Six million bills of £100 or more have been handed to UK patients in the past five years, totalling more than £1.3bn, JPIMedia Investigations can reveal.
While annual dental fee increases of 5% have become the norm in England in recent years, last year the cost of many common treatments saw inflation-busting hikes across Wales, Scotland and Northern Ireland as well.
Dentists in England are saying they are seeing an increasing number of patients saying that they would rather wait for more teeth to fall out before paying for a denture or for more than one tooth to require a crown as part of the same course of treatment. They are also seeing increasing numbers fail to show up for treatment or even disappear halfway through a course of appointments because they don’t have enough money.
Dentist Pramod Subbaraman works at practices in Hull, Scunthorpe and Grimsby and said he has had NHS patients postpone treatment because of costs.
He said this happens particularly with work falling into the most expensive fee bracket, Band 3, currently £269.30 across England.
“I have seen an increasing number of patients defer certain Band 3 treatments saying that they would rather wait for more teeth to fall out before paying for a denture or for more than one tooth to require a crown as part of the same course of treatment,” the 42-year-old said.
President of the Oral Health Foundation, Dr Ben Atkins, said he has had “quite a few patients” fail to show up for treatment or even disappear halfway through a course of appointments.
He said: “We’ve had people just disappearing and that’s the problem. They will book in for a treatment and then not turn up because they don’t have the money for it.”
Dr Atkins said help was out there for patients who do not qualify for free treatment, but he suspected people did not know where to find this.
He said: “It is wholly unacceptable for dental charges to continue rising above the rate of inflation.
“Sustained price hikes are making dentistry less affordable for the population and there is a real danger that more people are not able to access the care they need.
“We are highly concerned that this will mean more people avoid regular dental check-ups, which could lead to any number of diseases and conditions being missed and undiagnosed.
“Gum disease, tooth decay and mouth cancer can all be treated and managed if caught quickly. The consequences of late diagnosis can be life-threatening.
“Young people, families on lower incomes, and the elderly are all at risk of being alienated. The Government must be working to encourage people towards NHS dentistry, not driving them away.”
While NHS dental treatment is free for children and people on low incomes across the UK, for those who have to pay the cost can be in the hundreds.
In England, patients have had to pay Band 3 bills – the most expensive – some 4.6m times since 2015/16, totalling £1.1bn.
In Scotland and Northern Ireland, fees are not placed into bands and patients instead pay for 80% of the cost of their treatment, up to a maximum of £384; 200,000 NI patients have spent £31m in the past five years.
Fees increased in Northern Ireland in June and an uplift for 2020/21 is currently being considered by the Department of Health in England.
The NI Department of Health said charging for treatments “balances the need to provide sufficient income to dentists against the cost to patients who make a contribution to their dental care”.
Explaining how fees are set in NI, it said decisions around dental charges here are informed by recommendations from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), an independent body which makes recommendations to the NHS across the UK.
Over 2,300 people turned up at NI’s overstretched A&E departments last year with toothache and other dental complaints.
The Department of Health (DoH) said this was appropriate in dental emergencies.
But research from NI’s Business Support Organisation found most of Co Fermanagh and some of Co Tyrone and Co Londonderry have less than 50% of adults registered with a dentist; and that registration rates are also generally lower for children in more deprived areas. The BDA says most practices in the west of NI are open to new patients, who often forget to stay registered.
The DoH confirmed that NI is the only part of the UK where patients are automatically deregistered after a time limit – two years. But it said that over the past decade, registrations “have risen markedly and are now at their highest ever levels”.
Over 77,000 people went to A&E departments across the UK last year with dental problems. Critics say the situation in England is due to rocketing fees and difficulty accessing appointments.
:: Low Income Scheme: If you have a low income but aren’t entitled to free dental care, you might get help with the costs under the Low Income Scheme. To read about applying to the scheme, go to: https://www.nidirect.gov.uk/publications/claim-help-health-and-travel-costs-form-hc1
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