The mixing of NHS and private dental treatment within the same system can be confusing for patients, so it helps to have an idea of what things should cost.
In our guide, we explain how to find the right dentist for you, how much you should expect to pay for treatment, and how NHS and private options differ.
Whether you opt for an NHS dentist (if you can find one) or go private, prices should be communicated clearly upfront – but this isn't always the case. In fact, when we asked 1,000 survey respondents in 2019 about their experiences with their dentist, one in five told us that they'd had treatment without being sure what the cost would be.
We help you to navigate the NHS charging structure, find a dentist and explain what to do if things go wrong or if you're faced with unexpected costs.
There are currently three NHS charge bands. The amount you spend will vary depending on the type of treatment you need.
You should pay only one charge for a course of treatment, even if you visit the dentist a few times – so three fillings and a crown recommended on the same treatment plan would all be covered by band three.
If you need band two or three treatment and pay dental charges (in other words, you aren't exempt), you should be given a written treatment plan.
If you need treatment, you shouldn't be expected to pay privately, although your dentist should explain suitable private options you can consider. Dentists aren't allowed to refuse any treatment available on the NHS but then offer it privately, or to suggest that NHS treatment is inferior.
In Northern Ireland and Scotland, the same system is in place. Unless you're covered by one of the groups entitled to free NHS dental work, the charge to the NHS patient is 80% of the dentist's fee up to a maximum of £384.
Your dentist should have a prominently displayed price list in the surgery – if you don't see it, ask.
We asked major private practice chains for details on their pricing for different procedures. Our dental treatment pricing table below will help you identify whether you're getting a decent deal on care or paying over the odds.
Below the table, you'll find more detail on what each kind of treatment entails, what's different if you go private and what to check before going ahead.
|Treatment||NHS band||NHS price||Private price|
|New patient consultation or check-up||Band 1||£23.80||£20 to £120|
|Simple X-rays/radiograph*||Band 1||£23.80||£5 to £40|
|Hygiene clean/scale and polish||Band 1/Band 2 (deep scaling)||£23.80/£65.20||£25 to £85|
|Amalgam/metal filling||Band 2||£65.20||£30 to £175|
|Composite/white filling||Band 2||£65.20||£40 to £250|
|Root canal treatment||Band 2||£65.20||£45 to £970|
|Tooth extraction||Band 2||£65.20||£50 to £370|
*price included in consultation or check-up if done as part of the appointment.
Ask how long your private consultation will last, and whether any X-rays are included (including the type of X-ray) as it varies between practices. Subsequent routine appointments are usually cheaper, but we suggest that you ask for ongoing prices.
Routine private appointments will generally be allocated more time than those on the NHS and appointments may be offered out of hours (evenings and weekends). If you don’t want to take time off work and want to ensure that you can be seen quickly, a private appointment could be the way to go.
As a new patient, you will usually have simple X-rays of your back teeth (called bite-wings). This will be included in the price of a new patient consultation.
Usually, any X-rays required as part of a check-up are also included. But you may need more complex specialist X-rays to get a view of the whole mouth from ear to ear – this may well be more expensive if done privately.
Band 1 covers a range of basic treatments, including a scale and polish, if dentally necessary. But 'necessary' is the key word here. If your dentist recommends a clean for more cosmetic maintenance, you're likely to be asked to make an appointment with a private hygienist.
Privately, you’ll definitely get a longer appointment and usually a more intensive clean.
If you like having a regular clean from the hygienist, there’s no evidence to suggest you shouldn’t keep doing it. But, equally, the evidence isn’t there to say routine scale and polishes make your mouth healthier. Next time your dentist suggests a hygienist visit, ask if it is clinically necessary, as you might be entitled to cleaning under the NHS.
Looking after your teeth
Patients also have their part to play in preventative dental care. Brush twice a day with fluoride toothpaste and don’t rinse after you spit, and regularly clean between teeth with interdental brushes or floss. You could also use mouthwash (although not straight after brushing as it will wash away the concentrated fluoride on your teeth), but it's not essential for most.
The cavity in your tooth is drilled so it can be filled with a mixture of metals. Private prices for all types of filling depend on the size and complexity of the treatment you need – for example, how many tooth surfaces it covers.
Amalgam is hard wearing and good for the back chewing teeth. This is the more common type of filling you'll be offered on the NHS. If you're going private, it may be worth upgrading to a white filling.
Composite fillings are trickier to carry out (the tooth surface must be dry when the resin gel is bonded on) and can be less hard-wearing for back teeth that chew and grind. More expensive private ones are lab-made for you.
On the NHS, you’re more likely to get them on front teeth, but your dentist gets to decide what is necessary.
If decay gets deep into your tooth and affects the root, a root filling (root canal work) can save the tooth.
Private prices range greatly, as root canal can be a technically demanding treatment and you may be referred to a specialist endodontist. How much you pay depends on the tooth size and position (back teeth tend to be more expensive), and the complexity.
Some teeth will be routinely extracted in the dentist’s surgery – known as a simple extraction. Others will need referral to a dentist with advanced skills in surgical treatments because they’re awkwardly shaped or placed and surrounding bone may need to be removed to free them.
Crowns are shaped like natural teeth and fit like a cap over your own teeth. Private prices depend on materials used and time taken.
Any lab that makes crowns for the NHS is governed by strict regulations about the materials used, and many will be producing both private and NHS work. But dentists can use different suppliers or technicians for NHS and private patients. The difference in the end result is likely to lie largely in cosmetic aspects, such as the colour matching and finish.
Crowns may be made of materials including porcelain (most expensive for a very natural tooth look), porcelain bonded on to precious metal or all metal (generally less expensive and used on back teeth).
NHS crowns are usually made of a metal core surrounded by a porcelain wrapping, which may not be an entirely realistic ‘tooth’. The dentist can choose from a limited number of colour shades, so the result may not produce an accurate match for your teeth.
Private crowns may be made of precious metals (eg gold, platinum or palladium) or a combination of minerals and porcelain, and will give a more natural appearance.
As with crowns, the labs that make dentures and bridges for the NHS are held to strict regulations about the material they use, and produce work for the private firms as well as the NHS. Again, the difference is mainly in the aesthetics – colour and finish.
NHS dentures are usually made of solid acrylic, which can feel bulky and less comfortable in the mouth than some private options. Dentures made privately may be made from a more expensive flexible acrylic or chrome, which can feel much more natural.
Bridges tend to look better and feel more comfortable than dentures, plus some people may want a permanent replacement rather than a removable prosthesis.
Bridges are sometimes refused on the NHS, because they can be seen as a cosmetic choice over the more practical and less invasive option of a denture. A bridge can compromise the long-term health of the teeth on either side, so a dentist can argue that it’s not the best option for making you dentally fit.
If your dentist is unwilling to give you a bridge on the NHS, they might still offer it privately, if that is the option you really want.
Note: Private costs listed above are correct as of February 2020.
Based on prices quoted by leading private dental chains including Bupa, Dentalcare group, MyDentist and Rodericks. We also contacted private dentistry companies Genix Healthcare and Southern Dental, but they declined to provide any pricing information.
Be aware that some practices are asking patients to pay a surcharge to cover increased costs of PPE (personal protective equipment) due to the pandemic.
More is being charged for aerosol generating procedures (AGPs). This is where machinery is used which produces aerosol sprays from your mouth which could contain the virus. AGPs include fillings, crowns, bridges and some hygiene treatments), and requires a higher level of PPE.
If you're more at risk and have concerns, contact your dentist to find out what procedures they have in place to minimise risks to patients.
Ideally, you'll want a dentist that isn't too far away, so you can easily get there in case of an urgent dental problem. In England, you can use the NHS website to search for nearby dentists. Head to the page and search for a town, city or postcode.
Note that you shouldn’t be asked to pay a deposit before booking an NHS appointment, a poor practice we have uncovered in previous investigations.
Depending on where you live, you may still have to ring around to find a dental practice to take you as a new patient.
At the moment, it can be particularly difficult to sign up as an NHS patient at a dental practice due to the impact of Covid. It's also a bit of a postcode lottery – some areas have much higher waiting lists and backlogs than others. But you shouldn't feel you have to see a private dentist because there are no NHS appointments available, even if it's suggested as an alternative.
Before you book, check whether you’re booking NHS or privately so you don't get any nasty surprises on your bill.
If you're using the NHS, it’s a good idea to book your next check-up on the way out from your last, or at least some weeks ahead of when it’s due, to ensure you get a slot when you need it.
For urgent treatment, you might be able to get an emergency appointment from a local dentist, or call NHS 111 to be put in touch with an emergency dental service. The NHS number can also offer self-care advice.
In emergency situations, you should be seen quickly, whether that's under the NHS or privately. Bear in mind, though, that GPs aren't able to offer emergency or out-of-hours dental care.
If you're nervous about your upcoming appointment, know that you aren't alone as dental anxiety is pretty common. Here are some ways to manage your concerns:
You can also check if your dentist provides any specialist services for nervous patients. Most dentists will be used to dealing with anxious patients, but it's a good sign if they go out of their way to address this in practice information.
There are options for extremely anxious patients, such as sedation, on both the NHS and privately. But establishing a good relationship with a dentist you trust can also help in the long term, and is likely to be cheaper and more practical than having to opt for sedation each time.
Don't avoid going, as the more familiar and comfortable you are, the less stressful any urgent treatment will be (and less likely if you're having regular check-ups).
Before your appointment, make sure you know how much your visit will cost, plus whether or not X-rays will be included if you're paying privately.
In order to take full advantage of your time at the dentist, come armed with key questions, such as:
It's also worth finding out how you can contact your dentist after your treatment. If you forget to ask this during your appointment, you'll likely find contact details on the surgery's website.
Getting a second opinion is an option if you're unsure about whether to undertake treatment, or whether it’s worth paying privately – this might be done for free if it’s within the same practice.
If you're unhappy with the service provided by your dentist, you do have the right to complain. Here are typical steps and advise on who to contact:
If you’ve got concerns or complaints about NHS or private treatment, ask your dentist or dental practice to investigate. They should take it seriously and are required to have a complaints procedure.