Susannah Kirkman discusses the options of treatment outside the NHS. As the proportion of dentists offering treatment under the National Health Service dwindles, more independent schools are thinking of offering cut-price dental insurance to staff.
Since the Government cut dentists' fees by around 7 per cent, more than 650,000 patients have been deregistered and now have to pay private fees for their treatment. Meanwhile, the cost of NHS treatment has soared; everyone except children, pregnant women, nursing mothers and those on family credit must pay 80 per cent of the cost of treatment, up to a maximum of Pounds 275. BUPA, which already offers a 30 per cent group discount to independent school teachers on medical insurance, believes it will not be long before schools will want to provide discounted dental cover for staff, too. "It's an attractive idea because people are looking for ways of spreading the costs of dental treatment," a spokesman said.
Denplan, the country's most popular dental care programme, with more than 550,000 registered patients, reports an increase in enquiries from schools and colleges about its corporate membership scheme. "It's not just that people can't find an NHS dentist," said a spokeswoman for Denplan. "They're also unhappy with the quality of the treatment. In a lot of cases, NHS dentists are not able to provide the standards of care they would like to."
Under Denplan's scheme, for instance, white amalgam fillings are offered as a matter of course, and the accent is on preventive rather than remedial work. Denplan, BUPA Dental Cover and Norwich Union Healthcare all remunerate dentists through a capitation scheme, rather than paying them for each filling or extraction. According to Norwich Union, this encourages good preventive care. "It's in the dentists' own interests to avoid problems so that they don't have to carry out expensive remedial work later," a spokesman said.
One drawback is that dental plans generally restrict your choice of dentist, as you must find one who is on the list of the insurers you choose. And most dentists only offer one company's plan, which could limit your choice of provider if you want to stay with the same dentist.
What private cover offers: There are wide variations in the cost and provisions of dental cover. Under Norwich Union Healthcare, for example, monthly premiums for the lowest level of care could be as little as Pounds 6.90 in London and Pounds 5.55 in Scotland. But this would only include basics like examinations and scaling and polishing. Fillings, extractions and treatment for gum disease can only be covered at higher premiums of up to Pounds 12 a month. Dentures and bridgework are not included.
There is no need for a dental assessment before joining, but only patients who have already reached a reasonable level of dental fitness, at their own expense, will be accepted. Bupa Dental Cover does include bridges and dentures, excluding laboratory costs, as well as crowns and root fillings. The premium is based on the condition of the patient's teeth.
Cover for good, healthy teeth will be around Pounds 5, while very poor teeth will cost up to Pounds 18; the majority pay about Pounds 11 a month. If the member's teeth improve or worsen, the premiums may change. Removing restorative work from the cover will cut monthly payments. Under Denplan, the dental wing of Private Patients' Plan, members must pay the laboratory costs for crowns, bridges and dentures, usually around 35 per cent of the total. But the dentist's time is included for these procedures, as are root fillings and treatment for gum disease.
Premiums are calculated according to a patient's dental health; they vary from Pounds 6.33 to Pounds 20 a month, and are usually somewhere between Pounds 10 and Pounds 14.
Norwich Union Healthcare offers a 40 per cent discount for children. BUPA offers Pounds 5 off per person, per year, to two members from the same family. Three or more members from the same family receive Pounds 10 off per person per year.
Denplan gives a scaled discount for each additional family member. Two family members will receive a 5 per cent discount. Four or more members of the same family will each receive a 15 per cent discount.
Some dentists are continuing to treat children under the NHS, even if the parents themselves are now expected to pay private fees.