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New Patient information - nhs

From April 2026, NHS-funded care will continue to be available, but delivery will prioritise urgent care, stabilisation of dental disease, and preventive treatments in line with national changes.

Independent Charges

Notes

1. Independent pricing is designed to reflect care that you would expect to receive under the NHS where for lack of capacity NHS care is not available.

2. The Dental Therapists are qualified dentists in their own countries with extensive experience, but their scope of practice is limited in the UK. They are charged at the same rate as the Associate Dentists only to reflect their experience, not their scope of practice.
3. Treatments not included in the banding above include complex x-rays and treatment that might be considered specialist or cosmetic in nature. Such treatments will be priced separately, with examples under private treatments.

Hygiene treatments can be carried out by any clinician, though usually by the Hygienist or Dental Therapists.

Frequently asked questions

What’s Changing in April in the NHS?

A:The government are trying to target resources towards urgent care and patients with complex needs as well as encouraging a more preventive approach. They are doing this by weighting the payment structure within the current dental contract to encourage more patients with higher needs to be seen and encouraging Dental Skill Mix. Dental Skill Mix is utilising a range of clinical staff like Dental Therapists, Hygienists and Dental Nurses to provide dentalcare within their scope of practice, freeing dentists to do more complex work that only they are qualified to do (see paragraphs below for more detailed information). They anticipate that time for urgent and higher needs patients to be seen will be made by dentists extending recall intervals for regular patients. Since 2006 dentists have been expected to recall patients in line with NICE guidelines where instead of routine six monthly checkups a recall period of any three-month period between three months and 24 months should be chosen depending on the patient’s risk of disease. The government believe that if more people are seen less regularly there will be more space in dentists’ books to see higher needs patients. There is no additional funding for the proposed changes, only that more of the existing contract funds will be used on urgent and complex care.

 What are the Benefits of Dental Skill Mix?

• Flexibility and Efficiency: Skill mix allows dental professionals to take on additional roles, leading to more flexible and efficient use of resources within dental practices, increasing accessibility for patients. 
• Enhanced Teamwork: Working together as a team, dental professionals can provide a more comprehensive range of services, benefiting both patients and the dental team. 
• Direct Access: The introduction of direct access allows dental therapists to perform their full scope of practice without needing a dentist to do an initial examination, streamlining patient care. 
• Positive Patient Feedback: Evidence shows that patients have a positive experience when receiving care from dental nurses and hygienists.

All these factors lead to an effective use of resources and positive patient outcomes.

What’s changing in April at the practice here?

A: During COVID the practice struggled to maintain an NHS service with a low number of clinical staff. Recruitment for dentists proved extremely difficult, as has been the case nationally and in this region especially. I am very pleased to report that since then we have recruited two Dental Therapists and two relatively recently qualified Dentists. Along with the rest of the team, we are now able to utilise Dental Skill Mix to provide more care to more people.

In 2010 we were awarded a second NHS dental contract which doubled our capacity to see NHS patients at that time. Whilst the first contract we had was a permanent one the new contract had to be renewed annually after the first five years. This happened until 2025 when the commissioners decided to terminate it. Following negotiations the contract has been made permanent, retaining the capacity, but funded at a lower rate. We are pleased that the contract now safeguards the NHS care we have been delivering, although we will need to run the practice more cost effectively.

In light of this and our increased capacity to provide additional Dental healthcare we have decided to offer more treatment privately. We anticipate that the majority of NHS work will be absorbed by the Dental Therapists and the Associate Dentists and so the Hygienist and Principal Dentist will be offering services predominantly on a private basis from April. In order to make the offering relatively reasonably affordable we have tried to follow a similar pattern to the NHS banding charges, albeit at higher rates and have published them here.

We anticipate that further changes may occur during the year depending on what occurs within the NHS and how long current funding lasts. It could be that the Associate Dentists run out of funding towards the end of the year for example or the Principal Dentist may be able to do more NHS work if additional funding is made available and taken up by the practice.

The DentalSkill Mix we now have means that most children will be seen routinely by the Dental Therapists. Some adults can be seen routinely by Dental Therapists as long as their treatment needs fit within their scope of practice. Referrals can take place within the practice as well as to specialists outside the practice.

Whilst many patients with a history of attending the practice see this as their practice and in most cases, we consider you as our patients there is no such thing as registration under the NHS dental contract and any member of the population is equally entitled to NHS care at any one time. So, with more people trying to access the service than there is funding for, it makes it more difficult to retain the loyalty of a practice. In our experience it is better to remain at the same practice where the history is known and records kept. Records are only shared between practices on specific request and the same with the wider NHS. With this in mind many practices are offering private maintenance plans to patients for which patients are invited to pay relatively modest payments on a monthly basis. This covers a number of maintenance visits with the Dentist and Hygienist. We are looking at introducing a similar scheme possibly later in the year.

What is the scope of practice of different clinicians?

A: Dental Nurses can assist a dentist at the chairside and undertake cross-infection control procedures as well as conduct clerical duties like collecting medical histories. With additional training they can apply topical fluorides, provide oral hygiene advice, take impressions, take x-rays and remove sutures.

Dental Hygienists can do all of the above, scale and polish teeth and apply fissure sealants

Dental Therapists can do all of the above and extract or fill children’s teeth and fill adult teeth provided the fillings are simple.

Dentists can do all of the above along with treatment involving the nerve chamber of a tooth, extract adult teeth, supply dentures, crowns and bridges and other similar work.

All clinicians should operate within their level of skill and competency.

Why is there a shortage of Dentists?

A: Some areas of the country are amply serviced with dentists, mostly more affluent areas. Increasingly in recent years more areas are poorly serviced. This region is particularly poorly serviced. This is largely due to location and the absence of a training centre. For dentists to migrate here they need a good reason to do so.

The production of dentists nationally has not kept pace with need. More dentists work part time and have career breaks than they did. Interestingly the number of dentists registered have increased, but there are no proper statistics on what hours they work or in what spheres of dentistry.

The shortage is more profound in the NHS since the NHS dental contract has become increasingly unpopular as funding hasn’t kept pace with inflation and targets have been difficult to reach. This and the shortage of dentists to do the contract has meant that contracts have been handed back.

All in all, this has led to patients finding it difficult to see a dentist, more patients presenting with pain and swelling, problems escalating and becoming more difficult to treat.

In a survey done in 2023 on the dental health of adults they found that oral health had worsened from 2009 to the levels seen in the previous survey more than a decade before that.

So, what is happening to help?

A: There is currently a strong move to establish a Dental School at the UEA which is quite advanced awaiting funding approval from government and then recruitment of sufficient academic staff to run it.

There are a lot of dentists from overseas trying to get on the dentist’s register in the UK, but there are many hurdles for them to jump over, and it takes a long time for them to demonstrate they have reached the standard required. The government have introduced steps to try and speed things up a little.

The idea of DentalSkill Mix and allowing Dental Hygienists and Dental Therapists to see patients without seeing a dentist will undoubtedly have an impact over time, though most practices have not taken the concept on board yet and tend to use Dental Therapists purely as Dental Hygienists.

I have already mentioned the Changes NHS England are making in April in the hope that access will be improved for urgent care and patients with higher needs. Following years of very large sums of money being handed back to NHS England through failing to meet targets or contracts handed back, the amount clawed back last year was around 90% less than the previous year, meaning more of the money intended for dentistry got spent. This may be because of previous tweaks to the contract making it easier for dental practices to meet their targets. Without additional funds going into NHS dentistry though, it simply means that existing funds will be used up quicker. The British Dental Association continue to push for more money in the system and a complete revision of the existing contract.

What should I do as a patient?

A: Take note of any preventive advice you receive and act on it. The best dentistry is no dentistry. The next best dentistry is minimal dentistry. Extensive dentistry, besides being costly requires more monitoring, more maintaining and more work to put right.

The two major diseases in the mouth gum disease and tooth decay are fully preventable with a sensible diet and good oral hygiene.

See a Dentist/Dental Hygienist or Dental Therapist regularly to pick things up when they are small. Hoping problems will go away by themselves is almost always wishful thinking as dental problems get worse when left.

Be on good terms with your dentist. Keep appointments, cancel in good time, pay the charges and don’t wait for recall communications. If you think you haven’t been seen for a long time, phone the practice. The three main reasons patients are taken off the books at a dentist are because they habitually miss appointments or cancel at short notice or don’t pay their bills. Additionally, when demand is so high, as it is now, patients who haven’t been for a long time get behind in the queue. Patients are generally considered new if they haven’t been seen for two years unless that is their recall period.