Dental costs will set your teeth on edge

Harvey Jones explains how to take the pain out of your dental costs even if you can't find an NHS dentist.

If you have a decent NHS dentist, be grateful, because these days they're as rare as hen's teeth. Dentists have been fleeing the NHS for years, exhausted by having to "drill and fill" an endless stream of patients to earn their fees.

Some 35% of us now struggle to find an NHS dentist, up from 27% last year, according to the latest annual survey from dental and cash plan provider Simplyhealth. And a hefty 43% have put off going to the dentist over fears about the cost. No doubt the credit crunch hasn't helped.

So what can you do to keep a smile on your face?

Open wide

Even if you can find an NHS dentist, you still have to pay. Costs are divided into three bands. A basic check-up, including scale and polish, costs £15.90, while a check-up plus any fillings, root canal treatment and extractions will set you back £43.60. All this plus more complex procedures such as crowns, bridges and dentures will cost £194.

This may seem pricey, but people on benefits get their costs reimbursed, and it's a lot cheaper than going private.

Open wider

Private dentists aren't tied to set fees, so how much you pay depends on the dentist and how much staff and premises cost in their area.

Charges range from £25 to £60 for a check-up and £35 to £100 for extractions and mercury fillings, while a crown could cost between £250 and £400, and a bridge £650 to £800.

Exercise your right to shop around, by popping into a few local practices and asking to see their charges.

Now rinse, please

Having seen those costs, you might want to give finding an NHS dentist another try. The British Dental Association lets you search for dentists in your postcode zone at www.bda-findadentist.org.uk.

Although don't build up your hopes, because when I tried searching for an NHS dentist on a south-east London postcode, I was given 14 recommendations, of which only three were in the capital (none close to me), and the rest were dotted around Tunbridge Wells, Brighton, Derby and Coventry. But I turned up scores of private dentists.

Dental plans

If you're worried about dental costs, you might consider taking out one of the two main types of dental insurance.

A growing number of companies offer dental cash plans, including specialists HSA and Westfield, and high street favourites Boots and Tesco.

You typically pay a flat monthly fee regardless of your age and the state of your teeth, and get between 50% and 100% of your ongoing dental costs reimbursed, up to annual limits. Remember to keep your receipts.

Plans covering 100% of any NHS treatment typically cost around £9 a month (this doesn't cover kids who are still treated free on the NHS) rising to between £15 and £20 for private treatment. I think this makes the private plans much more attractive.

Working out which is best value is tricky, because they all have different limits and levels of cover. But HSA Dental Core boasts a good range of cash benefits for just £7.70 a month.

So are they worth it?

Dental cash plans can anaesthetise you against some of the financial pain of going to the dentist, and unlike other forms of insurance, you will definitely claim - and regularly.

If your teeth are in a particularly bad way then you might get more than your money back. But they won't save most people money, merely spread the cost and protect against the shock of an expensive bill.

You might claim more frequently on a healthcare cash plan, which applies the same principle to a wider range of health costs including glasses and contact lenses, physiotherapy, maternity and hospital stay, as well as dentistry.

HSA is the most popular cash plan provider, covering around three million people, and can be good value for families.

Capitation plans

Dental plans, sold by private dentists, also charge a fixed monthly premium, and this time it does depend on the state of your teeth.

Your dentist first examines your pearly whites to clear up existing problems (and bills you in the normal way), then calculates how much treatment you will need in future. Your premium will depend on the state of your teeth - expect to pay between £15 and £30 a month.

Again, you can choose between cheaper plans covering routine costs such as check-ups, x-rays, scaling and polishing, and more expensive plans covering major treatments such as crowns, fillings and dentures.

Again, a capitation plan spreads the cost of treatment, but won't actually save you money. If you have bad teeth, you merely pay more. But it does give you a financial incentive to see your dentist regularly, which means you could end up with much better oral health.

More means more

Most people will still recoil at the thought of paying £20 a month just to protect their teeth. For a little extra, you could get much better value from a low-cost private medical insurance plan that includes dental cover.

Innovative health insurer National Deposit (www.nationaldeposit.co.uk) offers comprehensive health cover for a fixed monthly cost (£50 a month if you're over 50).

Half your monthly premium goes to pay for any medical treatment and the remainder sits in a savings account in your name. If you claim, the insurance pot will cover a percentage of your medical costs (up to a maximum £50,000), with the remainder coming from your savings account. If you don't claim, you keep the money in the savings account.

Crucially, as far as this article is concerned, it also includes dental cover for bridges, crowns, fillings and dentures, up to £750 every year. The premium is higher, but you're getting full private medical cover as well.  

More: How private medical insurance worked for me | Protect your health for £2.25 a week