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Understanding NHS Dental Charges

Dentistry is one of the few NHS services where you have to pay a contribution towards the cost of your care. The information on this page explains what you may have to pay for your NHS dental treatment.

Emergency dental treatment – £20.60

This covers emergency care in a primary care NHS dental practice such as pain relief or a temporary filling.

Band 1 course of treatment – £20.60

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.

Band 2 course of treatment – £56.30

This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or removal of teeth but not more complex items covered by Band 3.

Band 3 course of treatment – £244.30

This covers everything listed in Bands 1 and 2 above, plus crowns, dentures, bridges and other laboratory work.If you need help with dental charges see our section on Help with health costs.

Any treatment that your dentist believes is clinically necessary to achieve and maintain good oral health should be available on the NHS.

You will not be charged for individual items within a course of treatment. Depending on what you need to have done, you should only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it. A course of treatment is finished when your dentist considers good oral health has been achieved.

If you are referred to another dentist

If you’re referred by your dentist for specialist NHS dental work as part of an existing course of treatment, you should only pay one charge. However, if your are referred to another dentist such as for a full course of treatment under sedation then this is generally regarded as a separate course of treatment and you will have to pay a second charge. The amount you need to pay will depend on the treatment you need.

If you have completed a course of treatment and need further treatment

  • If you have completed one course of treatment but you need another treatment, you do not have to pay
  • You need more treatment within the same or a lower charge band (such as another filling) within two months ofcompleting a course of treatment.
  • You need repair work or a replacement for certain types of restoration within a year of the original work being done. You should return to the same dentist. Please note certain conditions apply, which your dentist should discuss with you.

again if:

When to pay for your treatment

If you have completed one course of treatment but you need another treatment, you do not have to pay again if:

  • You need more treatment within the same or a lower charge band (such as another filling) within two months of completing a course of treatment
  • You need repair work or a replacement for certain types of restoration within a year of the original work being done. You should return to the same dentist. Please note certain conditions apply, which your dentist should discuss with you.

Who does not have to pay for NHS Dental Treatment?

You do not have to pay for NHS dental treatment if, when your treatment starts, you are

  • under 18
  • under 19 and in full-time education
  • pregnant or you’ve had a baby within the 12 months before treatment starts
  • staying in an NHS hospital and the hospital dentist carries out your treatment
  • an NHS Hospital Dental Service outpatient (although you may have to pay for your dentures or bridges)

You can also get free NHS dental treatment if, when the treatment starts or when you’re asked to pay:

  • you’re included in an award of Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance or Pension Credit guarantee credit or Universal credit (check entitlement after October 31 2015)
  • you’re named on, or entitled to, a valid NHS tax credit exemption certificate
  • you’re named on a valid HC2 certificate
  • If you’re named on a valid HC3 certificate, you may not have to pay for all your NHS dental treatment. HC2 and HC3 certificates are issued under the NHS Low Income Scheme.

If you receive any of the following benefits you will not be exempt from paying for NHS dental treatment unless you also fall under one of the categories listed above

  • Incapacity Benefit
  • contribution-based Jobseeker’s Allowance
  • contribution-based Employment and Support Allowance
  • Disability Living Allowance
  • Council Tax Benefit
  • Housing Benefit
  • Pension Credit savings credit

Proof of your entitlement

You’ll be asked to show your dentist written proof that you’re entitled to financial help with dental treatment. This will vary depending on your circumstances. To check what documents you need, see the NHS HC11 leaflet: Help with health costs (PDF, 452kb).

NHS Low Income Scheme

The NHS Low Income Scheme provides financial help to people not exempt from charges, but who may be entitled to full or partial help with healthcare costs if they have a low income. Anyone can apply as long as they don’t have savings or investments over the capital limit. In England, the capital limit is £16,000 (or £23,250 if you live permanently in a care home).

Help is based on a comparison between your weekly income and assessed requirements at the time the claim is made. Entitlement broadly follows Income Support rules to decide how much, if anything, you have to pay towards your healthcare costs, including dental treatment.

The NHS Business Services Authority (NHSBSA) website has more information about the NHS Low Income Scheme, including how to apply.

Read the answers to more questions about dental health.

Further information:

How to claim a refund

If you think you’ve been charged wrongly or that you’ve paid too much, talk to your dentist in the first instance. Your dentist will know what work was done and whether it was NHS only or a mix of NHS and private work. The dentist will be able to make the relevant refund if appropriate. For Band 2, Band 3 and any mix of NHS and private treatment, you should have had a dental treatment plan outlining the costs and treatments.

If you paid for NHS treatment but later found out that you were entitled to have it free of charge or to pay a reduced amount, you can claim a refund of the NHS charge. You need to do this within three months of the date that you paid. To find out how to make a refund, read about help with dental costs.

If you are not happy with the way your dentists dealt with your claim then you should follow the NHS complaints procedure.

List of dental treatments by Bands

If the treatment your dentist believes is clinically necessary to achieve and maintain good oral health is available on the NHS. This means that the NHS provides any treatment you need to keep your mouth, teeth and gums healthy. It does not include treatments such as teeth whitening or veneers, which you might want for cosmetic reasons but which are not clinically necessary.

The following list of dental treatments is therefore not a comprehensive list of treatments that all patients are entitled to under NHS services provision. For each individual course of treatment, a dentist will indicate the treatment options that are clinically appropriate for your personal circumstances and based on specific clinical judgement each time.

Band 1 course of treatment: £20.60

  • Clinical examination, case assessment and report
  • orthodontic case assessment and report
  • advice, dental charting, diagnosis and treatment planning
  • radiographic examination and radiological report
  • study cast
  • colour photographs
  • instruction in the prevention of dental and oral disease including dietary advice and dental hygiene instruction
  • surface application as primary preventive measures of sealants and topical fluoridepreparations
  • scaling, polishing and marginal correction of fillings
  • taking material for pathological examination
  • adjustments to and easing of dentures or orthodontic appliances
  •  treatment of sensitive cementum

Band 2 course of treatment: £56.30

  • non-surgical periodontal treatment gum disease treatmentincluding root-planing, deep scaling, irrigation of periodontal pockets and subgingival curettage and all necessary scaling and polishing
  • surgical periodontal treatment, including gingivectomy, gingivoplasty or removal of an operculum, raising and replacement of a mucoperiosteal flap, curettage, root planning and bone resection
  • free gingival grafts
  • permanent fillings in amalgam, composite resin, synthetic resin, glass ionomer, compomers, silicate or silico-phosphate, including acid etch retention
  • sealant restorations
  • endodontic treatments (root canal treatmentof permanent or retained deciduous teeth, pulpotomy and apicoectomy
  • extraction of teeth
  • transplantation of teeth
  • oral surgery including surgical removal of cyst, buried root, unerupted tooth, impacted tooth or exostosed tooth and alveolectomy
  • soft tissue surgery in relation to the buccal cavity and lips
  • frenectomy, frenuloplasty, frenotomy
  • relining and rebasing dentures including soft linings
  • addition of tooth, clasp, labial or buccal flange to dentures
  • splints (other than laboratory made splints) in relation to periodontally compromised teeth and in connection with external trauma
  • bite raising appliances (other than laboratory made appliances)

Band 3 course of treatment: £244.30

  • laboratory made porcelain or composite veneers, including acid etch retention
  • inlays, pinlays, onlays and palatal veneers, in alloys containing 60% or more fine gold, porcelain, composite resin and ceramic
  • Crowns including any pin or post aids to retention:
  • full or three-quarter crown cast in alloys containing not less than 33⅓% fine gold or platinum or  palladium
  • full or jacket crown cast in alloys containing stainless steel or cobalt chromium or nickel chromium
  • crown in porcelain, synthetic resin and other non-metallic crowns
  • full or jacket crowns in alloys containing not less than 33⅓% fine gold or platinum or palladium, or alloys  jacket crown thermally bonded to wrought platinum coping
  • prefabricated full or jacket crown, including any pin or post retention

Bridges including any pin or post aids to retention:

  • bridges in alloys containing 60% or more fine gold with or without thermally bonded facings
  • bridges cast in alloys containing stainless steel, cobalt chromium or nickel chromium, with or without thermally bonded facings
  • acid etch retained bridges
  • bridges in other materials
  • provision of full (completed) or partial dentures, overdentures and obturators in synthetic resin or metal or both synthetic resin and metal, including any cast or   wrought metal components or aids to retention
  • orthodontic treatment and appliances
  • other custom made applications excluding sports guards

What to expect when you visit your dentist

When you see your dentist for a check-up, they will first carry out an examination or assessment. This is the first part of each course of NHS treatment and is included in the Band 1 (£19.70) charge.

You do not have to register with a dentist in the same way as with a GP to receive NHS treatment. Therefore, you should not be asked to have an examination or pay for any private work before being accepted by an NHS dentist.

If you haven’t seen a dentist for several years because of fear or anxiety, read our tips to ease fear of the dentist

Read about your dental team for an overview of the different professionals you may see at your dental practice.

At your check-up, your dentist will assess your current oral health, any risk of future disease, and advise you on the care and treatment required to secure good oral health. It is important that you try to keep your teeth healthy and clean to maintain good oral health.

At your check-up, your dentist may:

  • carry out a full examination of your mouth, teeth and gums
  • ask about your general health and any problem smoking  you have had with your teeth, mouth or gums since your last visit
  • ask about and give advice on your diet smoking and drinking

ask about your teeth-cleaning habits and give you advice on the most appropriate ways to keep your mouth, teeth and gums healthy

  • explain any risks, as well as costs, of all treatment you may need
  • discuss with you when your next visit should be
  • You don’t necessarily need to see your dentist every six months. Your dentist will recommend how often you should come to see them, based on your current dental health.

If you have problems with your teeth between check-ups, contact your dental practice to make an earlier appointment. Find out about emergency dental care.

The dental treatment plan

Download a treatment plan (PDF 19Kb) and take it with you to your next dental appointment

If your dentist recommends a Band 2 or Band 3 dental treatment, you’ll be given a personal dental treatment plan (PDF, 19kb) in advance. This outlines all the treatments you are having on the NHS and how much they will cost. If you are not given a treatment plan, ask for one. Treatment plans are usually not given for Band 1 dental treatments, but you can ask for one if you like.

If your dentist says you need a particular type of treatment, you should not be asked to pay for it privately. Where alternative private options have been discussed, then those options should be listed on your treatment plan. Separate details of private treatment and charges – usually on the same form as your NHS treatment plan – should always be provided in writing before you commit to it. If this isn’t done, query this immediately with the practice or make an official complaint.

You’ll be asked to sign the plan and you’ll be given a copy to keep.

If you’re unhappy about agreeing to your treatment plan or signing it, you have the right to say no to all or any of the recommended treatments. You also have the right to seek a second opinion from another dentist. However, you will have to pay another Band 1 fee for this new consultation.

If you decide not to proceed with a certain treatment option then inform your dentist. Likewise the dentist should inform you of any necessary changes to the treatment plan. A dentist may suggest a different treatment sometimes on further investigation or due to changes in your oral health following the initial assessment. Any changes to treatment should be discussed and agreed with you. If your dentist tries to change that course of treatment without your agreement, query this immediately with the practice or make an official complaint.

To find out more about how Dental Services work you can also go to the following page: http://www.nhs.uk/NHSEngland/AboutNHSservices/dentists/Pages/dental-services-available-on-the-NHS.aspx#complaints

How can I access an NHS dentist in an emergency or out of hours?

If you have a regular NHS dentist and need urgent treatment, contact your dentist for advice. If you do not have a regular NHS dentist, you can contact NHS 111. They can give you details of out-of-hours dental services in your area. You could also see if there are any urgent care services near you that provide emergency dental treatment.

Out-of-hours dental care

If you have a problem outside normal practice hours or you’re in pain, you can first try helping yourself by taking painkillers. If you feel the problem can wait until normal practice hours, you can call NHS 111 for self care advice.

Emergency dental care

  • If your problem is more urgent, you can access out-of-hours dental services in your area by calling:
  • your dentist, who should have an answerphone message with details of how to access treatment out of hours

NHS 111

Go to the accident and emergency (A&E) department of your local hospital if you:

  • are in severe pain that is not helped by painkillers
  • are bleeding a lot and it won’t stop
  • trauma of the face, mouth or teeth after a recent accident or injury

NHS out-of-hours or emergency dental care

NHS dental care is available in an emergency if it is clinically necessary, whether or not you have a regular dentist. Emergency and out-of-hours NHS dental care will cost you £18.50. After this you may have to make another appointment for separate non-urgent treatment, where you will have to pay a second charge in the relevant treatment band.

How do I complain about a dentist?

If you have a problem with your dentist and you are not happy you are able to complain.

You can do this directly with your dental practice first and try and resolve it in an informal manner.

If that does not work, then you can make it formal by putting the complaint in writing and address it to the Senior Partner/Manager of the Practice. If you then receive a response and are still not happy after you have received the response you can go directly to NHS England, who will investigate your complaint and come back to you with a response within 28 days using the contact details below:

By post to:

NHS England
PO Box 16738
Redditch
B97 9PT

By email toengland.contactus@nhs.net

Please state: ‘For the attention of the complaints team’ in the subject line.

Once you receive a response and are still not happy, you will need to go through the Parliamentary and Health Ombudsman athttp://www.ombudsman.org.uk/ who will be the final aribiter in whether the complaint is justified or not and advise of any further action that might be taken.

Second stage of the complaints process

If you are not content with the response, the next step is to ask the Parliamentary and Health Service Ombudsman (PHSO) to review your complaint and how it has been handled.

The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP

Telephone: 0345 015 4033

Email: phso.enquiries@ombudsman.org.uk

The PHSO undertakes independent investigations into complaints alleging that government departments and other public bodies in the UK, including NHS England, have not acted properly or fairly or have provided a poor service. The Parliamentary and Health Service Ombudsman (or Health Service Commissioner for England) has the same powers as a court of law. NHS England therefore has a legal duty to co-operate fully with any inquiry or investigation that the PHSO carries out in relation to a complaint and to provide any relevant documents.

If you are unhappy with the Ombudsman’s decision, you can appeal directly to the PHSO http://www.ombudsman.org.uk/. Once the Ombudsman or one of their senior staff has considered the complaint and sent a response, their decision is final. They will acknowledge any further correspondence but unless you raise new issues that they consider significant, they will not send further replies.

If you require further support

If you require further support there is an Independent Advocacy Service available who are able to help with complaints, providing they are are NHS funded. POhWER will assign an advocate and take you through the process from start to finish and the details are below:

POhWER is a charity and membership organisation which provides information, advice, support and advocacy to people who experience disability, vulnerability, distress and social exclusion.

POhWER was set up in 1996 and  developed by service users who, tired of others making assumptions about their capabilities and views, wanted equal access to information and a voice of their own.

Reflecting their origins, the majority of their Board are people who fall into the terms of the Equality Act and our membership is largely drawn from people who have used our services.

Their services are designed by service users for service users. Last year they provided direct advocacy to over 19,000 people and 35,000 downloaded information from their website. POhWER is one of the largest providers of advocacy in the UK.

They work regularly work with:

  • People who feel they have been let down by the NHS and want to make a complaint,

Older people,

  • People with mental health issues,
  • People with sensory impairment,
  • People with physical disabilities,
  • People with learning disabilities,
  • Children and young people,
  • People with autism,
  • People whose first language is not English,
  • People who have experienced discrimination or exclusion.

They aim to enable people to have information, choice and control over decisions that affect their lives, no matter what their needs.

Telephone: 0300 456 2370 (charged at local rate)

Minicom: 0300 456 2364

Text: Send the word ‘pohwer’, your name and number to 81025

E-mail: powher@pohwer.net

Skype: powher.advocacy – 8.00am – 6.00pmFax: 0300 456 2365

Post: P O Box 14043, Birmingham B6 9BLThe Support Centre is open from  Monday to Friday 8.00am – 6.00pm

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