A SHORTAGE of NHS dentists is turning toothache into wallet ache.
Nine out of ten NHS dentists won’t accept new adult patients, meaning that most must pay for pricey private care.
Louise Ansari, who runs British health consumer champion Healthwatch, says the situation is “a national crisis”, with NHS dentistry in need of “rapid and radical reform”.
We explain what’s going on, and how to pay for dental care cheaply.
The cost of tooth pain
Most dentists carry out private and NHS work but will only take on a set number of NHS patients. Once the NHS list is full, they only offer private treatment.
Those under the NHS can pay half as much as private patients for the same procedures.
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A dental examination, X-rays and scale and polish costs £23.80 in England and £14.70 in Wales under the NHS. A similar procedure at a private dentist would cost £50, according to dental services website AP Care.
If a patient also needs a filling, root canal or to have teeth removed, an NHS patient will pay £65.20 in England or £47.20 in Wales, while the equivalent private cost would be between £100 and £200.
Jill Harding, director at dental charity Dentaid, says the charity is receiving increasing calls from toothache sufferers who can’t pay the price.
“People regularly call saying they are indentalpain but can’t find adentistor afford private care,”
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Why dentist books are full
Natalie Quail, a dental consultant for NHS and private dental groups Smileright and Smiletime, says the problem is caused by a funding crisis.
“Funding has been scaled back and back. Dentists want to stay open for NHS patients, but they are being let down by the system themselves. They need more funding from government.”
The Government says that changes made to the contract between dentists and the NHS should increase the amount of NHS funding, but the British Dental Association (BDA), which represents the oral health industry, says that the changes are merely “tweaks”, and the service is “on its last legs”.
“We need honesty, ambition and investment,” says BDA Chair Eddie Crouch.
“There are no new dentists, no new contract and no new money.”
What sufferers can do
Despite the shortages, those needing dental work, or even a regular check-up, should start by trying to find a dentist who will take them on as an NHS patient.
Some areas have more NHS availability than others, so persistence may pay off.
Quail, at Smileright, says that many dentists will prioritise giving NHS places to those who are eligible for free NHS care, so if you fall into these categories, it is particularly important to seek an NHS list.
Free dental treatment is offered to children under the age of 18, pregnant women and those who have a baby under 12 months old. It is also available if you are under 19 and in full-time education, getting Income Support or income-based Jobseeker’s Allowance or Employment Support Allowance.
Those in receipt of the Guarantee Credit portion of Pension Credit, in possession of an HC2 certificate because of a low income, or an NHS Tax Credit Exemption Certificate are also eligible for free care.
Karen Coates, Oral Health specialist at charity the Oral Health Foundation, says that NHS charges change every year, and even if you are receiving NHS care you should always ask for a written treatment plan and estimate of charges before agreeing to dental care.
For the millions of people unable to access NHS dental care, private care is the only alternative. Private dentists set their own prices, so shop around for one that is affordable but has good reviews locally.
If you are seeking regular dental care and are not in an emergency situation, there are plans available that can spread the cost.
Some people prefer to buy dental insurance or a payment plan, meaning that they pay a fixed monthly cost for dental care to be covered. The cost of this will vary depending on your circumstances and the type of procedure that is covered.
Many dentists offer Denplan or other ‘capitation plans. These are available at a variety of price levels depending on whether they cover emergency work or simply routine check-ups, as well as on the state of your teeth.
An ‘Essentials’ plan with Denplan starts at under £9 a month but only covers routine preventative care, while it can cost over £50 a month for a plan that covers more extensive work.
The cost of these plans varies between dentists, and it is vital you understand what is covered, and what is not, before joining up. These schemes are not available to those with poor teeth.
“You will need to have a clean bill of health for your mouth before you can join most schemes,” says Coates at the Oral Health Foundation.
An alternative to a capitation plan is dental insurance, which can cover unexpected emergencies as well as routine care. This can be bought either individually or through your employer, and costs will vary depending on your oral health and what is covered.
Insurers such as Boots, BUPA and AXA offer this cover, but before you take it out check whether there is a long wait between signing up and being available to claim and how much the policy will pay out per treatment as this may be capped.
Buying dental insurance through your employer can be cheaper, as the whole family can be covered using a salary sacrifice scheme, where the premium is taken out of your pre-tax income, and you do not pay national insurance on the payment.
“It’s a cost-effective way to buy that insurance but only you can decide if it’s worth it,” says Jonathan Watts-Lay, Director of employee benefits scheme WEALTH at work.
Health cash plans are another way to spread the cost of dental treatment. These plans are like 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, and some cover other routine healthcare as well as dental work.
Plans are offered by companies including Hive, WHA and Sovereign Healthcare. However, if you do not routinely spend a lot on dental and other care, they may be poor value, while they also have many exclusions.
An everyday cashplan from WHA covering prescription charges, some optical work and routine dental costs £9.62 per adult per month
“We advise you to check how much the refunds and benefits are for your individual plan,” says Coates at Oral Health Foundation.
Pay as you go
For many people, simply paying for the dentistry needed will be the only option. If you cannot afford to pay for it upfront, most dentists will allow you to pay by credit card or may be able to arrange a payment plan.
Those with a good credit rating could apply for a zero per cent credit card, allowing them to pay the balance upfront and pay it back over time without incurring interest.
Putting money away into a separate savings account to cover annual dental bills could be a cheaper option than paying for a health cashplan or insurance.
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If you are desperate, and cannot afford dental help, the charity Dentaid holds clinics for the most vulnerable people in the country
People queue for hours to receive emergencydentalcare from teams of volunteers. There’s more information on the public access clinics on the Dentaid website.