Crisis in NHS dentistry pushes patients toward private plans, experts say

Britons are increasingly unable to access NHS dentistry as providers withdraw from NHS-funded work amid a long-running contract dispute, leaving millions without an NHS dentist and prompting a shift toward private options. Healthwatch England reports that a lack of NHS dentists has driven some patients to pull out their own teeth, travel hundreds of miles to find a practitioner, or call NHS 111 in desperation. The problem is not simply access—it is cost, with many people unsure how to afford private care when government subsidies for NHS treatment are bundled into a subsidised price rather than free care. Health leaders describe the crisis as translating into a two-tier system, where private care fills gaps left by the NHS.

The financial math is stark. In England, a yearly NHS check-up that includes scale and polish (if needed) and X‑rays costs about £27.40 for Health Service patients. Private care, by contrast, commonly charges £40 to £75 for a check-up, with scale and polish typically costing £90 to £130 and each X‑ray around £10 to £20. Taken together, a full private visit could run £225 or more for a single episode. Against that backdrop, some patients turn to monthly payment plans offered by private schemes. These plans have grown in popularity and can be found with providers such as Denplan and Bupa Smiles, along with smaller firms like Optima Dental Care and DentalSavers.

Denplan’s cheapest monthly scheme costs around £13 per month, which equates to about £156 a year and covers one annual check-up plus a hygienist visit and any necessary X‑rays. The most expensive Denplan options run toward £30 a month, potentially delivering two check-ups and multiple hygienist appointments each year. Bupa Smiles mirrors this price range, with the cheapest plans generally similar to Denplan’s in monthly cost. Yet even the cheapest plans are typically more expensive than NHS care when viewed on an annual basis. Experts say the key question is whether a private plan truly reduces the cost of necessary care, or simply provides a more predictable monthly outlay.

“Usually you need to get a check-up once every 18 months,” says Dr Jaavad Mirza of Pear Tree Dental Centre in Nottingham. “So while an extra few visits for only a tenner more a month might sound like a good deal, it’s usually unnecessary. The only exception would be if you have a history of tooth problems, so you might require closer observation.” He also notes that some local practices run independent payment plans that can be cheaper than the big private schemes because they eliminate the middleman.

Avoiding unnecessary treatments is a central tenet of smart private-economy dental care. Most monthly plans do not cover invasive procedures, so patients must ensure the treatment is actually needed. The most common UK dental procedures are fillings, root canals and crowns, and the cost gap between NHS and private care can be substantial. NHS patients in England typically pay about £70 for a filling-type service, while private patients may face around £150 for a filling, £320 for a root canal and £600 or more for a crown. While monthly plans may offer some discount, they usually do not drastically cut the price of these major procedures. Some plans, such as Bupa Smiles, offer limited discounts (for example, around 10% on standard procedures for selected plans), but the savings are unlikely to be transformative for larger treatments.

In contrast, Denplan’s Care scheme offers a different model: its premium plans can cover restorative treatments like crowns and fillings, but the monthly cost depends on a patient’s dental history. A patient with no previous issues could pay as little as roughly £23 per month, while someone with prior treatments could pay £33 to £75 per month. Experts say the down side is that more routine, smaller procedures may still require out-of-pocket payments, and patients should seek evidence (such as X-rays and images) to confirm necessity before proceeding with recommended work.

Insurance is not a universal solution for most people. The consensus among dental experts is that regular check-ups and hygiene appointments largely prevent the need for expensive restorative work, making comprehensive dental insurance less cost-effective for many patients. “Dental issues very rarely happen out of nowhere,” notes Dr Adam Thorne, a London dentist. “If you see a dentist once a year and they don’t have any concerns, it’s unlikely you will need any restorative treatment.” For those who do sign up for private insurance, the typical monthly premium ranges from £15 to £50 and often excludes pre-existing conditions. Some insurers offer limited coverage for abroad emergencies; Denplan’s own insurance, for example, costs about £7.20 per year and focuses on emergencies abroad or far from a patient’s registered practice. Still, coverage varies widely and tends not to produce dramatic savings unless a patient expects frequent expensive procedures.

International travel for dental care also features in the public conversation, with some Britons seeking cosmetic or restorative work overseas to save money. Experts warn that overseas treatment carries risk. The General Dental Council has reported that a notable share of patients seek overseas care, with Turkey and Hungary among popular destinations due to price differentials. A ceramic crown, for instance, may cost about £1,000 in the UK but around £170 in Turkey. Still, for complex procedures like wisdom tooth removal or dental implants, traveling abroad is generally discouraged. Dentists warn that complications after overseas treatment may require UK-based follow-up care, and language or certification issues can complicate post-procedure management. Check that the dentist has proper English-language ability and accreditation, and consider obtaining a second opinion in the UK before proceeding with major work when planning a trip abroad.

The private-healthcare shift is also playing out in real-world scenarios. Martin Stanford, a 77-year-old former law worker from the Wirral, found his NHS dentist had stopped offering NHS services. He transitioned to private care with Wallasey Village Dental Practice and joined a monthly plan that costs about £32 and covers two check-ups, X‑rays if needed, four hygienist visits per year, and discounts on urgent treatments. “I see my dentist and hygienist much more regularly than I used to,” he says, adding that the extra monitoring helps catch issues early and steer treatment decisions before problems escalate.

Health officials emphasize that the current state of NHS dentistry is a long-term challenge. The shortage of NHS-affiliated dentists has persisted for years, fueled in part by disputes over contract terms and funding. While the private market offers alternatives, the cost and scope of coverage vary widely, and many patients remain uncertain about which path offers the best value for their needs. For now, experts advise a careful assessment of any recommended procedures, an evaluation of payment options with local practices, and prudent consideration of whether private plans truly lower out-of-pocket costs relative to NHS services. They also urge patients to seek a second opinion when uncertain about the necessity of requested work, and to be mindful of the implications of traveling abroad for dental care.

Healthcare observers say the crisis will likely endure for the foreseeable future, underscoring the importance of clear information for patients trying to navigate dental care in the UK. While some Britons will benefit from private plans or insurance, others may remain on waiting lists or in locations far from NHS services. What remains clear is that the choice between NHS care and private provision involves a balance of access, cost, and the perceived value of preventive care—and in many cases, a patient’s decision will hinge on local availability as well as personal financial circumstances.