Rising costs on the NHS are forcing people to dig deep for treatment, while others are forced to go private with NHS dentists reluctant to take on new patients. The latest Simplyhealth annual dental survey also shows that 40 per cent of working adults skip routine check-ups because they can't afford the bill.
It seems that getting a toothache in England is more of a concern than it is in Wales, where charges have been frozen at 2006 levels, or in Scotland, where dental patients pay only 80 per cent of NHS treatment fees. As of last month, English patients have to cough up an extra 50p for a check-up, now £17, and will pay £47, an increase of £1.40, for fillings and root canals, known as band-two treatments. Band three treatments such as dentures and bridges have gone up by £6 to £204.
"With the rising cost of living and with NHS dental charges in England on the increase, it's important that people be financially prepared for the costs associated with looking after their oral health," says James Glover, a Simplyhealth spokesman.
The good news is that there are several ways you can insure against these costs.
If your teeth are generally in good condition, capitation plans from the likes of Denplan, DPAS or Practice Plan are one option and can be bought directly from certain dentists. With these you pay a monthly fee, determined by your existing oral health, in order to spread the cost of treatment over the year. If your teeth and gums are healthy, you can expect to pay about £15 per month, but if your oral hygiene is poor, your monthly premiums could triple.
Denplan is by far the biggest provider of capitation plans and offers a basic essentials policy for routine work, which includes check-ups, X-rays, scaling and polishing. Denplan Care offers additional cover for fillings and restorative care such as gum treatment, crowns, bridges, dentures and root fillings. Neither policy covers referral fees, laboratory fees, prescriptions, orthodontics, implants or cosmetic treatment.
"Capitation plans will cover things such as crown and bridgework, so long as they are clinically necessary, but only for the cost of the dentist's time, so you will have to pay the laboratory bill," says Dr Nigel Carter, the chief executive of the British Dental Health Foundation.
If a capitation plan proves too expensive for your particular set of gnashers, it may be cheaper to opt for a stand-alone insurance policy. You pay a monthly premium but there is usually no need for an oral assessment and you settle any bills after treatment.
Dental insurance plans don't cover cosmetic dentistry so you can forget about claiming for a new Hollywood smile, but you can claim for general treatment, injuries and emergency treatment. Providers include Boots, Dencover, Tesco and Western Provident Association (WPA). Monthly premiums vary widely and may depend on your age, as well as whether you want cover for NHS and/or private work. With most of these policies, you will have to stump up some cash yourself as many set maximum annual payouts and cover only a fixed percentage of the treatment cost.
For example, a 30-year old would pay £13.50 for WPA's Level 2 dental cover for both NHS and private treatment. However, this covers only 75 per cent of costs for emergency treatment up to £1,000, 75 per cent of costs for general treatment up to £250, £20,000 for dental injuries and £10,000 for oral cancer.
Cosmetic dentistry and pre-existing conditions are not included and you are unlikely to get a payout for accidents sustained during a hazardous sport. Crucially, you will typically need to be signed up for between three and six months before they will pay out so you won't be covered straight away.
Another way to protect yourself with insurance is with a health cash plan which will contribute towards most of your medical costs by paying out a cash sum. "Most health cash plans will include a cash benefit for dental treatment. Some pay as much as £1,000 per year but most are in the region of £175 per person," says Ben Heffer, an insight analyst for protection at Defaqto.
Although most cash plans are designed to cover various medical expenses, whether it's a trip to the optician or the chiropodist, Simplyhealth does offer a dental-only cash plan. The basic Simply Dental Plan costs £7.50 a month, offering 100 per cent cash back up to £25 for check-ups, 75 per cent cash back up to £30 for scale and polish and 50 per cent cash back up to £200 for dental treatment. For extra peace of mind, the plan also offers full cash back up to £500 for emergency treatment and up to £5,000 for treatment following an accident and a one-off £5,000 payment for primary mouth cancer. If you can stretch to £22.50 per month, the Level 4 plan will top up cover to £100 for check-ups, £120 for scale and polish and £800 for dental treatment.
Once again, watch out for exclusions and note the limits on the value of claims as well as the number of claims per year. Some plans allow you to claim the full amount but many apply a percentage, so although they do help to lighten the burden, they don't necessarily pay it all. Always read the small print carefully; with the Simply Dental Plan, for example, under dental accident you are not covered for treatment as a result of injury caused by eating, chewing or drinking. Similarly, if you have an accident playing sport without wearing the appropriate mouth guard, your claim is invalidated.
If you decide to forgo insurance altogether and pay as you go instead by covering any dental costs as and when you need to, be sure to compare prices.
You may not be used to shopping around for healthcare, but fees for everything from check-ups to scale-and-polish treatments will vary from one private dentist to another, so visit a few surgeries for quotes.
Case Study: Fiona Pratley
For Fiona Pratley, a barrister with Hampshire County Council, paying £500 for dental treatment led her to take out cover with Simplyhealth in October 2008 to cover her husband, Stephen, and two young daughters, Anna and Ameilia.
"I found the NHS increasingly costly, even just for maintenance. And as you had to pay for treatment as you went along, there was no way of planning or budgeting for unexpected expense," she says.
The Pratleys now pay £31.95 per month for their Simply Dental Plan which covers the whole family for dental maintenance, including two check-ups a year, hygienist and X-rays and up to 75 per cent of the costs of dental treatment including crowns, bridges, white fillings and lab fees. The monthly fee hasn't taken long to pay for itself with Fiona having two silver fillings replaced; two root canal treatments, a crown replaced and a new crown, all of which would have otherwise cost well in excess of £1,000.
"It was my 40th birthday last year just after my course of treatment ended. My husband flew me to Guernsey for a short holiday and we also enjoyed a lovely family holiday in summer with the girls in Dorset. If I hadn't been covered with Simplyhealth, we would definitely have had to cancel one or other of these trips," she says.
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