NHS Dental Banding System Explained

Care under the NHS is generally free at the point of service, however there are some exceptions and dentistry is one of those. The aim of this post is to explain the NHS dental banding system. This post primarily refers to NHS dentistry in England, as there are subtle differences in how dentistry works across the home nations. Unfortunately, a common misconception amongst patients is that NHS dentistry is always free – this is not true.

What is the NHS Dental Banding System?

NHS dentistry is about providing functional dentistry and NOT cosmetic dentistry. With any treatment that is carried out, it is done with a view of functional improvement and disease prevention for the patient. Cosmetic work is not provided under NHS dentistry.

The NHS dental banding system essentially refers to the four bands of treatment under the NHS. Each band has an attached cost to it which is what the patient pays. These prices usually change every April but prices are correct as of the date of posting.

Band 1

This costs the patient £23.80 and includes any number of the following (full list in the image):

• A clinical examination, assessment and reports
• Application of sealants or fluoride on teeth
• Marginal correction of fillings
• Clinical photographs

Band 2

Band 2 costs the patient £65.20 and includes the following items (full list in image):

• Restorations
• Root canal treatments
• Extractions
• Root surface debridement

Band 3

This would cost the patient £282.80 and it basically includes anything that the lab would need to be involved with. It includes items such as crowns and bridges, dentures and veneers.

Band 4

This is the emergency band of treatment and would cost the patient £23.80 (the same as Band 1). Examples of treatment include:

• Extraction of no more than two teeth
• One permanent filling
• Drainage of an abscess

Free Treatment

There are certain treatments that are free on the NHS. These include:

• Suture removal
• Denture repairs
• Stopping bleeding

If a patient is having treatment covering multiple bands of treatment then they would pay the highest band of treatment only. For example, if a patient is due to have a filling and a crown then they would just pay a Band 3 charge and not a Band 3 + Band 2.

Rules and Exceptions

There are a few variations and rules to be aware of related to NHS dentistry. If a patient has a course of treatment completed but they return within two months for further treatment, then this would be included in their previous course of treatment provided it is in the same band or lower. If it’s for a higher band, then they would pay the difference.

Certain treatments are also guarantee under the NHS for up to 12 months. These include:

• Restorations
• Root canal treatments
• Inlays/onlays/veneers and crowns

However, these items are not guaranteed if:

• The patient has received private treatment on the same tooth since the original restoration was done
• The restoration was intended to be a temporary restoration and the patient was aware of this
• The patient was advised that an alternative treatment option was more appropriate at the time but they went against this advice
• The replacement/repair is due to trauma

Advanced Mandatory Referral Remit

If you are referring a patient for certain procedures under the NHS, for example endodontics, periodontics and surgical dentistry, then this may fall under the Advanced Mandatory Referral Remit. In this situation, the patient is charged the full amount at the referring dentist so that they do not pay again at the location they are referred to.

For example, if a patient attends for a check-up and is being referred for an extraction, the patient would pay for a Band 2 at the dentist. They wouldn’t then pay at the final destination where they have the extraction. However, if we consider UDAs, the referring dentist would only receive one UDA and not three (i.e. they would only receive UDAs for a Band 1 and not a Band 2 course of treatment).

Exempt patients

NHS dental treatment is completely free for some patients. These include (full list below):

• Those under the age of 18, or under 19 and in full-time education
• Pregnant patients or within 12 months of having a baby
• Low income benefits, including income support
• HC2 certificate

Patients must declare their exemption on a FP17 document. If they are not exempt, but sign to say they are exempt, then they may get fined.

Summary

• NHS Dentistry is not generally free
• Dental treatment is divided in to four bands of treatment
• NHS treatment may be under guaranteed depending on the situation
• Some patients are exempt from NHS dentistry

Useful Links

• ExamineDental
• Single Best Answer Questions for Dentistry