The NHS was founded on the principles of quality and equity: that good healthcare should be available to all; is free at the point of use; and is based on clinical need, not on the ability to pay. Prior to its creation in 1948, thousands of people died each year from treatable illnesses because they could not afford to pay for their healthcare.
Fast forward 70 years and we appear to be back where we started. To be fair, large swathes of the population haven’t started dying, yet. But it is distressing to learn that over the last four years, two million fewer people are claiming the NHS dental care they are entitled to because a punitive system dissuades them from doing so.
Between 2018 and 2019, more than 400,000 people were issued with a £100 fine for “misclaiming” NHS dental care. Many were elderly and frail, some had dementia and others were learning-disabled, according to the British Dental Association. Although entitled to the free care, they were fined because they struggled to understand a complex system of declarations.
Claiming a benefit should not about dodging bureaucratic obstacles. But that is exactly what it must feel like to hundreds of thousands of households where someone is living with multiple disabilities, is elderly and frail, or is disadvantaged simply because of their poor literacy or English-language skills, and so cannot communicate their exemption status.
Predictably many vulnerable people, including children, are now going without dental care, thus exacerbating the oral health inequalities that should not exist in 21st century Britain. Dental care for children and some adults is free. But many people now are unaware of their entitlement because the narrative around claiming a benefit has become toxic.
As with every problem, there are a number of solutions. One involves building communities of compassionate individuals who don’t think twice about looking out for those who, for whatever reason, can no longer do battle for themselves. Whether that’s a struggling neighbour, an ailing friend or ageing relative. And one of the simplest ways to help is by sharing the vital information that could make their life easier, and which could help get rid of these unacceptable oral inequalities once and for all.
NHS dental charges exemptions
NHS dental care is free of charge to all children under 18 years old and to young people under 19-years old who are in full-time education. Pregnant women and women who have given birth in the last 12 months also receive their dental treatment free.
People in receipt of income-based Jobseeker’s Allowance, income-related Employment and Support Allowance and Income Support are entitled to free NHS dental treatment. Their partner and dependent children under the age of 20 also qualify for free treatment.
If someone or their partner receives Pension Credit Guarantee Credit or Pension Credit Guarantee Credit with Saving Credit, they are entitled to free NHS dental treatment. However, anyone who receives Pension Credit Savings Credit on its own is not.
For those who receive Universal Credit, their entitlement to free dental care depends on their earnings for the most recent assessment period. The assessment period is usually calculated as the month that ended immediately before the date a person claimed free NHS dental treatment.
They are entitled to free NHS dental care if their earnings during the period were £435 or less or £935 or less if their Universal Credit includes an element for either a child or limited capability for work. For those claiming Universal Credit as a couple, the earnings limit applies to the joint income of the couple. The qualifying criteria for Tax Credits claimants is complicated. Please visit this flow chart.
Help with NHS dental costs
Pensioners in receipt of Pension Credit Savings Credit only and people who are living on low-incomes or who are in receipt of contribution-based Jobseeker’s Allowance, contribution-based Employment and Support Allowance do not receive free NHS dental treatment. But they can apply for help with their dental costs through the NHS Low Income Scheme.
How much will I pay for NHS dental treatment?
For those patients who are not exempt from dental charges, there are three bands of charges for all NHS dental treatments in England. Patients pay one charge per course of treatment, even if this means that they need to visit the dentist on more than one occasion to complete a course of care. Dentists can allow patients to pay this charge in instalments.
Band 1 dental treatment: £22.70 in England and £14.70 in Wales
Treatment includes a dental examination, the diagnosis of a problem using X-rays if necessary, and advice and information on the care necessary to prevent problems occurring in the future. This band also covers a scale and polish if clinically required, and preventative care. This is usually an application of fluoride varnish or fissure sealant.
This band also covers any emergency dental treatment that is required, such as pain relief or a temporary filling, and which is carried out in a primary care dental practice.
Band 2 dental treatment: £62.10 and £47.00 in Wales
This band covers everything detailed in Band 1 plus any necessary treatments such as fillings, root canal work, sometimes known as a root filling, and the extraction or removal of one or more teeth.
Band 3 dental treatment: £269.30 in England and £203.00 in Wales
Treatment covers everything listed in Bands 1 and 2, plus any other more complex procedures that are required such as crowns, sometimes known as a cap on a tooth, dentures or false teeth, bridges and other laboratory work.
Applying for a refund
If you have recently paid NHS dental costs and have now discovered that you should have received your treatment free, you can claim a refund provided you submit your claim within three months of paying the dental charges. To do so, you will need to downland and complete HC5(D) form.
Dental implants on the NHS
In general, dental implants are not available on the NHS and only available via a private dentist. However, they may be available on the NHS in cases where a person cannot wear dentures because the loss of teeth has led the mouth to shrink so much that it cannot support dentures. They may also be available on the NHS when a patient’s face and teeth have been damaged due to mouth cancer or because they have been in an accident that's knocked a tooth out.
