2. Do I need to register with a dental surgery?
3. Which treatments are not available on the NHS?
4. The Community Dental Service
5. Hospital dental service
The government has said that everyone should have access to a National Health Service dentist. But in reality it is still difficult for some people to find a dentist providing NHS treatment, and recently the number of people receiving treatment on the NH....
In 2006 the government introduced a new contract for dentists with the aim of improving access to NHS treatment. NHS patients in England and Wales now pay one of three fixed prices for their treatment and it is no longer necessary to register for NHS treatment.
In the UK most dental surgeries will treat a mixture of private and NHS patients. Dentists are paid a fixed sum each month to provide a set amount of NHS treatment. However, treating private patients brings more money, which dentists claim they need to provide their surgeries with the latest equipment.
Dental practices do not operate the same ‘catchment area’ policy that GPs do. You do not have to live locally to your dental practice; it is up to you how far you are prepared to travel.
1. Can I qualify as an NHS patient?
Under 18s get free dental treatmentAll British citizens are entitled to dental treatment provided by the National Health Service. However, unlike treatment from a GP at your local surgery, dental treatment is not free of charge.
Patients have been charged for NHS dental services since the 1950s. But, by 1990 dental health care in the UK was far behind the rest of Europe and a revised system of charges and NHS registration lists was introduced with the hope of improving access to treatment.
Now that contract has been replaced in England and Wales and the charging system revised once again.
Under the new contract NHS patients in England pay one of three charges depending on the amount of treatment they need:
- £15.90 - Covers a check up, diagnosis and preventative care such as scale and polish
- £43.60 - Covers all treatment in the previous band plus fillings, root canal treatment and extractions
- £194 - Includes treatment in first two bands and also covers more complex procedures such as crowns, dentures and bridges
Prices are determined by the government through the Department of Health and are standard throughout any NHS dental surgery in England. There is more information on NHS charges (pdf) on the NHS website.
In Wales, patients also pay a fixed price, but the charges are set by the Welsh Assembly. The current charges in Wales are:
- £12 - Covers a check up, diagnosis and preventative care such as scale and polish
- £39 - Covers all treatment in the previous band plus fillings, root canal treatment and extractions
- £177 - Includes treatment in first two bands and also covers more complex procedures such as crowns, dentures and bridges
Dentists in Scotland and Northern Ireland are not subject to the new contract in England and Wales.
In Scotland NHS dental examinations are free for everyone. After the initial examination, NHS patients then pay for 80% of the cost of any further treatment up to a maximum of £384.
In Northern Ireland NHS patients pay for 80% of the cost of all treatment including the initial examination, up to a maximum cost of £384.
However, NHS treatment is completely free in England, Scotland, Wales and Northern Ireland for certain groups. These include people who are:
- Under 18
- 18 but in full-time education
- Pregnant or having given birth within the last 12 months
- Receiving state benefits or with a partner receiving benefits (such as income support, job seekers allowance or tax credits)
It is worth picking up forms HC11 and HC12 from any Post Office to check your personal entitlements. Or telephone the ‘Help with Health Costs Helpline’ on 0845 850 1166.
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2. Do I need to register with a dental surgery?
Under the latest contracts for dental practices, it is no longer necessary to register with a dentist to get NHS treatment in England and Wales. You are entitled to approach any surgery providing NHS treatment and ask if they have any NHS appointments available.
However, it may still help to be registered with a practice so they can keep track of your dental records and remind you when you need a check up.
Patients in Scotland and Northern Ireland still have to register with a dental surgery to receive NHS treatment, as dentists there are not subject to the new contract.
The best place to look when thinking of finding a dental practice are the NHS websites. The dentists' index for each country can give you a list of your nearest NHS dental services. All you need to do is type your postcode:
In Northern Ireland the Central Services Agency has a list of Health and ... where you can find a dental practice. Patients in England and Wales can also phone NHS Direct for information on local services.
The General Dental Council registers all qualified dentists and regulates dental professionals and dental education in the UK. You can search their online register for information on any qualified dental professional.
Once you have found a practice, you should arrange an introductory appointment telling them that you want NHS treatment. As most surgeries treat both NHS and private patients there will be a limited number of NHS appointments.
A surgery can turn you away if they have no NHS appointments available. However, they cannot impose conditions on your NHS treatment, such as insisting on a private check up prior to NHS treatment or providing NHS treatment to children only if their parents have private treatment.
For more information on how dental surgeries should provide NHS treatment, take a look at the guidance for Primary Care Trusts on misleading informat... (PDF).
New patients get a full dental check-upOn your first visit your new dentist should give you a dental health check-up. If you are an NHS patient they should present you with a form listing all the treatment you are entitled to under the NHS.
Patients in Northern Ireland should also remember to take their medical card issued by the Central Services Agency to their first appointment.
On following appointments, you must keep your dentist aware of any changes to your general health, for example if you become pregnant or if you are prescribed any medication.
Emergency treatment
As an NHS patient you are eligible for any emergency work to be done out of hours. The charge in England and Wales for out of hours treatment is the same as the lowest band for NHS charges. In Scotland and Northern Ireland the charge is the same as for other NHS treatment.
In England and Wales out-of-hours dental treatment is co-ordinated by your Primary Care Trust and you should contact them to find an out-of-hours service. There is no standard out-of-hours contract and each area is likely to have its own arrangements. In most cases the Primary Care Trust will have a rota of practices providing an out-of-hours service. If you have a regular dentist surgery, you could also ask them if they provide NHS out-of-hours treatment.
In Scotland you should call NHS 24 (their number is 08454 24 24 24) where you will talk to a nurse who will then refer you an emergency dental practice, most likely at your local hospital.
In Northern Ireland you should call your dentist surgery for emergency treatment. Surgeries generally try to treat emergency patients within 24 hours of being notified. If you are not registered with a dentist, then you should contact your local hospital who will have an emergency dental pain service.
Patients who are treated privately may also be eligible for emergency treatment, but this depends on the dental practice or the details of their dental insurance. All private patients should be made aware of what emergency treatment they are entitled to when registering. Patients with private medical cover are still entitled to NHS emergency treatment if they prefer.
Access to your dental records
All patients, whether NHS or privately registered, have a right to obtain copies of their dental records. This can be done by requesting a copy in writing to your practice. Sometimes a fee of £50 will be charged if the records are held manually or £10 if the records are kept on computer. Once payment has been made a patient should receive a copy of their records within 40 days of the request.
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3. Which treatments are not available on the NHS?
When you are having dental treatment your dentist will generally be happy to perform certain procedures not available on the NHS, but you will have to pay extra for these.
The NHS contract is to treat oral health not to improve the look of your teeth. You may get a clean and polish included as part of your check up, if your dentist thinks it is needed for oral health, but cosmetic treatment, such as teeth whitening, is not covered.
For the same reason NHS treatment will often provide amalgam fillings, with white fillings offered as an alternative private treatment. However, your dentist may provide white fillings as part of NHS treatment in some cases.
Private charges are set by the individual dentist or practice you visit and therefore prices will vary. You should be told about any private treatment, and be aware of how much you will be expected to pay, before the work starts. The Office of Fair Trading has a guide to private de... that can tell you more about choosing your treatment.
You might want to check with your dentist whether any treatment you have with a hygienist will be covered by your NHS charge.
Your dentist must give you a written treatment plan showing NHS and private costs if you ask for one. For private dental care you should also sign a contract to show you understand the treatment. Keep a copy of all forms for your records.
Many patients who get private treatment take out dental insurance. This means the monthly payments they make to their insurer cover the costs of routine or emergency procedures when they arise.
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4. The Community Dental Service
Many dentists are taking part in the Community Dental Service (CDS) which was set up in the UK to provide dental care to those who may not otherwise seek or receive it. These include:
- Adults with special needs
- Housebound
- Hospital long-stay patients or in-patients
- Living with a physical or mental illness
They may also treat people referred by other dentists who are unable to undertake some treatments. For information on your local Community Dental Service contact your local health authority.
Dental access centres
There are more than 50 access centres operating across the UK. They provide NHS treatment and advice to patients who have been unable to get regular treatment. All dentists who work through an access centre are experienced in the NHS.
Access centres will still require you to book an appointment in advance by phone. However, you may be able to get an appointment at shorter notice than with other dental practices.
All NHS charges and exemptions apply when you are seen or treated, so it is advisable to take your National Insurance card with you when you visit. Dental access centres treat both adults and children.
For information on an access centre near you contact your local health authority.
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5. Hospital dental service
This service provides dental care, including consultant advice and treatment, through hospital-based dentists, for those who need specific types of treatment.
Hospital dentists practise oral surgery, paediatric dentistry and orthodontics and can provide the surgical care you may not find elsewhere. Patients needing particular treatment would usually be referred to the hospital dental service by their regular dentist or their GP.
Hospital dentists treat long-stay patients and in-patients when in hospital. They also treat short-stay patients if it is in the patient’s interest. They are also able to provide hospital-based care for out-patients when they are advised to return for treatment.
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