2023 the Band 3 charge is £306.80 and the NHS Dental Charge for a Band 3 in Wales is £203.

A Band 3 Dental charge will cover anything that involves a dental lab to make something for you. This includes onlays, inlays, crowns and new dentures.

If you are paying a Band 3 Dental Charge for a Course of Treatment, this will also include any work done under a Band 1 or Band 2, regardless of how many appointments you require.

For example:

• You may have a checkup and require a root canal treatment. 
• The root canal treatment is a Band 2, but the dentist advises you that a crown helps protect the tooth after the root filling. 
• You choose to have a crown on top of the tooth as soon as you finish the root filling, so you will pay a Band 3 charge. 
• You will only pay the final price for a Band 3, not the cost of a Band 3 plus a Band 2. If you opt not to have a crown straight after the root filling is finished, but change your mind at a later date (for example, at your next checkup), then you would pay Band 2 when the root filling is completed and Band 3 when the crown is completed.

Some exceptions to banding rules

NHS dental Band charges in England and Wales follow strict regulations. It is possible to have fairly extensive treatment at an affordable price this way, but there are some considerations.

The price is for one course of treatment. If you require additional treatment at a later date, after your treatment has been completed, you will most likely need to pay for a new course of treatment.

Courses of treatment open for more than two months

Your course of treatment can only be kept open for a maximum amount of time, usually 2 months, without you coming back. 

In reality this means that if you have a checkup and then don’t come back for your filling for three months, then you will be expected to pay for two courses of treatment.

In other words, you will pay for your Band 1 checkup for the original checkup. When you return for your filling you will need a new checkup because the previous one is out of date, so you will pay the full Band 2 charge for checkup and filling when you return (even though you paid for a checkup 3 months ago). 

For example (in Wales):

• You come for a checkup in January and are told you need to come back for a filling. You will pay £14.70 for your checkup. You book your filling appointment for the following week, where you would  then pay the remaining £31.70 (to make a total of £47).
• Unfortunately you have to cancel the filling appointment, and then forget to make another appointment. 
• At the end of March, you book another appointment for the filling in April (more than 2 months after your checkup).
• When you return, the previous treatment plan will have been closed down. You will pay £47 at this appointment for the filling and a new checkup.

This would also apply if you have paid a Band 2 charge but need to return for a Band 3 treatment, for example if you have a filling but also want a new denture (in England this time!):

• You go to your annual checkup appointment. You require one filling and a new upper denture, which would be a Band 3 Course of Treatment, total £306.80.
• At your checkup appointment you pay £25.80.
• Your next appointment is for a filling and the first set of impressions to start the denture. You pay a further £39.40. The total you have paid is £70.70, a Band 2 charge.
• You change your mind about the denture so the treatment plan is closed down when your filling is done.
• Three months later your existing denture breaks (a disaster!). You will now need to pay the full Band 3 charge of £306.80 for a new denture despite starting the work before, because you changed your mind and the treatment plan was closed down. If you had continued with the denture as originally planned you would only have paid a further £207.20 on top of the filling. 

Failing to attend

Courses of treatment may also be closed down before the 2 month point if your dentist tries getting in contact with you multiple times, but you still don’t get booked in. 

If you fail to attend appointments for your course of treatment, even if it is within the 2 month time scale, the course of treatment may also be closed down. As above, you will be expected to pay for a new checkup when you do return.

NHS Guarantee

Some NHS treatment is under guarantee for a year, and so if treatment fails on the tooth you had treatment on, you would not normally be expected to pay again for the same level of treatment.

Any treatment covered by the NHS guarantee that fails within 12 months will also be replaced free of charge – read on to find out more about this.

However if you have a more complex treatment, for example a crown, instead of a filling, you would need to pay the Band 3 charge.

Coming back within two months

If you return for treatment within two months of your last course of treatment being closed down, you also should not pay for treatment. This is what dentists would call a continuation of treatment. This applies to treatment on any tooth within 2 months of your last course of treatment as long as it falls within the same band or at a lower band.

Dental Charge Exemptions

In some cases, you may not need to pay at all for NHS treatment, for example if you are entitled to exemptions or help with NHS dental treatment. I will cover this in detail later.

Free treatments

Some treatment you are not required to pay for at all, and this includes:

• A repair of a broken denture.
• Removal of stitches by a dentist.
• Going to your dentist to stop bleeding.

Summary of NHS Dental Charges in England and Wales

Band	Examples of what is included	Charge – England	Charge – Wales
1	Checkup, x-rays, preventative treatment, OR emergency treatment	£25.80	£14.70
2	Perio treatment, fillings, RCT, extractions, denture addition	£70.70	£47
3	Inlay, onlay, crown, new dentures	£306.80	£203

NHS Dental Charges in Scotland and Northern Ireland

In Scotland and Northern Ireland, dental charges are completely different, and will vary depending on your treatment plan. 

You will pay 80% of the dentist charge, up to a maximum of £384. 

The price schemes are complex, but your dentist will talk you through the cost of your treatment, and provide you with a written breakdown of this, before starting treatment.

The same as in England and Wales, NHS dentistry in Scotland and Northern Ireland will provide all treatment that is clinically necessary. 

Any treatment for cosmetic or aesthetic purposes will not be provided on the NHS and you would need to pay privately for this.

NHS Dental Charges in Scotland

In Scotland, the prices are set by NHS Scotland.

An NHS dental check up is free for everyone in Scotland. 

X-rays are not included in this, and standard bitewing x-rays (one each side, which are normally taken once per year) are £5.

The NHS dental charges in Scotland follow a pricing structure that is complex and will vary between patients which makes it difficult to give exact prices for treatment before a checkup. 

NHS Scotland does provide the following table for guidance on their pricing structure, however the full list and explanation can be found on their Statement of Remuneration.

The cost to you as a patient is 80% of the dentist’s fee, up to a maximum of £384 per course of treatment.

As with treatment in England, and Wales, the NHS Dental Charges in Scotland do not apply to everybody. Some individuals are entitled to free NHS dental care in Scotland. You can read more about that below.

NHS Dental Charges in Northern Ireland

In Northern Ireland, the prices that you pay are set by the Health Service of Northern Ireland.

The minimum cost of a checkup in Northern Ireland is £7.03, not including x-rays.

This price may increase if a more detailed examination is required (for example a further examination of the gums) or if x-rays are required. 

Standard bitewing x-rays (one on each side, which are normally taken once per year) are £4.90.

The NHS dental charges in Northern Ireland follow a pricing structure that is complex and will vary between patients and so it is difficult to give prices before a checkup is completed. 

Health Service Dental Charges are outlined in the table below taken from NI Direct Government Services website. A full list of explanations of the costs of Health Service dental treatment can be found through their Statement of Remuneration, which is updated every year.

In total the cost you will pay is 80% of the dentist’s fee, up to a maximum of £384 per course of treatment.

As with treatment throughout the rest of the UK, the NHS Dental Charges in Northern Ireland do not apply to everybody. Some individuals are entitled to free NHS dental care in Northern Ireland and you can read more about that below.

What if something goes wrong?

If something goes wrong with NHS dental treatment, it may be replaced for free under the NHS Dental Treatment Guarantee.

Whether you are treated in England, Wales, Scotland, or Northern Ireland, most dental treatment is covered by this NHS guarantee.This means that if re-treatment is required within 12 months of a tooth being treated, you are not expected to pay for that treatment.

This only applies when it is the same tooth being treated, and when you need the same item of treatment replaced. If it is a different problem, for example a different filling has fallen out, then you will be expected to pay. 

The re-treatment must be similar to the original treatment. However, under the NHS General Dental Services Contract Regulation, the replacement does not have to be like-for-like. For example, a different material may now be more appropriate.

This guarantee also only applies if you return to the same dental practice. If you go to another dental practice, you will be expected to pay.

Not all types of treatment are covered by this guarantee, but the following types of treatment are included:

• Fillings
• Root fillings
• Inlays
• Porcelain Veneers
• Crowns

You will notice that treatment for gum disease, and dentures are both missing from this list.

Any treatment not on the above list is not covered by the 12 month guarantee. According to the NHS website a free replacement will not be provided if: 

• Within the 12-month period another dentist has carried out any treatment on the same tooth that has been restored.
• Private treatment has been provided to the same tooth since the original restoration was provided.
• The original restoration was intended to be temporary. If this is the case then a permanent replacement within 12 months will need to be paid for. 
• The dentist advised you originally that a different type of restoration was more appropriate, but you elected for the treatment provided. In this case the treatment that was actually provided is not covered by the guarantee.
• The repair or restoration is a result of trauma.

There is some further small print to this, and your dentist can go through this with you if you ask. 

As with all treatment with your dentist, potential replacement costs and exceptions to the guarantee should be discussed when the original treatment is provided. If you do have any questions, feel free to leave one in the comments section below!

Can I be charged for missing an NHS appointment?

You cannot be charged for missing an NHS appointment. This is a rule set by the NHS.

However, if you fail to attend an appointment, or cancel at short notice, then you could lose your place at the practice. 

If you have already started a course of treatment and fail to attend other appointments, you will still need to pay the relevant charge for the treatment that has been completed (Band 2 or otherwise).

NHS courses of treatment will be closed down if you do not return for treatment within 2 months of your checkup.  

If you fail to attend appointments for your course of treatment, even if it is within the 2 month time scale, the course of treatment may also be closed down. 

The treatment plan may also be closed down before the 2 month point if your dentist tries getting in contact with you multiple times, but you still don’t get booked in.

If a treatment plan is closed down because you do not attend you will be expected to pay for a new checkup when you do return. 

Do I need to register with a dentist to receive NHS dental care?

Essentially the answer is no in England and Wales, but yes in Scotland and Northern Ireland.

There are, however, some conditions with this.

Much like the charges I have been talking about, the rules for this differ depending on what part of the UK you are in.

Once registered, you can then be offered appointments as you need them, and in line with the recommendation from your dentist.

Depending on local practice and health board policies, you can lose this NHS registration (and go back to the bottom of the waiting list), for example if you don’t turn up for multiple appointments, or if you have not been seen for a long time (e.g. a couple of years).

Registering with a dentist in England and Wales

In England and Wales, you do not need to be formally registered with a practice to receive NHS dental treatment.

However, in reality, because of long waiting lists amongst other reasons, most practices will still “register” you as a patient in England and Wales. 

When you do this, you may have to join a waiting list before you can be offered an appointment. The length of this waiting list varies greatly across the UK.

Registering with a dentist in Scotland

In Scotland you do need to register with a practice to receive continuing care.

If you are not registered with a practice in Northern Ireland, you may only be entitled to receive limited care as occasional treatment (for example, in an emergency).

Registering with a dentist in Northern Ireland

In Northern Ireland once you are registered, you stay on that dentist’s patient list for 24 months. This registration period will be extended if you return for another examination or further treatment during that period.

If you are not registered with a practice in Northern Ireland, you may only be entitled to receive limited care as occasional treatment (for example, in an emergency).

How to register with a dentist

The best way to register with an NHS practice is to ring around different practices.

There is no central way of registering for an NHS place, or to find a practice taking on NHS patients, so calling practices will give you the most up to date information.

For further help finding an NHS dentist visit the relevant local websites:

• England https://www.nhs.uk/service-search/find-a-dentist
• Wales https://www.wales.nhs.uk/ourservices/findannhsdentist
• Scotland https://www.scottishdental.org/public/register-with-a-dentist/
• Northern Ireland http://www.hscbusiness.hscni.net/2070.htm

Can I change my NHS dentist?

Yes, you can change your NHS dentist if you want to. You may wish to change your dentist because:

• The practice is no longer convenient, for example if you have moved home or work.
• You are unhappy with the dental care you have received.
• The practice you are at no longer provides NHS dental care.

If you would prefer to stay in the same practice, you can request to see a different dentist.

If you want to move practices you will need to go through the same procedure as when you originally found a dentist.

When changing dentists, it is worthwhile getting in contact with your old practice to get a copy of any important notes or x-rays (radiographs) and to let them know that you no longer need appointments there. You can also ask to be removed from any mailing list or reminders too.

It is also worth letting your practice know if you do not intend to be seen there any more so that they can offer your space to someone else. You do not need to give a reason why, if you don’t want to.

In England and Wales, because you are not “registered” with a practice in a traditional sense, you can pick an NHS practice at a convenient location for you. Depending on the availability of dentists in the local area, you may have to join a waiting list before you can be seen.

In Scotland, if you register with a new dentist that provides NHS treatment, you’ll no longer be registered with your old dentist so will no longer be able to be treated there.

Private dental charges

If you are not receiving NHS dental care, then you will be receiving private dental care.

In fact, even if you are receiving NHS dental care, then you can still seek private treatment as well. Having private treatment will not exclude you from returning to NHS treatment should you want to.

As well as NHS dentistry, your dentist may also offer private dentistry on top of the regular NHS care. Some practices will only do private dental care. This includes any payment schemes such as DenPlan or DPAS. You may choose to see a private dentist. For example if:

• You want dental treatment not provided on the NHS, such as cosmetic or aesthetic treatment.
• You want more convenient access, for example private dentists may be open after work or at weekends.
• You do not want to wait for NHS dental care, for example if there are long waiting lists you may choose to go to a private practice with shorter waiting lists.
• You want to be on a payment plan such as DPAS or DenPlan, and enjoy the perks they have to offer.

Private charges overview

Private treatment will be charged normally on a fee-per-item basis. This means that you should expect to pay for each type of treatment you have done.

For example, in one course of treatment you would need to pay for: examination (ccheckup) + x rays + filling + extraction.

This is similar to the NHS charging scheme for Scotland and Northern Ireland, although prices are typically more for private treatment. This is because with NHS care you are paying towards the cost of treatment, but not for the full cost of treatment.

This way of paying is very different from NHS payment schemes in England and Wales where you pay a maximum price band, regardless of how many different types of treatment you have in that one course of treatment.

However, there are numerous ways that private treatment can be paid for. You may pay as you go, paying per item, or you may choose to join a payment scheme such as DenPlan or DPAS.

Pay as you go

With pay as you go private dentistry you will normally pay a price for each item of treatment completed, as it is completed. You can spread out the cost by having longer between appointments.

The cost for a type of treatment can vary greatly between practices, but your dentist will talk you through all costs before starting any work.

Payment schemes

Payment schemes, can be dental plans or dental insurance, and exist for a number of reasons. 

I will try to explain the difference between such systems, but the Money Advice Service also had good impartial advice to explain the difference.

These schemes may be something you pay for personally, and you pay a monthly fee for them. In some cases your employer may have signed you up to such a scheme as a benefit for working for them. 

There are different ways to be covered by these schemes, and they can also offer different levels of cover. There are some advantages to payment schemes, e.g:

1. They allow you to spread the cost of private dental care. You pay in small monthly amounts to spread the cost of having a checkup and hygienist appointment throughout the year. 
2. They reduce the cost of treatment, if it is needed. Some schemes will have the cost of treatment included in the monthly price, whereas others will give you a reduction off the pay as you go price. 
3. They give you access to a wider range of treatments not normally available on the NHS. For example, white fillings in back teeth.
4. With payment schemes you will have some bonuses included, such as free worldwide emergency dental cover.

Cosmetic or aesthetic work, such as tooth whitening, is normally excluded from payment plans and dental insurance, although you may be offered a reduced price for these sorts of treatments.

Dental plans

You may have heard of DenPlan, or DPAS, to name only a couple of capitation plans, which are offered at your dental practice.

The idea of these is to help you spread out the cost of seeing the dentist. 

These are for purely private treatment.

For the amount you pay per month you normally have at least your checkups and hygiene appointments included.

More comprehensive plans will include fillings and other restorative work, such as root fillings. 

Normally you will be assessed by your dentist, who will set a fee based on the condition of your teeth. You would then set up a monthly payment depending on the fee set by your dentist.. 

The prices charged at a practice for their monthly schemes will vary, as will the benefits included. However, expect to pay between £10 and £20 per month for the most basic care, which will include checkups twice a year and two hygiene appointments per year. 

If you have a lot of existing dental work and are going for a scheme that includes the cost of treatment (normally excluding any lab bills), you could reasonably expect to pay £40+.

It is possible to move between bands if your oral health improves or gets worse.

Dental Insurance

Dental insurance schemes differ from a payment plan in that you pay a charge set by the insurers the cost for the insurance policy.

If you needed treatment during the policy period, you would pay the dentist for the treat and you will then claim back the cost of this from the insurers. 

The insurance policy can cover you for NHS or private treatment. 

Different levels of cover will provide routine care such as checkups, whilst more comprehensive cover can reimburse you for thousands of pounds worth of private dental treatment. Often there is a cap of the amount you can claim, as well as when you are able to start claiming.

Most insurance will also provide some sort of cover for if you are diagnosed with oral cancer, including a cash benefit if you have to stay in hospital overnight.

Examples of these schemes are those that may be offered by companies such as AXA or BUPA, amongst others.

For comparison of different insurance companies, you might wish to look at a comparison site such as Which?.

Can I be charged for missing a private appointment?

Yes, you can be charged for missing a private appointment.

Whilst you cannot be charged for missing an NHS dental appointment because of NHS regulations, there is no such protection for private treatment.

If you fail to turn up to a private appointment, are so late that you miss your appointment, or cancel with less than 24 hours notice, you are at risk of being charged a fee by the dental practice. Each practice has different policies on this.

Ask your practice what the charge is that you will be expected to pay. There is so one way of setting this fee, so you should ask your dental practice what their policy is for missed appointments.

To give you an idea, some practices will charge you the cost of the treatment you were due to have completed on that day.

This is because the time has not been able to be offered to someone else.

Some practices may charge a set fee per appointment missed, whilst others will charge you a percentage or even the whole cost of the treatment you were due to have done that day.

Comparing NHS vs Private Charges

Which? Undertook research to compare the private prices of different types of treatments. Using their research, I have compiled the table below to show how NHS charges compare to private charges for common types of treatment.

Where NHS charges are discussed, this is the price if you need to pay for treatment. Some groups of people do not pay for treatment, as I discuss below.

If you are exempt from dental charges, all NHS dental treatment is free, but read on to find out a little bit about the different types of treatment and appointments.

Treatment	NHS – England	NHS – Wales	NHS – Scotland	NHS – Northern Ireland	Private – PAYG	Private – Payment Scheme
New patient examination (more info)	Band 1 £25.80	Band 1 £14.70	Free	£4.03-22.11	£20-120	£20-120
Checkup (more info)	Band 1 £25.80	Band 1 £14.70	Free	£4.03-22.11	£20-120	Normally included in the monthly fee
Radiographs (x-rays) (more info)	Included with Band 1	Included with Band 1* (see below)	£5.00	£4.90	Normally included in the monthly fee	Normally included in the monthly fee
Emergency appointment (more info)	Band 1 £25.80	Band 1 £14.70	Depends on treatment	Depends on treatment	Depends on treatment	Included/percentage off
Tooth and gum cleaning (scale and polish/hygienist appointment) (more info)	Band 2 £70.70	Band 2 £47.00	£11.40	£11.16	£25-85	Normally included in the monthly fee
Metal filling (more info)	Band 2 £70.70	Band 2 £47	£7.76-19.92	£7.51-19.32	£30-175	Included/percentage off
White filling (more info)	Band 2 £70.70	Band 2 £47.00	£14.64-22.76	£14.72-37.3	£40-250	Included/percentage off
Root canal treatment (more info)	Band 2 £70.70	Band 2 £47.00	£41.96-87.80	£10.26-84.72	£45-970	Included/percentage off
Tooth extraction (more info)	Band 2 £70.70	Band 2 £47.00	£7.16	£6.94-41.89	£50-370	Included/percentage off
Crown (more info)	Band 3 £306.80	Band 3 £203	£61.60-114.96	£74.90-111.65	£250-1180	Included/percentage off
Single denture (more info)	Band 3 £306.80	Band 3 £203	£61.60-93.82	£59.88-98.32	£355-2520	Lab fee cost / Included / percentage off
Upper and lower dentures (more info)	Band 3 £306.80	Band 3 £203	£157.60	£152.98	£710-5040	Lab fee cost / Included / percentage off

New patient examination

A new patient examination or assessment will be the first regular appointment you have at a practice. The dentist will fully assess you, including radiographs (x-rays) if needed. The appointment length will normally be longer compared to a checkup appointment,

For an NHS appointment, the cost is the same whether you have a new patient assessment or a regular checkup. 

• In England radiographs (x-rays) are included in the price. 
• In Wales radiographs are included in the price unless you are aged 18-25 pr 65+, when the checkup is free, but you pay £14.70 if you have radiographs.
• In Scotland, you pay extra for radiographs (£5 for a pair of bitewing radiographs).
• In Northern Ireland, you pay extra for radiographs (£4.90 for a pair of bitewing radiographs).

For a private appointment, this can be quite a long appointment, half an hour or even more. Even if you plan to join a dental plan, you will normally still need to pay for the initial assessment appointment.

Checkup

A regular dental checkup is key to making sure you are keeping your mouth healthy. During the appointment the dentist will fully assess you, including radiographs (x-rays) if needed. The dentist will discuss any treatment plan with you.

For an NHS appointment, the cost is fixed for every checkup, depending on which country you are in.  

• In England radiographs (x-rays) are included in the price. 
• In Wales radiographs are included in the price unless you are aged 18-25 pr 65+, when the checkup is free, but you pay £14.70 if you have radiographs.
• In Scotland, you pay extra for radiographs (£5 for a pair of bitewing radiographs).
• In Northern Ireland, you pay extra for radiographs (£4.90 for a pair of bitewing radiographs).

For a private appointment, the appointment may be longer, and the price is set by the individual practice, so can vary quite a bit. The price normally included any extra tests you need, including radiographs.

Depending on your dental plan or dental insurance, you may have your checkup included in the monthly fee. 

Radiographs

There are different types of radiographs, depending on what the dentist needs to see. It is common to have bitewing radiographs taken at checkup appointments. This is a pair of small radiographs to check for dental decay and to look at bone levels around the teeth.

You may need other types of radiographs, for example to look at your lower wisdom teeth or jaw joints. The price of these is different in Scotland and Northern Ireland.

For NHS appointments:

• In England radiographs (x-rays) are included in the price of any banded treatment – checkup or emergencies included. 
• In Wales radiographs are included in the price of any banded treatment, unless you are aged 18-25 pr 65+, when the checkup is free, but you pay £14.70 if you have radiographs.
• In Scotland, you pay extra for radiographs (£5 for a pair of bitewing radiographs).
• In Northern Ireland, you pay extra for radiographs (£4.90 for a pair of bitewing radiographs).

For some private checkups, radiographs will be included in the price of the checkup, however some practices will charge extra, but this should be explained to you before you agree to have them.

Depending on your dental plan or dental insurance, you may have any radiographs required included in the monthly fee.

Emergency appointment

A dental emergency appointment is an unplanned appointment to try and get you out of pain. This is usually to provide treatment:

• Where an accident or trauma has caused 1 or more teeth to be knocked out or very loose
• To control significant bleeding that won’t stop.
• To ease severe pain that isn’t helped by painkillers.
• To manage swelling that affects the eye, or throat so that you are struggling to swallow or breathe.

An NHS appointment will provide you with treatment to manage any of these scenarios, although the treatment may only be temporary. They may also provide some other treatments such as to repair a chipped tooth.

• In England and Wales the price is fixed at the cost of a Band 1, although this does not include a checkup.
• In Scotland and Northern ireland, the cost of an emergency appointment depends on the treatment provided, for example an extraction is from £7.16 (Scotland) or £6.94 (Northern Ireland)

Private practice charges can vary. If you are already registered with the practice, the fee will depend on the exact treatment you require, and you will be charged for that treatment.

If you are not registered with the practice, many private practices will offer a one-off emergency appointment for a flat fee, to provide treatment to manage your problem. This price can vary from £80 to £150 (or more).

Some private practices may open up outside of normal working hours to provide treatment, and there will be an additional charge for this (set by the practice).

Depending on your dental plan or dental insurance, you may have emergency treatment included in the monthly fee. This is more likely if you have more comprehensive cover.

If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

If paying privately even on a dental plan you may still need to pay an out of hours fee upfront and then claim this back from your cover provider.

Tooth and gum cleaning (scale and polish/hygienist appointment)

There are different levels of scaling and polishing, depending on the level of your gum disease.

The NHS will provide treatment that is clinically necessary, normally this will be if you have more advanced gum disease including bone loss – this may be referred to as a “deep cleaning” or root surface debridement. If you only require cleaning for removal of stains and small calculus deposits, but your gum health is otherwise ok, then cleaning is not always clinically indicated, and in this case you may need to pay privately.

Whether you have treatment by the dentist or hygienist, you will receive appropriate care for your gums and teeth. Both can provide superficial and deeper cleaning.

NHS dentists will focus on disease, including removal of calculus and cleaning underneath the gum surface. This will normally be a Band 2 treatment (England and Wales), or from the prices stated above in Scotland and Northern Ireland. They will normally scale and provide care advice for you, as well as doing further examination. They do not need to do polishing. If receiving NHS care you will often see the dentist as there are not many NHS hygienists available.

For a general clean to remove stains and small amounts of calculus that are not causing gum disease, you will likely need to pay privately for this. You may have the choice of ultrasonic scaling or other options such as air polishing. The price for this is set by the practice. Often this is done by a private hygienist at the practice rather than the dentist. The hygienist can also do deeper cleaning privately too.

If you have a payment plan, regular hygiene appointments are often included in the price.

Metal filling

If you have tooth decay, chances are you will need a filling at some point.

There are different options for filling a tooth, and the material chosen depends on how string the filling needs to be, if how the tooth looks is important, how deep the filling is, and whether or not the tooth can be kept drying whilst filling.

Whilst amalgam metal fillings are controversial, they can still be used in the UK. Although metal fillings are being phased down, so that they are no longer an option in some cases, they are still a good option for some teeth.

The way a metal filling is placed is the same whether you have NHS treatment or private treatment. The costs includes any injections to numb the tooth and the cost of the material.

If you are an NHS patient, expect to have a metal filling on a back tooth. You will rarely be offered a white filling on a back tooth on the NHS.

• In England and Wales the cost of a filling is set, no matter what material is used. The cost is a band 2 cost and includes as many fillings as you need. This includes any treatment in a lower band on the same course of treatment.
• In Scotland and Northern Ireland, you will pay per filling and the price depends on how many tooth surfaces the filling covers.

If you are a private patient, metal fillings are often cheaper than white fillings, and are still a good option in some cases, so you may choose to pay privately for a metal filling.

The cost of the filling is set by the practice so can vary between practices and dentists. The cost may also vary depending on the size of the filling, so a bigger filling costs more. This is the same no matter what type of filling you have.

If you have a comprehensive dental plan, the cost of a metal filling may be included in your monthly fee. If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

White filling

If you have tooth decay, chances are you will need a filling at some point. There are different options for filling a tooth, and the material chosen depends on how string the filling needs to be, if how the tooth looks is important, how deep the filling is, and whether or not the tooth can be kept drying whilst filling.

White fillings are technique sensitive and require a very dry area to be placed, as well as being more expensive to buy.

A white filling will match your tooth colour. Whilst the way a filling is placed is the same whether you have NHS treatment or private treatment, there are some more expensive types of white filling available privately and you may wish to pay more for these. The colour matching may be better, although an NHS fillings will be functional. The costs include any injections to numb the tooth and the cost of the material.

If you are an NHS patient, you would normally only be offered a white filling on a front tooth. Although there are some exceptions to this. And some dentists are choosing to switch to white fillings as much as possible.

• In England and Wales the cost of a filling is set, no matter what material is used. The cost is a band 2 cost and includes as many fillings as you need. This includes any treatment in a lower band on the same course of treatment.
• In Scotland and Northern Ireland, you will pay per filling and the price depends on how many tooth surfaces the filling covers.

If you are a private patient, white fillings are normally more expensive than metal fillings because they take longer to do. This is especially true in back teeth.

The cost of the filling is set by the practice so can vary between practices and dentists. The cost may also vary depending on the size of the filling, so a bigger filling costs more. This is the same no matter what type of filling you have.

If you have a comprehensive dental plan, the cost of a white filling may be included in your monthly fee. If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

Root canal treatment

Root canal treatment is an option to try and keep a tooth where there is damage to the nerve of the tooth – this could be because of decay or trauma, for example.

The treatment involves drilling into the tooth and removing the nerve, cleaning out the nerve area with chemicals, and then placing a special filling that goes all the way to the tip of the root. 

If you do not want a root canal treatment, you may need to have the tooth extracted. Root canal treatment is not always the best option for the tooth, for example if the tooth is too broken, and then the tooth may need extraction.

Root canal treatment can be provided on the NHS or privately. In both cases the treatment is largely the same, although private treatment is more likely to use specialist tools and files. You may choose to visit a private specialist for root canal treatment. The treatment will include injections to numb the tooth and a filling on top after the root filling is completed. You might also need a crown after a root filling is completed, but this will cost extra.

For NHS treatment, the price is set regardless of how many visits you need. A simple root filling can be completed in one appointment, but a more complex tooth may require two or more visits for root canal treatment.

• In England and Wales, the cost of root canal treatment on the NHS is Band 2. This includes any treatment in a lower band on the same course of treatment.
• In Scotland and Northern Ireland, a root canal treatment cost depends on whether it is a front or a back tooth.

Private treatment may be charged per appointment, or per tooth. Again, the price depends on the practice and the dentist. Expect to pay more for treatment with a specialist dentist.

If you have a comprehensive dental plan, the cost of root canal treatment may be included in your monthly fee. If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

Tooth extraction

A tooth extraction is an option if a tooth has an abscess, or is broken because of trauma. There are also other reasons a dentist may recommend this treatment for you.

Whether you are having NHS or private treatment, a tooth extraction procedure is pretty similar, and will include any injections needed as well.

Some dentists may refer more complex extractions that could require surgery. This will be discussed with you before treatment is started. NHS may be more likely to refer these sorts of teeth because of the amount of time and the equipment needed to do a surgical extraction. Private dentists and specialists have the equipment in house to be able to deal with surgical extractions, however such a treatment will cost more.

The prices quoted are for a simple extraction, not requiring any bone removal or other surgery.

As an NHS patient a dental extraction costs:

• Band 2 in England and Wales (this is also the same if you require NHS surgical extraction, even if it is carried out by a specialist elsewhere). This includes any treatment in a lower band on the same course of treatment.
• In England and Wales you might have a tooth extraction as emergency treatment under Band 1, but this does not include a checkup.
• From £7.76 in Scotland, and this price increases for more complex extractions.
• From £7.51 in Northern Ireland, and this price increases for more complex extractions.

Private treatment is normally charged per tooth. Again, the price depends on the practice and the dentist. You will pay more for a more complex extraction. Expect to pay more for treatment with a specialist dentist.

If you have a comprehensive dental plan, the cost of tooth extraction may be included in your monthly fee. If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

Crown

A crown or cap may be recommended by your dentist to protect a broken tooth, or after root canal treatment.

You are entitled to a crown on the NHS, where it is clinically necessary. The types of crowns are usually restricted to metal crowns in back teeth or porcelain bonded to metal in teeth further forward.  You cannot have a crown for purely aesthetic or cosmetic reasons on the NHS.

If paying for private treatment, you may choose to have dental crowns for cosmetic reasons. Private treatment can also provide you with a wider range of materials used for the crown. You could have gold or more cosmetic zirconia for example.

As an NHS patient, you would pay:

• Band 3 in England and Wales. This includes any treatment in a lower band on the same course of treatment.
• From £81.92 in Scotland, and this price depends on the type of crown placed.
• From £76.93 in Northern Ireland, and this price depends on the type of crown placed.

Private treatment is normally charged per tooth. Again, the price depends on the practice and the dentist. You will pay more for a more aesthetic crown, for example a crown made from zirconia. This is because the laboratory making the crown charges the dentist more for such a crown.

If you have a comprehensive dental plan, the cost of preparing a tooth for a crown may be included in your monthly fee, but you could still have to pay the lab fee (usually between £100-300 depending on the type of crown). If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

Single denture

A denture, or plate, is an option for fillings gaps caused by tooth loss. A partial denture replaces one or more teeth, around any natural teeth you still have. A full denture will replace all teeth in one arch.

You are entitled to a denture on the NHS, where it is clinically necessary.  This would include front teeth and multiple missing back teeth. The types of dentures are usually restricted to plastic dentures, unless there is a clinical justification for a metal denture. This is because of the high cost of making a metal denture.

If paying for private treatment, you may choose to have a plastic or a metal denture. There is also the option of flexible dentures if paying privately, or dentures fixed to implants. You have a wider choice of materials which can look and feel more natural, although this comes at a cost.

As an NHS patient, you would pay:

• Band 3 in England and Wales. This includes any treatment in a lower band on the same course of treatment. This is the same whether you have one denture or two.
• From £61.60 in Scotland, and this price depends on the type of denture and how many teeth are on it.
• From £64.83 in Northern Ireland, and this price depends on type of denture and how many teeth are on it.

Private treatment can depend on the material and the number of teeth on the denture. Again, the price depends on the practice and the dentist. You will pay more for a metal denture, because the laboratory making the denture charges the dentist more.

If you have a comprehensive dental plan, the cost of the appointments with the dentist could be included in your monthly fee, but you could still have to pay the lab fee (usually between £100-600 depending on the type of denture). If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

Upper and lower dentures

A denture, or plate, is an option for fillings gaps caused by tooth loss. A partial denture replaces one or more teeth, around any natural teeth you still have. A full denture will replace all teeth in one arch.

You are entitled to a denture on the NHS, where it is clinically necessary.  This would include front teeth and multiple missing back teeth. The types of dentures are usually restricted to plastic dentures, unless there is a clinical justification for a metal denture. This is because of the high cost of making a metal denture.

If paying for private treatment, you may choose to have a plastic or a metal denture. There is also the option of flexible dentures if paying privately, or dentures fixed to implants. You have a wider choice of materials which can look and feel more natural, although this comes at a cost.

As an NHS patient, you would pay:

• Band 3 in England and Wales. This includes any treatment in a lower band on the same course of treatment. This is the same whether you have one denture or two.
• £171.04 in Scotland for both upper and lower dentures.
• £165.64 in Northern Ireland for both upper and lower dentures.

Private treatment can depend on the material and the number of teeth on the denture. Again, the price depends on the practice and the dentist. You will pay more for a metal denture, because the laboratory making the denture charges the dentist more. If you are having both upper and lower dentures, the cost is normally just double the cost of a single denture. 

If you have a comprehensive dental plan, the cost of the appointments with the dentist could be included in your monthly fee, but you could still have to pay the lab fee (usually between £200-1200 depending on the type of denture). If you have a plan that gives you money off private treatment, then you may pay the private fee minus the discount.

What NHS treatment is available/what will it cover?

As previously explained, everyone is entitled to NHS dental care. 

You may have difficulty finding a regular NHS dentist in your area, even if this is the case, there will be provisions in place to allow you access to emergency dental care to get you out of pain soon, rather than waiting for a permanent dentist. Read on to find out more about this.

Emergency Dental treatment on the NHS

Even if you do not have access to a dentist for regular care, you should still be able to see an NHS dentist for emergency care.

This may be called “NHS Direct” or “Access”.

The idea of such an appointment is to relieve extreme pain, stop bleeding, manage facial swelling, or manage dental trauma (a tooth that has been knocked out).

There are a few options if you would like an NHS emergency appointment:

1. Ring around practices and ask if they have any appointments.
2. Call your local health board.
3. Ring NHS Direct dental services on 111.

If you are offered an appointment, it may only be a short appointment, and will focus on helping you with the emergency problem. Such an appointment is not for checkups or routine care.

NHS rules explain the sorts of treatment that can be provided for an emergency appointment which includes:.

• Examination, assessment and advice with x-rays if needed
• Dressing of teeth 
• Re-implantation of a luxated or subluxated permanent tooth following trauma including any necessary endodontic treatment or any other treatment immediately necessary as a result of trauma
• Repair and refixing of inlays and crowns, bridges
• Extraction of not more than 2 teeth
• Providing after care following an extraction, including treatment of infected sockets
• Adjustment and alteration of dentures or orthodontic appliances
• Urgent treatment for acute conditions of the gums
• Treatment of sensitive cementum or dentine
• Incising an abscess
• Not more than 1 permanent filling

An emergency appointment has a fixed charge in England and Wales, which is the same as a Band 1 charge. 

For treatment of a dental emergency in Scotland and Northern Ireland, the exact cost will depend on the treatment provided.

Which treatments are not typically available on the NHS?

The NHS will provide dental care to ensure you have a healthy mouth, and to help you smile, talk and eat with confidence. This includes a range of different treatments from checkups, to filling, to removal of teeth and dentures.

There are different options available for dentists depending on the circumstances of the patient, and your dentist will want to provide you with appropriate care, but which is also cost effective. 

This means that in some cases some materials and options may not be available on the NHS, where there is a cheaper option available.

White fillings in back teeth

One example of this is metal fillings in back teeth. This is a controversial topic, as many people have read about mercury toxicity. It is is long debate to get into, but you could look here for more information.

Evidence has shown that the metal released by these fillings is not at harmful levels, and so metal fillings remain a reasonable option, especially in the back teeth. A dentist will normally only provide a metal filling in a back tooth, because this will get the job done. 

If you decide that you do not want a metal filling because you do not like the look of it, then you could request a white composite filling. A white filling may be appropriate, and if so then the dentist can offer this to you privately. In some cases a white filling might not be suitable for your tooth, and your dentist may not be able to offer that to you, even if you are willing to pay privately for it.

Following recent changes in rules, and depending on your personal circumstances, a white filling in back teeth may offered on the NHS in some circumstances:

• For treatment of baby teeth or adult teeth in children under the age of 15.
• For the treatment of pregnant and breastfeeding women.
• For the treatment of patients with specific metal allergies.
• When replacing metal fillings in patients with lichenoid reactions to metal fillings.

Metal Dentures

The main purpose of dentures is to fill gaps left by missing teeth, in order to improve your confidence, as well as your ability to talk and eat food.

The most cost effective way to make dentures is as plastic (acrylic) dentures. These will indeed get the job done, and this is the least invasive option for filling gaps left by teeth (compared to implants for example).

Dentures are, however, available in thinner, flexible plastics, as well as very thin metal dentures. These are much more expensive to make, and so are not normally offered on the NHS.

Your dentist may offer you these options privately if you decide that you do not want an NHS plastic denture.

Only very rarely will metal dentures may be offered on the NHS, for example if you have an allergy to the material used to make plastic dentures.

Dental bridges

Dental bridges are another option for gaps caused by missing teeth.

Dental bridges are a fake tooth (crown) that is stuck on to the teeth left beside the gap. There are a variety of ways that this can be done.

There are circumstances when a bridge may be a better option than a denture.

Dental bridges are often not the first line treatment for missing teeth because, in theory, they could damage adjacent teeth. The teeth and gums next door also need to be perfectly healthy before bridges are an option.

So, in theory, whilst dental bridges are an NHS option, often a denture is the better option. 

Sometimes a patient would simply prefer a bridge as they do not want something that is removable. This is not the scope of NHS treatment, so private treatment may be offered in this case.

Dental implants

As already explained, dentures are normally the first option for filling gaps caused by missing teeth.

Sometimes a patient would simply prefer a bridge as they do not want something that is removable, or they want something that feels as natural as possible.

Implants can also be used to help keep dentures in place.

Because of the cost, implants are not normally provided on the NHS, and you would need to pay privately for these.

There are some limited criteria for NHS dental implants.

Implants are not available in a general dental practice under the NHS.

But the NHS patient information website advises “They’re sometimes available on the NHS for patients who can’t wear dentures or whose face and teeth have been damaged, such as people who have had mouth cancer or an accident that’s knocked a tooth out.”

This means that NHS Hospital Dental Services, which usually have a restorative department, may consider giving you dental implants in the following cases:

• If you are born with numerous missing teeth or a cleft lip and/or palate.
• If you have tooth and tissue loss following trauma, e.g. road traffic accidents or after surgery for head and neck cancer.
• If you continue to have problems with dentures even though they are well-made and well fitting complete dentures (usually requires a referral via consultant in Restorative Dentistry).

If you meet the criteria and are accepted for NHS dental implants, treatment will be free.

If you do not meet the criteria, you will need to pay privately for dental implants, and this is the most common course of action.

Tooth whitening

The NHS also will not provide treatment that is purely for aesthetic or cosmetic purposes, for example tooth whitening.

Tooth whitening for all teeth just to lighten their colour and improve  aesthetics is not available on the NHS.

There are some rare cases when tooth whitening may be offered on the NHS, if it is deemed clinically necessary.

This will usually only treat a single black tooth with an internal bleaching technique.

Help with the costs of NHS dental treatment

So far I have talked a lot about what you will pay if you have treatment with an NHS dentist. 

However, there are some situations that mean you won’t need to pay.

NHS treatment is always free for children, but there are also other ways to get help paying for NHS dental treatment.

If you normally pay for dental treatment, but are in reciept of certain benefits, you may be eligible for free dental treatment with an NHS Exemption Certificate. I will discuss free NHS dental treatment eligibility later on.

If you don’t receive benefits but struggle to pay for NHS dental treatment, you may be able to apply to the Low Income Scheme for help with paying for dental care (and in some cases to cover the whole cost).

Even if you pay for your treatment upfront, you may be able to claim back the cost if certain criteria apply to you.

So I have discussed and clarified the charges that apply to both NHS and private treatment. In some cases, you may, unfortunately, struggle to be able to pay for NHS treatment. Or perhaps you are receiving some kind of benefits and wondering if benefits entitle you to free dental treatment?

Well read on to find out about:

• Who is entitled to free NHS dental treatment.
• Which benefits give you exemptions for free NHS dental treatment.
• How you can get help paying for NHS dental treatment with the Low Income Scheme.

Who is entitled to free NHS dental treatment?

Yes, certain criteria will make you eligible for free dental treatment.

There are certain people who will never pay for treatment:

• Under 18 years old (children).
• Under 19 years old and in full-time education.
• Treatment by a hospital dentist whilst you are in a hospital as an in-patient. 
• Hospital dental services. 
• Community dental services (although you may still need to pay for labwork such as dentures).

NHS exemptions

Where the above does not apply to you, you may still have exemptions from NHS Dental Charges.

Free NHS dental treatment is available to those with NHS Tax Credit Exemption Certificate or a Maternity Exemption Certificate.

Pensions who receive Pension Credit Guarantee Credit can also get help paying for NHS Dental Charges. NHS Pension Guarantee Credit can also give you access to free NHS dental care.

In each of these cases you need to be receiving the relevant benefits to be able to claim your NHS Dental Charges Exemption Certificate.

But do be aware that an NHS Medical Exemption Certificate does not entitle you to free dental care.If you are not eligible for an exemption certificate, you may still be entitled to help with paying for NHS dental care as part of the Low Income Scheme, which I discuss in another section.

NHS Tax Credit Exemption Certificate

The NHS Tax Credit Exemption Certificate is available to cover the costs of all medical and health costs, including (where applicable) prescriptions and dental charges.

According to NHSBSA you are entitled to this exemption certificate if your annual family income used to calculate your Tax Credits is £15,276 or less and you receive either:

• Child Tax Credit
• Working Tax Credit and Child Tax Credit paid together
• Working Tax Credit which includes a disability or severe disability element.

You do not need to do anything to apply for this certificate, it will be sent through the post to you, but they are only valid for 7 months.

If you have questions about this type of exemption certificate you can call the NHSBSA on 0300 330 1347.

What about if I am in receipt of benefits?

You may think that if you are in receipt of any type of benefits, you automatically become eligible for free NHS dental care. However, this is not the case. 

Income based credits automatically entitle you to free NHS dental care, whereas contribution based credits do not entitle you to free NHS dental care.

The types of income based credits that do count in England, Wales, Scotland and Northern Ireland:

• Income Support
• Income-based Jobseeker’s Allowance 
• Income-related Employment and Support Allowance.
  • If you’re getting one of these benefits, your partner and any dependent young people under 20 are also entitled to free treatment.
• Universal Credit, depending on the income during your most recent assessment period. If you had an income of:
  • £435 or less; 
  • £935 or less if your Universal Credit includes an element for either a child, or limited capability for work.

As well as free NHS dental treatment, you will also be able to receive help with other healthcare costs.

Contribution based credits do not entitle you to free dental treatment. Universal credit with income above those stated above also will not entitle you to free dental treatment. But you may still be eligible for the Low Income Scheme for help with costs.

Maternity Exemption Certificate

If you are pregnant, or have given birth in the last 12 months then you are entitled to free dental treatment.

To prove your eligibility for free dental treatment the most common method is via a Maternity Exemption Certificate. 

A maternity exemption certificate entitles you to free dental care throughout the UK. This will also entitle you to free prescriptions if you live in England (prescriptions normally carry no charge in Wales, Scotland or Northern Ireland).

You can apply for one of these through your GP, midwife or health visitor.

Once applied for, it will not expire until 12 months after either your due date or after the baby is born, and if your baby is born later than you can extend the expiry date. 

This means that if you start your course of treatment whilst you are pregnant, or if you have given birth in the last 12 months, that you are entitled to free treatment. This applies even if you have appointments as part of the same course of treatment when you are no longer pregnant or if your baby turns 1.

For information about the Maternity Exemption Certificate:

• In England and Wales, you can visit the NHS BSA website.
• In Scotland, visit NHS Inform.
• In Northern Ireland, you can find out more information via NI Direct.

According to NHS BSA, you can also prove your eligibility for free dental treatment using:

• MatB1 certificate.
• Notification of birth form.
• Birth certificate.
• Stillbirth certificate.

NHS Medical Exemption Certificate

An NHS Medical Exemption Certificate can be provided to people who suffer from certain medical conditions. 

Whilst and NHS Medical Exemption Certificate entitles you to free prescriptions (in England; prescriptions elsewhere are already free), it does not provide you with access to free dental care. 

To find out information about the NHS medical Exemption Certificate for England and Wales, visit the NHS Business Services Authority Website. 

In Scotland, there is no need to apply for an NHS Medical Exemption Certificate because prescriptions are free. Only if you need to regularly collect prescriptions in England do NHS Inform recommend you apply for an NHS Medical Exemption Certificate. 

If you live in Northern Ireland, HSC BSO explains that NHS Medical Exemptions Certificates are no longer required because prescriptions are free.

Do Pensioners get free dental treatment?

If you are over 60, you do not automatically get free NHS dental care. 

You continue to pay NHS dental charges over 60 years old. 

The NHS dental charges for over 60 vary slightly between different countries with checkups being free in Wales and Scotland, but not in England and Northern Ireland. Generally speaking, although checkups are free, you would still need to pay for treatment unless you receive Pension Credit Guarantee Credit.

In England, you will continue to pay for all checkups and NHS dental care unless you or your partner are in receipt of Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Savings Credit. If you receive either of these two then you will be exempt from dental charges. If you only receive Pension Credit Savings Credit on it’s own, you are not entitled to free dental care. You could, however, apply for help with the costs of dental treatment under the Low Income Scheme.

In Wales, you become eligible for free check ups when you turn 60. Although checkups are free for over 60s in Wales, you will continue to pay for all NHS dental treatment (including x-rays) unless you or your partner are in receipt of Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Savings Credit. If you receive either of these two then you will be exempt from dental charges. If you only receive Pension Credit Savings Credit on it’s own, you are not entitled to free dental care. You could, however, apply for help with the costs of dental treatment under the Low Income Scheme.

In Scotland, your checkups continue to be free after the age of 60, however you will continue to pay for all other NHS dental treatment unless you or your partner are in receipt of Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Savings Credit. If you receive either of these two then you will be exempt from dental charges. If you only receive Pension Credit Savings Credit on it’s own, you are not entitled to free dental care. You could, however, apply for help with the costs of dental treatment under the Low Income Scheme.

In Northern Ireland, you will continue to pay for all checkups and NHS dental care unless you or your partner are in receipt of Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Savings Credit. If you receive either of these two then you will be exempt from dental charges. If you only receive Pension Credit Savings Credit on it’s own, you are not entitled to free dental care. You could, however, apply for help with the costs of dental treatment under the Low Income Scheme.

Do students get free or reduced price dental treatment? 

Students do not automatically get free or reduced price dental treatment.

Full time students will receive free NHS dental treatment until their 19th birthday. After that, you will be required to pay for NHS dental treatment.

You might be able to get help with the costs of dental treatment if you apply via the Low Income Scheme. If your application is successful under the Low Income Scheme, then you could have all your health costs paid for.

Armed Forces Veterans

If you are a veteran of the Armed Forces, you are not automatically entitled to free dental care.

If you have been medically discharged from the Armed Forces or are an Armed Forces Veterans are not automatically entitled to free dental treatment. 

However if you are a war pensioner and need the dental treatment specifically because of an injury or disability which you get a war pension for, then you may be eligible for free treatment.

If you have recently moved to a new area because of your service you may be eligible to be placed higher on waiting lists in line with the Armed Forces Covenant.

For information about the Armed Forces Covenant, visit their webpage here, or received an Armed Forces Compensation Scheme payment for.

Any other non-related treatment would need to be paid for as normal.

NHS Penalty Charges

It is important to get help if you are unsure whether or not you are eligible for an exemption certificate for NHS dental charges.

If you claim incorrectly you may be hit with a fine – also known as NHS Penalty Charges.

The NHSBSA (who issues the fines) warns: 

“It’s your own responsibility to check that you’re entitled before claiming free dental treatment. If you claim free treatment that you’re not entitled to, you could have to pay a penalty charge of up to £100.”

The reception staff at a dental centre may be able to provide answers with simple questions, but it is not their responsibility to check for you. 

A penalty charge may be imposed on patients who are found to have wrongly claimed total or partial help with health costs. The penalty charge is five times the amount owed, up to a maximum of £100. This is in addition to the original charge!

If you are in doubt, you can pay for treatment upfront and later claim back the costs.

If you need help, you can contact the NHSBSA, who issues exemption certificates. Their contact details are easily available on their website, where they also have this handy tool to check if you could be eligible for help with dental costs. The best option is to check before you tick!

Claiming back costs

You may have paid for NHS dental treatment and then realised you were entitled to an exemption or help with costs.

If this is the case, you can claim a refund for NHS dental charges.

You must claim a refund within three months of paying for your NHS dental treatment.

If you live in England, you can download the HC5(D) form here and then post the form to the relevant address contained in the form.

If you live in Wales, you cannot download the HC5 form on the internet, but you can call 0345 603 1108 and request that one is sent to you. This system is currently changing and will hopefully come online soon. You may be able to collect the form from your dental practice, GP practice or Jobcentre.

The form HC5 for Scotland, with advice, can be downloaded here and should then be completed and posted to the relevant address contained in the form. You may be able to collect the letter from your GP, dental practice, or community pharmacy.

In Northern Ireland, you need to collect the local HC5 form, which can be collected from your Social Security Office or Job and Benefits Office.

Low Income Scheme to help with NHS dental costs

The NHS Low Income Scheme (LIS) is available to help you pay for your health costs, including help paying dental costs.

The LIS may cover part or all of your costs, depending on your income.

The scheme can help with the costs of dental care, travel costs, and costs of prescriptions (if applicable). There are other health costs that the scheme also helps with.

As already mentioned, the scheme is for people with a low income. This means you (and your partner) are eligible only if you have less than:

• £16,000 in savings, investments or property (not including the place where you live) 
• £23,250 in savings, investments or property if you live permanently in a care home (£24,000 if you live in Wales).

If you think this applies to you, you could check if you are eligible for help with costs using the NHSBSA checking tool. This is not only an NHS Low Income Scheme calculator, but is the same 3 minute questionnaire to see if you are entitled to an exemption certificate.

If you are applying from England or Scotland, visit this website to download the relevant forms, or for information on how to order one. 

In Wales, this website contains all the information and forms you need, as well as important contact details.

For Northern Ireland, the relevant forms and information is here.

After you have submitted your HC1 form – the application for help with health costs, you will be assessed. If successful, you will be provided with either an HC2 certificate (for full help with health costs) or an HC3 certificate (for limited help with health costs).

Review

So hopefully I have helped you figure out:

• The difference between NHS and private dental treatment.
• The costs of your NHS dental treatment in the UK.
• The costs of private dental treatment in the UK.
• Help with paying for NHS dental treatment.
• Different ways of paying for private treatment.

If there is anything you would like more information about, or think needs covering, please leave a comment below.

FAQ

Do I have to pay for NHS dental treatment?

Yes, you will pay for NHS dental treatment UNLESS you belong to one of the groups eligible for free dental treatment; you are eligible for an exemptions; you qualify for help under the Low Income Scheme.

What is meant by clinically necessary?

Any treatment that you need to keep your mouth, teeth, and gums healthy and free of pain.

What if prices change during my treatment?

You should pay the price quoted at the start of your treatment plan.

What is covered by NHS guarantee?

Fillings, root fillings, inlays, porcelain veneers and crowns are all covered by the NHS guarantee for dental treatment.

How can I pay for private dental treatment?

You can pay for private dental treatment on a pay-as-you go basis, or could join a monthly payment scheme.

How do I get treatment that is not offered on the NHS?

Cosmetic and aesthetic dental treatment is not available on the NHS. You can pay privately for such treatment. Your own regular dentist ay offer you this private treatment, or you may need to go to a different dental practice.

https://www.gov.wales/low-income-scheme-help-nhs-health-costs