NHS Treatment

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

At Advanced Dental Aesthetics we are a mixed practice offering both NHS and affordable private dentistry for the whole family.

You may register as an NHS patients but also choose to have private treatments in addition, should you wish.

Who is entitled to free NHS dental treatment in England?

You do not have to pay for NHS dental services if you’re:

• under 18, or under 19 and in full-time education
• pregnant or have had a baby in the last 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
• Pension Credit Guarantee Credit with Savings Credit
• Universal Credit (depending on your earnings)

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
• a valid maternity exemption certificate
• People named on an NHS certificate for partial help with health costs (HC3) may also get part of the cost of dental treatment paid for.
• People on a low income can include some students and pensioners.

You’ll be asked to show your dentist written proof that you do not have to pay for all or part of your NHS treatment.

You’ll also be asked to sign a form to confirm that you do not have to pay.

IF YOU SIGN THE PR FORM AND IT IS WRONG YOU WILL BE FINED BY NHS FOR FRAUD £100 – this is not the liability of the practice AND will have to be resolved with NHS not the practice.

What dental services are available on the NHS?

• The NHS will provide any clinically necessary treatment needed to keep your mouth, teeth and gums healthy and free of pain.
• Decisions about which treatment is appropriate will be based on a clinical assessment and clinical judgement.
• Your dentist will make clear which treatments can be provided on the NHS and which can only be provided on a private basis, and the costs associated for each.
• If you decide to choose alternative private options, this should be included in your treatment plan. You’ll be asked to sign the plan and be given a copy to keep.
• Ask the dentist to explain in more detail the reason behind the treatment options being proposed.
• You should feel properly informed before any treatment is undertaken, including about the clinical risks and benefits.
• Your dentist has to provide you with a written treatment plan for Band 2, Band 3 or a mix of NHS and private treatments.
• Your treatment plan sets out the proposed dental treatment and associated costs.
• Treatment plans are not usually given for Band 1 or urgent dental treatments, but you can ask for one if you like.
• Inform your dentist if you decide not to proceed with a certain treatment option.
• Likewise, the dentist should inform you of any changes to the treatment plan.
• Sometimes a proposed treatment can change on further investigation or as a result of changes in your oral health after the initial assessment.
• Any changes to treatment should be discussed and agreed with you.

Description of phases

• Phased treatment may consist of up to three courses of treatment; all these CoTs will usually be completed within a 12-month period. It is acknowledged that often the first CoT (CoT 1) is an initial assessment with pain relief, stabilisation of active disease and initiation of initial preventive measures where it is not possible to produce a robust plan for further treatment at the examination stage.
• It is only after this first course has been completed and the patient reassessed to see how they have responded that a further treatment can be devised (CoT 2).
• In some cases, a further reassessment and plan will be required (CoT 3).
• At the very outset the patient should be made aware that they will be required to return for further courses of treatment, and that this may incur further NHS dental charges. It is not always possible to predict the exact nature and, therefore, cost of the next phase until the reassessment course of treatment.

Common dental treatments available on the NHS

Crowns and Bridges

Crowns and bridges are available on the NHS (Band 3, £306.80).

As with all restoration treatments, they may need to be replaced in the future.

You may be offered a metal-coloured crown on a back tooth to help restore it.

You could discuss with your dentist what alternative cosmetic options can be offered privately, and the risks and benefits of these, to help you make an informed decision.

Dental Abscesses

A dental abscess is a collection of pus that can form in the teeth or gums as a result of a bacterial infection.

Dental abscesses can be treated on the NHS (usually Band 1, £25.80).

If you feel unwell or have a large swelling in your face or mouth, your dentist may refer you to a specialist for treatment.

This treatment is also available on the NHS.

Dentures (false teeth)

Dentures are removable false teeth made of acrylic (plastic) or metal. Dentures are available on the NHS (Band 3, £306.80).

Orthodontics

Orthodontics is a type of dental treatment that aims to improve the appearance, position and function of your teeth.

There is a standard method for assessing whether orthodontic treatment is clinically necessary and available on the NHS.

Your dentist or orthodontist will be able to explain to you what alternative options exist if you or your child do not qualify for NHS-funded orthodontic treatment.

You cannot mix NHS and private treatment in orthodontics. The British Orthodontic Society offers patient information about general orthodontics, as well as information aimed at adults and teenagers.

Root Canal Treatment (endodontics)

Root canal treatment is a dental procedure to treat infection at the centre of a tooth (the root canal system). This treatment is available on the NHS (Band 2, £70.70).

Your dentist should be able to provide it for you or, where the treatment is complex, refer you to a practitioner with additional skills.

You may be offered an option to see a specialist privately as an alternative to being referred on the NHS.

It will be your choice whether you opt for the private treatment with this specialist or be referred to an NHS specialist service.

Scale and Polish

If your dentist says scaling is clinically required, this is available on the NHS.

This can be provided by a hygienist or dental therapist.

A simple scaling is included in a Band 1 (£25.80) course of treatment, but more complex treatment for gum problems may be charged within a Band 2 (£70.70) course of treatment.

Many dental hygienists now work under direct access, where you can request to see the hygienist directly for a scale or polish

Hygienists can only provide this open access on a private basis, and you should check the cost of the treatment before booking an appointment.

If your dentist says a scale and polish is not clinically necessary but you want one anyway, you will have to pay for it privately.

Wisdom Teeth

Wisdom teeth can be removed on the NHS when clinically necessary.

Your dentist will assess the need for removal based on guidelines from the National Institute for Health and Care Excellence (NICE).

Your dentist may perform the procedure or refer you to a dentist with additional experience.

You’ll be charged with a Band 2 (£70.70) treatment course.

Your dentist can also refer you for private wisdom teeth treatment if you wish.

White Fillings

Where clinically appropriate, white fillings are available on the NHS and are generally charged as Band 2 (£70.70).

For example, if you need a filling in one of your front teeth (incisors and canines), the filling material of choice may be a white filling.

If the filling is in one of your back teeth (such as molars and premolars), for a large filling the more clinically effective option may be an amalgam filling (a silver-coloured material).

Your dentist should explain the options to you in advance.

If you prefer to have the white filling or any other cosmetic filling options, your dentist will be able to advise you on the private costs for such treatments, and the risks and benefits associated with it.

What will happen at your check-up?

At your check-up, your dentist may:

• ask you about your medical history and whether you are currently taking any medicine
• 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 best ways to take care of your teeth and gums
• explain any risks, as well as dental costs, of all treatment you may need
• discuss with you when your next visit should be – if your teeth, gums and mouth are healthy, you may only need a check-up every 12 or 24 months
• explain your NHS treatment plan – if private treatments are available these should be clearly explained and agreed

Missed appointments

If you know you will not be able to attend an appointment then please give as much notice as possible to the dental surgery so they can cancel your appointment and offer your slot to another patient. Your dentist can terminate your treatment if you miss your appointment without letting the dental surgery know. You may then need to pay again for a new course of treatment.

NHS Treatment Costs

List of dental treatments by band

All 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 that you might want for cosmetic reasons but that 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 circumstances and based on specific clinical judgement each time.

Band 1 course of treatment: £25.80

• clinical examination, case assessment and report
• orthodontic case assessment and report
• advice, dental charting, diagnosis and treatment planning
• radiographic examination and radiological report
• study casts
• 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 fluoride preparations
• 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: £70.70

• non-surgical periodontal treatment (gum disease treatment), including 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 planing 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 treatment) of 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: £30680

• 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 ceramics
• 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 containing stainless steel or cobalt chromium or nickel chromium, with thermally bonded porcelain
• 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