I thought all NHS dental treatment was free? Isn’t it?

Very few people and, sadly, the number of people entitled to free NHS dental treatment is ever-dwindling thanks to the strict policies of successive governments and the long-standing underfunding of NHS dentistry. It’s not even automatically free for the elderly (outside of free prescription charges and, in some regions, examinations) as many may incorrectly think. Although over 30m adults in the UK do currently have a NHS dentist and pay for their treatment (plus many more who would have to pay if they could even find a NHS dentist), there are still thankfully some people who are entitled to free NHS dental care. This criteria differs in England, Scotland, Wales and Northern Ireland as follows: 

See who is potentially entitled to free NHS dental care in England here 

See who is potentially entitled to free NHS dental care in Scotland here

See who is potentially entitled to free NHS dental care in Wales here

See who is potentially entitled to free NHS dental care in Northern Ireland here

Chances are however that you may be exempt from NHS Dental charges if you are under 18, under 19 and in full-time education, are pregnant or have a baby under 12 months old, are in receipt of Universal Credit, Income Support or income-based Jobseeker’s Allowance/Employment and Support Allowance, are getting Pension Credit Guarantee Credit, have an HC2 certificate and/or you have an NHS Tax Credit Exemption Certificate. If you are on a low income then you may be entitled to some help towards your NHS costs and to apply for this help please see here.

NHS dental fee structures are complex and vary across the UK with different NHS charging rates for Wales, Scotland and Northern Ireland compared to England. If you're in Wales, Scotland or Northern Ireland then the Smile Assured NHS Dental Plan makes it easy for you by reimbursing all your NHS dental charges up to £500 per year using the NHS England scale of charges (so you're covered anywhere in the UK). While the England scale of charges is cheaper overall than Scotland and Northern Ireland, it is more expensive than Wales (who recently made the largest increase to charges in NHS history with some charges more than doubling). Any price increases outside of England have yet to be announced although Scotland, for example, officially says "there may be an increase in the price you pay for your NHS dental treatment to ensure we are able to continue to provide NHS dental services and reflect the increase in cost of delivering the care required for patients".

We'll list all the charges in the different regions for you below but here are examples of the current costs in England for the most common treatments:

Band One (£27.40): 
This covers basic everyday treatments like examinations, X-rays, scale & polish, moulds & also emergency treatment.

Band Two (£75.30): 
This includes fillings, root canals, periodontal treatments, teeth extractions, apicectomies etc.

Band Three (£326.70): 
This covers more complex procedures like crowns, bridges, dentures & various other NHS treatments.

For more precise cost figures for each country in the UK then here are some useful and official links for you:

You can see the costs of NHS dental treatment in England here (currently capped at £326.70 per course of treatment)

You can see the costs of NHS dental treatment in Scotland here (currently capped at £384.00 per course of treatment)

You can see the costs of NHS dental treatment in Wales here (currently capped at £260.00 per course of treatment)

You can see the costs of NHS dental treatment in Northern Ireland here (currently capped at £384.00 per course of treatment)

Do bear in mind that it is common for many people to need several different courses of treatment annually and that many people do indeed pay hundreds of pounds every year just for routine dental treatment. It is worth noting that the NHS has a "2 Month Rule". This means that if within 2 calendar months of completing a course of treatment you need more treatment from the same or a lower NHS charge band (such as another filling if you have just had one) then you do not have to pay anything extra. If the additional treatment needed is in a higher band though, you'll have to pay in full for that new NHS course of treatment. That means if you have a £75.30 filling and then need a crown then you would have to pay an additional £326.70. It also means if you have a Band One £27.40 examination then they will then charge you for most treatments that come out of that which tend to fall in either Band Two (£75.30) or Band Three (£326.70) so this two month rule often isn't as fair as it may sound. Worse still - if you visit at the end of any given calendar month then this rule only applies to a treatment that is then delivered by the end of the following month (if you can even get an appointment that quickly) so, in a lot of cases, it is often really just a 1 and a bit month rule and therefore quite misleading!

Based on a recent House of Commons Library estimate, real-terms funding for dental services (accounting for inflation) for the last accounted period of 2022/23 fell by 19% since 2010/11 despite a significant increase in population and need during that same period. This was also despite inflation busting increases in the costs of NHS dental treatment every year. This means that NHS dental funding dropped from £3.56 billion in 2010/11 to £2.90 billion in 2022/23. This underfunding has been dovetailed with a series of poor policy decisions by recent governments and what dentists have felt were poor remuneration contract offers. This has pushed many dentists who previously provided NHS treatment into now either working 100% privately or offering significantly less NHS dental treatments than they used to. That is why in many areas many people are still struggling to find a NHS dentist. We do offer tips below on how to find a dentist and there are plans in place to improve matters as we will come onto.

It's worth noting that the last government did have a so called 'NHS Dental Recovery Plan' which they announced in early 2024 (but then went on to completely not deliver on any of it at all) so let's just now focus on what the current government are doing (or at least claiming to):

700,000 Additional Appointments In England 

According to the Department of Health & Social Care, NHS England, Stephen Kinnock MP and Gov.uk on the 21st February 2025 then the current government announced that it is delivering on its manifesto commitment to roll out extra urgent appointments across the country and that ‘dental deserts’ (where patients struggle in particular to get appointments) are specifically being targeted. The British Dental Association at least called this “progress”.

According to Health Minister Stephen Kinnock’s announcement, hundreds of thousands more people across England (with action also being taken in Scotland, Wales and Northern Ireland) will very soon be able to access NHS dental care with the government and NHS rolling out an additional 700,000 dental appointments from April 2025. The minister stated that NHS England has written to integrated care boards (ICBs) across the country to direct health chiefs in each region to stand up thousands of urgent appointments over the coming year. All these extra appointments will be available from April and are being targeted at those dental deserts where patients particularly struggle to access NHS dentists. This includes parts of the east of England (such as Norfolk and Waveney) where there are just 31 NHS dentists respectively for every 100,000 people (way below the national average).

Focusing On Under-Served Areas

The government is recruiting new dentists to the areas that need them most and intend to reform the dental contract with a shift to focusing on the retention of NHS dentists. This includes a golden hello bonus incentive payment of £20,000 offered per dentist for up to 240 dentists who will agree to work in areas of the country that have traditionally been hard to recruit to. The last government promised this and delivered zero but the government has at least immediately delivered 68 of these posts with more to come.

It is worth noting that since early 2022, the NHS has already required dentists to operate at 85% of their pre-pandemic activity. There are still heart-rendering stories in the media of patients unable to find a dentist and having to self-treat but the fact is that all dentistry is more-or-less close to pre-pandemic levels on the great scale of things. Most of the areas that struggle with NHS dental availability have, typically, always struggled (coastal towns, remote & rural areas etc.) but it is clear there are far less NHS dentists than there used to be. Why? Well, COVID certainly didn’t help as dentistry effectively had to entirely close down for a significant period of time and, thereafter, services were still limited for a further period. However, since dentists are essentially all private contractors to the NHS, the contracts offered to dentists by successive governments (especially since 2010) have, unfortunately, encouraged many of them to move into private work as they were/are not happy with the NHS contracts offered. This is one of the main reasons why, for a lot of people, their dentist has suddenly switched entirely to private dentistry.  

None of these measures are close to perfect in our opinion and we want to see more deeds and less words by the government. It is good though that Labour promised to "tackle the immediate crisis with a rescue plan to provide 700,000 more urgent dental appointments and recruit new dentists to areas that need them most." and are now following through on that plus that they have committed "to rebuild dentistry for the long term" with by "reforming the dental contract with a shift to focusing on prevention and the retention of NHS dentists". It remains to be seen of course whether this all goes exactly to plan but for now we'll give you some simple facts and tips below on what to do if you are indeed still struggling to register with a new NHS dentist.

You can by the way see an actual list of the number of appointments being “purchased” by the government and delivered from April for all the individual integrated care boards here. 21,520 appointments are being purchased in Norfolk for example, 24,360 in Nottingham, 24,269 in Devon etc.

What Would We Do?

We may merely be a family run insurance business but we do have opinions on the current status quo as the more people who have a NHS dentist then the better it is for us! Aside from improving the dental contract on offer for dentists (so that more want to work in the NHS) and doing many of the things already mooted like focussing on the under-served areas, we of course want to see the dramatic underfunding of NHS dentistry put right by the government as that's clearly a big part of the picture. Cutting a cake by about 20% as the last government did over the past decade or so and then trying to feed even more people with the remnants was never going to work! With the cost of living crisis, we'd like the government to just give people a break by not significantly increasing the cost of NHS dental treatment every April as they just have yet again (albeit by a more modest 2.3% compared to anywhere up to 8.5% under the previous government) and for the relevant authorities to also now clamp down on those dentists who are advertising that they are taking on new NHS patients (when they aren't) so they can get people in through the door and then 'bait and switch' those same patients into paying for costly private treatment. That is predatory and it is wrong. If you see any malpractice like this then we would certainly urge you to report it to the General Dental Council here and also to the Advertising Standards Authority here.

If we had to give you just one big idea to fix matters quickly, here it is...

The percentage of new dentists who go straight into private work (after just receiving £300k of taxpayer funded payments of which a mere £100k is even remotely repayable by them) is, quite frankly, crazy. Of the more than 35,000 dentists registered with the General Dental Council in England, just over 24,000 delivered some NHS care in England in 2022 to 2023. This means that around a third of registered dentists are not contributing to NHS dentistry in any way at all and seem to be solely working in private practice. We are all for free enterprise but how do we shift this paradigm when we all want and need more dentists in the NHS and a better funded NHS dentistry regime yet we are effectively giving £200m away every year to new dentists and placing no obligation on them to ever work in the NHS? How do you force a dentist to work in the NHS though?

Well, we were, notionally, very pleased to see that there was actually a government consultation in 2024 about whether newly qualified dentists should be forced to deliver NHS care for several years after they graduate. If they do not then the penalty under discussion was that they should have to repay more (or indeed all) of that £200k or more of free funding that just got them trained to be dentists and, in doing so, gives them a serious and lifelong income thanks to the taxpayer. This consultation was done under the last government so we are not sure if it has since been followed through on but surely this would be a very good idea and be for the benefit of us all? National Service for dentists! 

Let's say for argument that the £200,000 that a new dentist just got for free should equate to them having to deliver 2,000 NHS dental treatments over a period of at least 2 years as a minimum unless they want to repay all of that money to the taxpayer. 2 years is equivalent to about 500 working days which equates to them treating just 4 NHS dental patients per day. NHS dentists see around 20 to 30 patients per day and private practice dentists typically see about 10 to 15 patients per day so this would absolutely not prevent them from doing a very large amount of lucrative private work if they so wished. Around 1,000 new bright-eyed dentists are unleashed into the wild every year so such an initiative would potentially see 1m more NHS dental appointments delivered to patients every year. This alone would largely solve the current crisis in terms of NHS dental treatment availability and possibly eliminate the need for more gimmicky things like the additional £20,000 "Golden Hello" payments currently being offered to dentists when many would argue that it's just the right thing for them to spend at least some time serving the NHS to start with! You may argue that some of these new dentists would work in the NHS anyway (which would skew that figure of 1m extra appointments) but in return for writing-off the £200,000 of taxpayer money then surely it is not too much to ask that they simply squeeze in an extra 2,000 NHS dental appointments over a period of say 2 to 5 years by slightly extending their working hours? Junior doctors for example generally work an average of 48 hours per week with up to 72 hours on duty in any given week so it's not an unreasonable expectation in this field! 

In addition to the 700,000 new NHS appointments that came online from April 1st 2025 then it is also true that more dentists have been offering NHS dental treatment over the last 12 months. From the figures released for just one quarter recently then nearly 500 more practices across England alone were accepting new adult patients in that period. According to data compiled from the NHS Find a Dentist website shown below, 1,417 practices were listed in that period as taking on new NHS patients compared to 929 practices listed in the previous quarter so that was a net increase of 53% (i.e. 488 more NHS dental practices taking on new NHS patients). Plenty more have come on-stream since then and are continuing to do so so the seeds of recovery do seem to actually be there. This NHS Find A Dentist tool is not the most accurate tool in the world (it is after a government tool) but it clearly does work for a lot of people including many people on our team!

While many people say they have tried and tried to call dentists like this, when questioned many admit that they have only really made cursory attempts, perhaps just every month or so. 5.4m adults have not even attempted to make an appointment in the last 2 years because they think, often wrongly, they will not get one. Anyway, regardless of why you don't have a dentist right now, the key to getting one is perseverance. Don't give up - especially when the new measures outlined previously will continue to take effect so in some ways it's "fastest finger first". It's always worth just getting yourself on a waiting list (or at several dentists which you are able to do) since although you may initially be told that a practice's waiting list is months or more, you may suddenly get a call asking if you can come in quickly because a cancellation has come up. Time is money and everyone is late and the fact is that dentists really don't like empty slots as it is dead space for them! On this point, many people tell us the reason they don't have a dentist anymore is because they missed 2, 3 or more appointments and were subsequently de-listed. Firstly, this happens all the time and, along with people who move away etc. is why spaces always eventually come up at a practice - you just need to have your name in the hat! Secondly, dentists lose money on no-show appointments which is why they have strict rules on attending appointments so the lesson here is if you get a NHS dentist then don't fail to show up for an appointment and expect the dentist to not take any action. In this day and age, cherish your place with a NHS dentist! 

Another more “creative” tip is to call a dentist who does NHS work but say that they are not accepting new patients, just private patients. Softly indicate to them that while you want routine NHS dental treatment, you may also want to take advantage of some of their private options. We have seen many dentists accept new NHS patients on this basis since they are often then looking at the future big pay-day from your "planned" private work like those implants you're dreaming of! 

Don't forget that you are of course fully entitled to call the NHS on 111 if you think you require urgent dental care. If applicable, they will facilitate emergency treatment for you. As highlighted previously, if you do get emergency treatment this way then you will often then be later transferred onto a NHS dentist thereafter and thus end up registered with them moving forwards. It may sound cynical but sometimes the truth is that the reason that some NHS dentists not accepting new NHS patients are choosing to accept hospital referrals is because the work they then get is often potentially more complex and lucrative. If you're worried about dental symptoms then you can also do all this online on the NHS 111 website here. You will simply have to answer some questions and, whether it is by phone or on the website, they will then tell you what to do next. Depending on your symptoms, this may involve you going to A&E, being sent to an urgent NHS dental treatment centre, getting you to see an emergency dentist or just helping find you a NHS dentist.

We also wanted to let you know that, as well as complaining to the General Dental Council if you have an issue with a dentist here, you should take a look at Healthwatch who are a health and social care champion. Their role is to make your voice heard to improve care. They have the power to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. They can help you find reliable and trustworthy advice and information, help you make complaints and they help around a million people every year have their say and get the support they need. You can find your local Healthwatch here.

Ultimately, we know it's a nightmare for a lot of people at the moment and we fully empathise even though it is completely beyond our control as a mere family run UK insurance business (plus it hurts us too since we can only help people with a NHS dentist). This was clearly one of the issues at the last ballot box for many people! Once you do find a dentist then you really should join us here and we'll quickly reimburse all of your NHS dental bills up to £500 every year with immediate cover, no excess, no hassle and not even an annual contract.

Not really but it’s reasonable question to ask. On the face of it then if you only had two check-ups in a year and claimed for nothing else then you would be reimbursed £54.90 versus the annual cost of £150. That's like any insurance though -  there are always peaks and troughs and what you’re really paying for is the total peace of mind and complete confidence that if you did suddenly get a large, unavoidable and unexpected dental bill then it will just get dealt with for you. Our tens of thousands of happy customers get that. To reiterate, the cost of just one Band 2 treatment (like a filling, extraction or root canal) is £75.30 and that's over 6 months of cover on our policy (plus it is rare to not also have to pay the Band 1 price of £27.40 for the examination to even identify that treatment in the first place pushing the overall cost well past £100). Band 3 treatments (like crowns, bridges, dentures etc.) are now £326.70 so that's over 26 months on our plan! We are thus very good value. That's why our customers stick with us.

Some years you may claim up to the maximum, others less so. Peaks and troughs as stated. Look at it like home insurance - you pay your premium and you get the peace of mind that if anything happened you know you will be covered for what could otherwise be a very high bill. The difference with us versus that type of insurance though is that our policy price doesn't change no matter how many times you claim and there is no annual contract and no excess. It just stays at £12.50 a month - the cost of a small takeaway!

Naturally, if you are lucky enough to have absolutely perfect teeth and have the conviction this situation will categorically remain unchanged over the coming year then sure - our policy may not be right for you at this moment in time! However, we would still argue that since we (like all insurers) do not ever insure anything retrospectively then it's always better to join us now before an unexpected dental event occurs rather than after. Even for those who sometimes spend a little more than they ultimately claim back, they are usually delighted to have avoided a big outlay at a particular moment in time since they have instead just averaged that large unexpected cost over the course of their policy. 

Just to expand on the only ways it is even remotely possible to get something like implants for free on the NHS:

(1) Severe medical need 

The NHS will cover dental implants in cases where they are deemed absolutely clinically necessary due to a very serious medical need such as reconstructive surgery after a major trauma or after head and neck cancer.

(2) Inability to wear dentures 

If a patient is unable to wear dentures then they may be eligible for NHS dental implants. This is exceptionally rare though as with modern techniques and technology, dentist’s will almost always be able to find an alternative solution or create dentures that do fit. And you have to be assessed as legitimately requiring dentures in the first place to even be in a position to then claim you are unable to wear them.

(3) Severe facial or tooth injury 

If a patient has a major facial or tooth injury that requires reconstructive surgery then, in exceptional circumstances, they may potentially be eligible for NHS dental implants.

If you qualify in any of the three areas above then yes, you should certainly speak to your NHS dentist but if you don’t then expect to pay several thousand pounds privately (most private cosmetic dentists do now offer payment plans though).

Just to give you an idea of the almost inescapable private costs involved, just one dental implant for just one tooth usually costs between £1,750 and £3,000 (depending on the provider). This price will include the implant itself, the abutment (which connects the implant to the artificial tooth), and the crown (the artificial tooth). We can cover the cost of crowns on our plan (as long as they are delivered as a £326.70 NHS treatment and not a private treatment) and can probably cover examinations too if they class them as a NHS Band One examination. The rest of the cost (which is most of the cost) is listed above and that involves the actual surgery plus all the other associated costs like consultations etc.

Yes. Don’t do it. We know it can be very tempting based on the prices and from what you may have seen from paid celebs and influencers but, trust us, it is very dangerous with many risks involved and it’s likely you have not seen the many, many horror stories. Yes you can get “Turkey Teeth” and save money doing so but, equally, you may well end up in lifelong pain and few (if any) of these cosmetic solutions are permanent anyway since you will usually need to get everything redone periodically (and that’s even if you still can because this kind of dental work usually involves literally destroying all of your healthy teeth and that’s just fundamentally counter-intuitive). Regardless - you will still always need basic UK based dental treatment anyway and that is still costly and will be far more costly again if you’ve become one of those many horror stories! Horrendous complications, serious infections, poor quality work with poor quality materials, abysmal aftercare and even permanent damage are very common abroad and a lot of the time you will end up getting sold unnecessary or premature procedures anyway with the only consideration being for your money and not for the long-term implications. 

In the UK all dentists must be registered with the General Dental Council (GDC) to ensure that they possess all the necessary qualifications and expertise. This registration serves as your first line of defence. Should any issues later arise during or after your treatment in the UK then your dentist is legally obligated to address them. If they fail to do so then you have legal recourse to compel them to rectify the situation or provide compensation and this is your second line of defence. Opting for dental treatment abroad completely lacks any of the same assurances of qualifications and experience. While you may encounter a qualified dentist during your initial consultations (or someone who looks like one), there's absolutely no guarantee that they'll even oversee your entire treatment (or even be involved in it at all) and this often leads to let's say "subpar outcomes". In the event of any complications then you'll also face the daunting task of navigating a foreign legal system and will have to do so in a language that you may not be fluent in. Many of these systems require residency for any legal recourse to be instigated in the first place which leaves you further vulnerable. The chances of you getting any real justice and compensation is very slim. The cost of correcting poor-quality work and complications will usually dramatically outweigh any initial savings you may think you are getting with this risky trend of dental tourism.

In essence, prioritising your dental care within the UK provides you with the most reliable safeguard for your oral health. Many UK dentists now offer payment plans for elective and cosmetic work. Yes it’s more expensive than some locations abroad but that’s because it is safer, better regulated and far superior. Remember that the ads for these companies only ever show you the good and never the bad or the ugly. And with many of those providers, their failures often outweigh their successes. Do not risk it.