Why do I have to pay my dentist when I don’t pay my GP?
Charges for NHS dental treatment were introduced in 1951 to help cover the cost of providing treatment. In a similar way charges for prescriptions and glasses were also introduced.
The NHS spends around £2.25 billion on dental treatment a year and patients only pay £550 million of this. So although it may not seem fair that you have to pay for dental treatment, the NHS still carries the biggest share of dental costs.
How can I pay for dental treatment?
You can pay for dental treatment on the NHS or as a private patient. This will depend on the arrangements you make with your dentist. If your dentist’s NHS list is full, or if they do not see NHS patients, they may only be able to treat you privately. If you cannot afford this, your local primary care trust will help you find a dentist in your area that will treat you as an NHS patient or you can visit www.nhs.uk.
There are a number of ways you can pay for treatment either on the NHS or privately:
- ‘Capitation’ schemes.
- Private medical insurance.
You’ll find more information about each of these later in the leaflet.
If you aren’t sure whether you are being treated privately or on the NHS, ask your dentist before committing to treatment and payment. Always get an estimate for charges from your dentist before starting treatment.
How much does NHS dental treatment cost?
There are now different NHS charges depending on which part of the UK you live in.
In England and Wales there are three ‘bands’ of charges, and these cover a course of treatment:
|Emergency||This covers emergency care in a primary care NHS dental practice such as pain relief or a temporary filling.||£23.80||£14.70|
|One||This covers an examination, diagnosis (including X-rays), advice on how to prevent future problems, a scale and polish if clinically needed, and preventative care such as the application of fluoride varnish or fissure sealant if appropriate.||£23.80||£14.70|
|Two||This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work, or the removal of teeth but not more complex items covered by Band 3.
|Three||This covers everything listed in Bands 1 and 2 above, plus crowns, dentures, bridges, and other laboratory work.
NHS charges in England should not be more than £282.80, and no more than £203.00 in Wales, for a course of treatment.
If you need to go back to your dentist within two months because of a problem with your treatment, and nothing extra is needed to correct it, then the dentist will not charge you again.
The maximum charge for a single course of NHS treatment in Scotland and Northern Ireland is £384; some treatments will require prior approval before a dentist can commence work on you.
Are there some people who don’t have to pay?
You will not pay for NHS dental treatment if you:
- Are under 19 and in full-time education.
- Are pregnant or have a baby under 12 months old.
- Are getting Income Support or income-based Jobseeker’s Allowance/Employment and Support Allowance.
- Are getting Pension Credit Guarantee Credit.
- Have an NHS Tax Credit Exemption Certificate.
Always check with your dentist if you aren’t sure whether you come under any of these groups. You may also be able to apply to pay a reduced charge if you are on a low income.
If you don’t come under any of these groups then you will have to pay the full costs.
NHS charges change every year.
Always ask for a written treatment plan and an estimate of costs before starting treatment.
What treatments are not covered on the NHS?
The NHS will not provide cosmetic treatments such as teeth whitening, which you may want to make your teeth more attractive, but are not clinically necessary.
How much does private dental treatment cost?
Private treatment does not have set charges, so the costs will vary from practice to practice.
Make sure you agree with the cost with your dentist before your treatment starts. The cost is usually based on the time you spend in the surgery, the work being done and the types of materials used.
Always get a written treatment plan and an estimate of charges beforehand.
So how do I pay?
You usually pay for treatment, NHS or private, either during the course of treatment or when it is finished. You usually pay at reception when you leave. Ask for a receipt for your payment.
‘Capitation schemes’ for private treatment
Capitation schemes are designed to help you ‘save up’ for treatment by making a monthly payment by direct debit. Your dentist or an independent company will run the scheme. There are two types of plans: maintenance plans and comprehensive plans. Costs will vary from dentist to dentist and may also be based on how healthy your mouth is.
A maintenance plan is provided through your dentist and is designed to offer preventive care. This would include a set number of examinations a year, including x-rays, and any scale and polishes you need.
You will have to pay extra charges for any other dental procedures and laboratory fees.
A comprehensive plan usually offers unlimited dental treatment, but again may not cover laboratory fees and some types of treatment (such as dental implants). You will need to have a clean bill of health for your mouth before you can join most schemes. You may need to have a full course of treatment (pay-as-you-go) to achieve this.
Some plans may include insurance cover for accidental damage and dental emergencies.
Dental insurance (this can cover both NHS and private costs)
You can get dental insurance yourself, or through your employer if they offer it. The cost will depend on the level of cover you choose.
Dental insurance is usually designed to cover both routine and unplanned treatment. It can also include accident or emergency treatment, both in the UK and overseas, oral cancer cover, hospital cash payments and other items.
There are a number of dental insurers, all providing their own dental insurance plans. It can be difficult to compare one plan with another. The main things you may want to consider when taking out insurance are:
- Is there a ‘waiting period’ before you can make a claim? That is, how long do you have to pay into the plan before you can claim on it?
- Is the level of cover suitable for your needs and the type of treatment you have (that is, NHS or private)?
- What percentage of the dentist’s costs will you get back?
- Is there a policy ‘excess’? In other words, do you have to pay for example the first £20 of any claim you make?
- What is the total amount you are covered for and are there limits for specific treatments?
- How does the insurer treat problems with your teeth that you already had before you bought the cover?
Private medical insurance
You can buy private medical insurance yourself or it is sometimes provided as a benefit by your employer. Most schemes do not cover ordinary dental treatment but will cover you in a situation where you need to be hospitalised for treatment. This could be, for example, having your removed or a broken jaw treated by a consultant. You need to read your policy very carefully as you may think you are covered for a certain treatment when you are not.
These plans are similar to insurance. They are designed for you to claim back some of the costs you have paid for medical and dental treatment either on the NHS or privately. Most of them have limits on the amount you can claim in any membership year.
You may also be able to use your cash plan for treatments by other professionals such as opticians, chiropodists and physiotherapists.
Although similar to insurance, cash plans are not regulated by law in the way that insurance policies are, and do not cover the unexpected. Therefore you will not get the same benefits as you would with dental insurance.
We advise you to check how much the refunds and benefits are for your individual plan.
Loans and credit agreements
If your dental treatment is expensive you may want to consider a loan. With a loan you borrow a sum of money and then pay it back over an agreed amount of time, often with interest. There are specialist loans for high-cost items of treatment such as cosmetic dentistry and implants.
Which should I choose?
How you pay for dental treatment will depend on your personal circumstances and the level of risk you want to take. You need to see a dentist regularly to keep your mouth healthy. Prevention is better than cure, and there will be costs if you visit the dentist regularly. But this is money well spent as it will help you keep your teeth and gums healthy.
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Thank you to Johnson & Johnson, who have kindly provided us with an for this information. Johnson & Johnson‘s support does not only allow us to develop and maintain this advice online but means that we can continue to provide this vital resource as a printed leaflet for dental practices and hospitals to hand out to patients and leave in waiting areas.