How to stop dental work being a pain in the wallet

There is a variety of ways to make a visit to the dentist hurt less financially, says Rob Griffin

Visiting the dentist may bring relief from the agony of toothache - but the real pain may only be felt when it's time to settle the bill.

Research published by consumer group Which? this week shows a shortage of dentists and the limited number of treatments available on the National Health Service has left many patients with little choice but to pay for private care. And unlike in the NHS, where there are standard prices for different procedures, fees charged by private dentists will vary enormously.

For example, a basic examination that would be just £6 could end up costing £45, according to the British Dental Health Foundation. Similarly, the price of small fillings can rocket over 700 per cent from £6 to £50.

It's no wonder that the private dental industry is big business. Every year we spend about £1.9bn on treatments, and industry observers expect this figure to increase substantially over the coming years.

Fortunately, there are ways to ease the financial discomfort. A bit of careful planning - before you need emergency treatment - can end up saving you a fortune in costly bills once you've left the dentist's chair.

PAY AS YOU GO

It is estimated that 75 per cent of people who have private treatment will pay straight out of their own pockets. The benefits are that you don't see money regularly disappearing out of your bank account into insurance schemes. Therefore, if you are fortunate not to require any work, then you won't have wasted any money. However, you are running the risk of suddenly being hit with a huge bill. Having two crowns fitted, for example, could set you back £1,000.

FIXED MONTHLY PAYMENTS

These are known as capitation schemes. The idea is you pay a set amount each month - often between £5 and £20. The exact premium depends on your dental history and the current state of your teeth.

The advantage is that you will be covered for an agreed range of treatments, such as check-ups, extractions and fillings. The downside is there may be a maximum number of claims you can make. Also, the schemes usually tie the patient to a specific dentist. If they move house - or dentist - it will usually require another oral assessment with their new practitioner.

DENTAL INSURANCE POLICIES

Specialist policies will cover the cost of private dental treatment up to a set limit, although there are also schemes covering NHS treatment costs. These insurances may allow you to be treated by any dentist and you probably won't have to undergo a check-up.

In many cases, insurance policies work out cheaper but can sometimes be less comprehensive than capitation alternatives. Prices will, of course, vary.

WPA, for example, has policies for adults starting at £11.84 a month. This will include cover of up to £250 a year for general dental treatment - including check-ups - and dental emergencies of £250 for each treatment and up to £1,000 in one year. You can compare prices charged by other providers by logging on to www.insuresupermarket.com.

CASH PLANS

These contribute to the cost of dental treatments - as well as the cost of areas such as chiropody and optical care - in exchange for a relatively modest monthly outlay of about £12. Rival providers will offer different benefits, which may include cover for a set percentage of dental treatment up to annual limits.

GENERAL HEALTH INSURANCE POLICIES

If you have general medical insurance, it's worth checking to see if dental work is covered by this existing policy. However, in most cases, it will probably only pay for surgical procedures such as removing wisdom teeth. Take a look at the terms and conditions on the document; if it's not clear, contact your insurance company directly for confirmation of its policy.

SO WHICH ROUTE OFFERS THE BEST VALUE?

According to Dr Nigel Carter, chief executive of the British Dental Health Foundation, it's not a case of one size fits all. "It all depends on your own personal circumstances," he says. "Some prefer to pay only when it's required, while others like the comfort of being able to budget and choose to pay into a monthly scheme."

For each option, you need to establish what is being offered and how much money it is going to cost you. After that, it's a judgement call. If you have teeth that have always been healthy, then it might not be worth paying out £20 a month for insurance.

Can you find an NHS dentist?

* All UK residents are entitled to NHS treatment and it will always be the cheapest option - but getting access in some areas of the country is tough.

* Adults with access to NHS care are charged 80 per cent of their fees up to a maximum of £384 for one course of treatment, while children, those on low incomes and expectant/nursing mothers get financial support.

* To check what's available in your area, contact NHS Direct - either on 0845 4647 or via www.nhs.uk.

* Recent studies by Which? have highlighted particular problems in Cornwall and Shropshire, where 75 per cent of dentists weren't taking on any new NHS patients. In other areas, the waiting list was nine months or more.

* Which? also warns that almost half of the 321 NHS dental practices it called this year couldn't offer urgent NHS appointments for unregistered patients.

* Steve Webb, the Liberal Democrat Shadow Health Secretary, warns: "More than three in five adults and about half of children are not registered with an NHS dentist."

* Health minister Rosie Winterton insists the problems are being tackled by increased government investment.

It's worth shopping around

* Do your homework before registering with a private dentist. We asked how much five dentists in Croydon charged for basic procedures.

* The prices quoted for a patient's first appointment, including an initial examination and x-rays, were between £25 and £70. A standard six-monthly check-up ranged from £15 to more than £40; while a basic scale-and-polish treatment carried out at the same time bumped the charges up to between £35 and £80.

* It was a similar story with fillings. The cost of having a small white filling - a treatment not available on the NHS - was a relatively modest £20 in the cheapest dental surgery we could find. Other practices, however, told us the starting price would be almost £100.

* The only stable set of fees was for tooth-whitening procedures - about £350 for home bleaching kits and between £450 and £500 if treatment was carried out in the surgery.

* Frances Blunden, principal policy adviser at consumer group Which?, advises people to research what's available before registering. "They shouldn't be frightened of asking how much treatments will cost, even though we're not used to shopping around for healthcare," she says.

* Before a decision, ask friends for recommendations, then visit at least three surgeries to compare prices and services.

* Ask them about consultation costs, the guide prices on treatments, whether they provide emergency out-of-hours cover, and how they keep up to date with the latest technology. It's also worth finding out if a registration fee is charged on top of the initial examination fee.

'My insurance has already saved me money ­ and not just on dental care'

Christine Hutchinson believes a health insurance policy that includes cover to fund the cost of future dental treatment is worth every penny.

Christine, a nurse, and her husband, Paul, from County Durham, pay about £50 a month into a cash plan from Medicash. And the couple ­ who have already claimed some money back ­ say the main benefit is knowing they are protected from financial blows.

"It's something for you to fall back on if the unexpected happens," she says. "For me, Medicash has been a life-saver."

"I think the policy is really good, and I keep trying to sell the idea to my work colleagues, who would also benefit from this type of deal."

The couple, who have two children and two grandchildren, have already used the policy ­ and this has not just been for dental treatments.

Within weeks of taking out her policy three years ago, Christine, 52, was diagnosed with breast cancer. She was subsequently able to make a claim. But even if the family doesn't get ill they can claim for the cost of routine treatments.

Medicash offers a number of different policies, although the starting point is £12 a month for standard membership, which entitles the holder to claim up to £80 a year for dental treatments.