NHS dental fees are set by the Government, an issue which has led many dentists to complain that they are being paid too little for the services they provide. The result has been a gradual exodus by many dentists from the state system, leaving parts of the UK and some large cities without dentists willing to offer NHS care.
Even if your dentist is prepared to see you on the NHS, costs can be high.
According to Which? magazine, which this month publishes a survey of dental insurance, you are required to pay 80 per cent of your dental costs up to pounds 330 for each course of treatment. Anything over that amount, plus the remaining 20 per cent, is paid by the state.
By contrast, private treatment might cost up to pounds 345 for a gold crown normally available on the NHS for pounds 36, while a small filling for which you pay pounds 4.64 on the NHS will set you back between pounds 18 and pounds 42 from a private practitioner.
While private dentists charge much more, arguably the service is better - at least from some members of the profession. In any case, whether or not this is true hardly matters if you are forced to go private because NHS dentists no longer practice in your area.
If you are paying private rates, insurance is one way of avoiding large and unexpected bills, while helping to spread the cost throughout the year. Some types of insurance also allow you to choose more expensive treatment, such as white fillings in back teeth instead of the metal-looking amalgam.
There are three main types of cover available: capitation, dental insurance and health care cash plans.
Capitation schemes: These are budget plans, typically available from your local dentist. You register and are given an initial dental check based on which the practitioner decides how much you should pay on a regular basis. The average monthly cost is pounds 10, although if your mouth looks like an indoor version of a moon crater, this can rise to pounds 25 a week.
There are some potential snags with capitation schemes. One is that you are required to pay for work on your teeth identified in the initial check before you are allowed to join.
Expensive treatment may not be fully covered, but on the other hand cheaper cover means you won't be covered at all. Finally, dentists will only sign up to one insurer, which means you are given no choice. The most common is Denplan, owned by PPP, which specialises in health and long-term care insurance.
Dental insurance schemes: These simply repay the cost of private treatment to the dentist, with some offered by insurers as standalone policies and others part of a medical insurance package.
You typically pay about pounds 100 a year for such a package. But major work may not be covered, while there may also be an excess, leaving you to find the first pounds 5 to pounds 25 of any claim. There may also be a limit to the amount paid out each year or a waiting period before you are allowed to join. As with capitation schemes, you may not be allowed to join if your teeth are not up to scratch.
Health care cash plans: The treatment you receive is a integral part of a package which may include optical treatment and maternity benefits.
Premiums are calculated on a flat-rate basis paid monthly or weekly, and do not depend on the state of your teeth. The plan then pays out a proportion of any dental bills incurred, capped at an upper limit of pounds 100, for instance. Payment takes the form of a reimbursement to you for treatment you have already paid for. The amount you receive depends on the cover you have bought.
However, in addition to the claim limit, you may find a long initial waiting period before making the first claim effectively negates the purpose of taking out such a scheme. Namely, the nasty pain in your upper left molar that drove you to check out the cost of insurance in the first place.