NHS Dental Treatment NHS dentist- Providing NHS and Private Dentistry

All treatment that is, in your dentist’s opinion, clinically necessary to protect and maintain good oral health is available on the NHS. This means the NHS provides any treatment that you need to keep your mouth, teeth, and gums healthy and free of pain, including:

dentures
crowns
bridges

Dental implants and orthodontic treatment, such as braces, are available on the NHS, but only if there’s a medical need for the treatment.

Charges for NHS dental treatment

There are three charge bands for all NHS dental treatments. For information on charges for NHS dental treatment, see:

Cosmetic dental treatment

NHS dental treatment does not include cosmetic treatments that are not clinically necessary, such as teeth whitening. Cosmetic treatments like this are used to improve the appearance of your teeth and make them look more attractive, and are only available privately.

If you’re interested in having any cosmetic dental treatments, you should ask your dentist how much private treatment will cost. Charges for any private treatment will be added to the charges for your NHS treatment.

Read the answers to more questions about dental health.

If you need dental treatment in an emergency

call your dentist: some practices offer appointments at short notice
if you don’t have a dentist, find one using NHS 111
look up urgent care services that provide dental treatment

If you need to see a dentist out of hours

call your dentist: their answerphone may advise where to get out-of-hours treatment
call NHS 111 to find an out-of-hours dental service near you

Don’t contact your GP, as they won’t be able to offer emergency or out-of-hours dental care.

If you’re in pain while waiting to see a dentist, take painkillers. NHS 111 can also offer other self care advice.

How much will I be charged?

An urgent dental treatment will cost £25.80 – see NHS dental charges explained.

If you’re entitled to free NHS dental care, you should be able to claim back the cost of any treatment.

Ensure you keep all receipts. For more information, see Help with dental costs.

If you’re asked to come back for further treatment, this will be considered to be a separate course of non-urgent treatment.

You’ll have to pay the relevant charge for the new course of treatment.

Ask the dentist what the treatment will cost or whether you can have a treatment plan.

When to go to hospital

Only go to accident and emergency (A&E) in serious circumstances, such as:

severe pain
heavy bleeding
injuries to the face, mouth, or teeth

If you’re not sure whether you should go to A&E, contact NHS 111, who will be able to advise you. Find out when to dial 999.

Complaining about NHS dental treatment

If you wish to make a complaint about a dentist or dental practice, try to resolve it directly with them first. Contact the dental surgery’s practice manager with details of your complaint. You can complain in writing, by email or by speaking to someone.

Your complaint must be made within 12 months of receiving treatment.

If you would rather not go directly to the practice, you can contact NHS England, which is responsible for NHS dental services.

If you’re not happy with the way your complaint was handled – either by the dental practice or NHS England – you may wish to contact the Parliamentary and Health Service Ombudsman (PHSO).

The PHSO makes the final decision on complaints that haven’t been resolved by NHS England. You can call on 0345 015 4033 or use the PHSO’s secure online form to raise your complaint (this only applies to NHS services in England).

You can find further information and support for making a complaint from:

a hospital’s Patient Advice and Liaison Service, if your treatment was carried out in a hospital
Citizens Advice
the Care Quality Commission (CQC) – the CQC does not settle individual disputes, but your feedback about a practice helps it to decide when, where and what to inspect

Complaining about private dental treatment

If you wish to make a complaint about private dental services, contact the practice manager of the private dental surgery. Your complaint must be made within 12 months of receiving treatment.

If your complaint is not resolved satisfactorily, you may want to consider contacting the General Dental Council, which sets standards of conduct and regulates all dental professionals in the UK. It may be able to investigate your concerns.

You can also contact the Dental Complaints Service on 020 8253 0800 (Monday to Friday, 9am to 5pm) or visit its website for more information.

Read the answers to more questions about dental health.

If you normally pay for NHS dental treatment, the amount you spend will depend on what treatment you need.

Some people don’t have to pay for NHS dental treatment – see Who is entitled to free NHS dental treatment in England?

NHS dental charges

There are three NHS charge bands.

Band 1: £25.80 covers an examination, diagnosis and advice. If necessary, it also includes X-rays, a scale and polish, and planning for further treatment.

Band 2: £70.70 covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).

Band 3: £306.80 covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.

For more information, see What is included in each NHS dental band charge?

What if I need more treatment?

If, within two calendar months of completing a course of treatment, you need more treatment from the same or lower charge band – such as another filling – you don’t have to pay anything extra.

If the additional treatment needed is in a higher band, you will have to pay for the new NHS course of treatment.

However, once two months have passed after completing a course of treatment, you’ll have to pay the NHS charge band (listed above) for any NHS dental treatment received.

Certain treatments (including lost items) are guaranteed for 12 months from the date they were completed. These are:

fillings
root fillings
inlays
porcelain veneers
crowns

Treatments provided under this guarantee must be similar or related to the original treatment, but they don’t have to be like for like.

Emergency or urgent treatment

If you require urgent care, you will pay a Band 1 charge of £25.80.

Most urgent treatments can be done in one appointment.

Once your urgent course of treatment is complete, you may be advised to make another appointment for a separate course of non-urgent treatment. In this case, the relevant NHS banding charge will apply.

When you don’t have to pay

There is no dental charge:

for denture repairs
to have stitches removed
if your dentist has to stop blood loss
if your dentist only has to write out a prescription – however, if you pay for prescriptions, you’ll have to pay the usual prescription charge of £8.80 when you collect your medicine(s)

Referral to another dentist

If you’re referred to another dentist to complete your treatment, the amount you pay is dependent on the type of referral and whether the NHS treatment is carried out as one course of treatment. Your dentist will inform you how much you have to pay.

If you’re referred to a private dentist (and you accept this option), you will:

pay the appropriate NHS banding charge to the dentist who referred you
also pay a fee for the dental work carried out by the private dentist you are referred to

You don’t have to pay for NHS dental treatment if you’re:

under 18, or under 19 and in full-time education
pregnant or have had a baby in the previous 12 months
being treated in an NHS hospital and your treatment is carried out by the hospital dentist (but you may have to pay for any dentures or bridges)
receiving low income benefits, or you’re under 20 and a dependant of someone receiving low income benefits

Low income benefits

You’re entitled to free NHS dental treatment if you or your spouse (including civil partner) receive:

Income Support
Income-related Employment and Support Allowance
Income-based Jobseeker’s Allowance
Pension Credit Guarantee Credit
Universal Credit (in certain circumstances)

Certificates to help with health costs

You can receive free NHS dental treatment if you’re entitled to or named on:

a valid NHS tax credit exemption certificate
a valid HC2 certificate – which is available for people on a low income

People named on an NHS certificate for partial help with health costs (HC3) may also get help.

You’ll be asked to show your dentist written proof that you don’t have to pay for all or part of your NHS treatment. You’ll also be asked to sign a form to confirm that you don’t have to pay.

What to expect when you visit the 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 (£25.80) 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 want to have any cosmetic dental treatment, such as tooth whitening, this will be done privately. You should ask your dentist how much this will cost.

Tip 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.

What will happen at your check-up?

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 problems 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 – see How often should I go to the dentist?

Many of us have got used to going to the dentist every six months but you might need to go more often or less often than this depending on how healthy your mouth and teeth are. Your dentist should talk to you about when you should have your next appointment.

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

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 any private treatment and associated costs – 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.

If you have had restorative treatment on the NHS, and something goes wrong, requiring repair or retreatment, within 12 months of the original treatment, then your dentist should carry out the necessary work free of charge.

Restorative treatment includes fillings, root fillings, inlays, porcelain veneers or crowns.

This will not normally apply if:

within the 12-month period another dentist has carried out any treatment on the same tooth that has been restored, or
the patient was advised at the time of the restoration that it was temporary or a different restoration was more appropriate, but the patient insisted on a different form of restoration, or
the repair or restoration is a result of trauma

Making a complaint

If you’re unhappy with your NHS dental work, you can make a complaint. For more information, see How do I make a complaint about my dental treatment?

Read the answers to more questions about dental health.

You should only be charged for private dental treatment if you agreed to have private dental work done.

When you visit a dentist they will begin by examining your mouth and teeth. If they think you need treatment they should give you a written personal dental treatment plan.

Treatment plans are not usually given for Band 1 or urgent dental treatment, but you can ask for one.

Most dentists offer both NHS and private treatment. Your NHS dentist should always:

explain which treatments are available on the NHS
explain which treatments are only available privately
make sure you know how much your NHS treatment and any private treatment will cost

Treatment plan

Before carrying out any dental treatment, your dentist should ask you to sign your personal dental treatment plan.

This confirms the NHS dental treatment your dentist is going to do, and the amount you will need to pay for the treatment on the NHS. If you have talked to your dentist about having private dental treatment, details and costs for this will be listed separately on the same form.

If you’re not offered a treatment plan for band 2 or 3 treatments, ask your dentist for one.

For more information about NHS dental bands, see What is included in each NHS dental band charge?

NHS dental treatment

The NHS will provide all treatment that your dentist feels is clinically necessary to keep your teeth, gums and mouth healthy.

This means that if your dentist says that you “need” a particular type of treatment, it will be available on the NHS. You should not be asked to pay for it privately.

For more information, see Which dental treatments are available on the NHS?

Choosing private treatment

NHS dental treatment does not cover any cosmetic treatments, for example teeth whitening, that are only to improve your appearance and not clinically necessary.

However, you may choose to have this dental work done privately. In this case, you will be charged privately and your NHS dentist should make sure you know how much this will cost before treatment starts.

What if I’ve been charged wrongly?

If you think your dental charges are wrong, you should first talk to your dentist or the person at your dental surgery responsible for patient feedback.

If you have paid for NHS treatment but you think you have paid too much, you should discuss this with your dentist. They will know what work was done and whether it was NHS treatment or a mix of NHS and private treatment.

Your dentist can arrange a refund if you need one.

Making a complaint

If you’re not happy with the response from your NHS dentist about the charges, see How do I complain about my dental treatment?

Read the answers to more questions about dental health.

There are three bands of charges for all NHS dental treatments.

As from April 2018, the current dental charges are:

Band 1 dental treatment: £25.80

This covers one or more treatments (as many as are necessary) from the following list :

adjusting false teeth (dentures) or orthodontic appliances, such as braces
applying sealants or fluoride preparations to the surfaces of your teeth
a clinical examination, assessment and report
marginal correction of fillings
moulds of your teeth – for example, to see how your teeth bite together
an orthodontic assessment and report
a scale and polish (if clinically necessary)
coloured photographs
taking a sample of cells or tissue from your mouth for examination
treating sensitive cementum (the tissue that covers the root of a tooth)
X-rays

Emergency treatment (when you need to see a dentist immediately) also costs £21.60.

Band 2 dental treatment: £70.70

This can cover anything listed in band 1 above, plus any of the following:

an addition to your dentures – such as adding a clasp or a tooth
apicectomy – removing the tip of the root of a tooth
a mouth guard to correct your “bite” (doesn’t include a laboratory-made appliance)
fillings
free gingival grafts – when healthy tissue from the roof of your mouth is attached to your teeth where the root is exposed
frenectomy, frenoplasty or frenotomy – surgery to the folds of tissue that connect your tongue, lips and cheeks to your jaw bone
treatment for severe gum disease – such as root planing (cleaning bacteria from the roots of your teeth), deep scaling and a polish, or a gingivectomy (removal of gum tissue)
oral surgery – such as removing a cyst, or soft tissue surgery to the mouth or lips
pulpotomy – removing dental pulp (the soft tissue at the centre of a tooth)
relining and rebasing dentures
removing teeth (extraction)
root canal treatment
sealant to fill small holes or grooves in your teeth
splinting loose teeth – for example, after an accident (this doesn’t include laboratory-made splints)
transplanting teeth

Band 3 dental treatment: £306.80

This can cover anything listed in bands 1 and 2 above, plus any of the following :

bridges – a fixed replacement for a missing tooth or teeth
crowns – a type of cap that completely covers your real tooth
dentures
inlays, pinlays and onlays – used to restore damaged teeth
orthodontic treatment and appliances such as braces
other custom-made appliances, not including sports guards
veneers and palatal veneers – new surfaces for the front or back of a tooth

Treatments such as veneers and braces are only available on the NHS if there’s a clinical need for them (not for cosmetic reasons). Similarly, other cosmetic treatments, such as teeth whitening, are not available on the NHS.

Read the answers to more questions about dental health.

Fillings and crowns available on the NHS can be made of several different materials.

Ask your dentist what material they recommend for you.

Fillings

Fillings are used to repair a cavity in your tooth caused by decay. The most common type of filling is dental amalgam, made from a mixture of mercury and different metals. Dental amalgam fillings are often used on your back teeth as they’re hard-wearing.

Your dentist will offer you the type of filling most appropriate for your clinical (medical) needs. For example, if you need a filling for one of your front teeth, your dentist may suggest a tooth-coloured (white) filling, but the use of tooth-coloured fillings on back teeth is considered purely cosmetic.

Fillings on the NHS can be made of:

amalgam (silver-coloured) – a mixture of metals including mercury, silver, tin and copper
composite (tooth-coloured) – powdered glass and ceramic added to a resin base; they’re not as hard-wearing as amalgam fillings
glass ionomer (tooth-coloured) – powdered glass, which reacts chemically with your tooth and bonds to it, but it’s weak so is only used on baby (first) teeth or around the sides of teeth

There are a number of scare stories about the alleged toxic properties of amalgam in various sections of the internet. These are groundless.

The British Dental Association recently reported that, “Dental amalgam has been in use and extensively studied for 150 years as a restorative material. Its safety and durability are well established, and it remains the most appropriate material for a range of clinical situations.”

Fillings on the NHS come under band two for dental charges (£70.70).

Crowns

A crown is a type of cap that completely covers a real tooth.

NHS crowns usually consist of a metal core surrounded by a porcelain wrapping. This wrapping gives the crown a tooth-like appearance, but isn’t entirely natural looking.

Crowns on the NHS come under band three for dental charges (£306.80).

More realistic looking “metal-free” crowns, often made of a combination of minerals such as zirconia and porcelain, are available – but it’s likely you would have to pay for these on a private basis.

Read the answers to more questions about dental health.

Dentures

Dentures are removable false teeth that fit snugly over the gums to replace missing teeth. They help with chewing and eliminate potential problems caused by gaps. You should remove your dentures at least once a day to clean them.

Dentures can be made of:

acrylic resin
metal
a combination of acrylic and metal

Bridges

A bridge is a fixed replacement for a missing tooth or teeth. A bridge can be made of:

porcelain bonded to metal alloys, which may contain gold, silver, nickel, chromium, titanium and molybdenum
metal alloys containing cobalt chromium, titanium, aluminium and vanadium
acrylic (plastic) for temporary bridges
porcelain

Bridges may also be made of other non-metallic materials. You should ask your dentist what is most suitable for you.

Veneers

A veneer is a new surface to fit over the front of a tooth. They’re available on the NHS if they’re needed to improve the health of your mouth – but not just to improve the appearance of your teeth (cosmetic reasons).

Veneers can be made of:

porcelain
composite materials (the materials that make white fillings)

Porcelain veneers are more realistic looking and long-lasting but also much more expensive than composite veneers.

Dental implants

Dental implants are artificial roots directly implanted into the gum and bone to hold crowns, bridges or dentures and replace missing teeth. They are not routinely available on the NHS. They are available privately but can be expensive.

Each implant is essentially a metal screw made of titanium. Titanium is “biocompatible”, meaning it is not rejected by the body and the metal will fuse with the surrounding living bone.

Read the answers to more questions about dental health.