Why getting a tooth fixed has become harder
The access problem is real and it is uneven. By early 2025, around 14 million people across the UK could not get NHS dental care, a figure repeated in a June 2026 parliamentary debate on access in West Sussex, where 63% of adults had not seen a dentist in the previous two years. Search the NHS find-a-dentist tool in parts of Chichester and you can get zero practices taking new adult patients within 12 miles. Try a London postcode and you might see ten. Same country, wildly different starting points.
When NHS lists close, the private quote becomes the only quote. A 2026 Which? investigation that screened nearly 5,850 people found 17% had experienced a problem with private dentistry in the previous two years. Among those, 22% paid more than quoted, 10% said a clinical mistake had been made, and 39% described the costs as excessive. One man quoted £3,400 for a root canal after a football injury ended up paying more than £10,000 as unsuccessful treatments repeated.
Anxiety removes another chunk of patients. Around one in nine UK adults scores high on standard dental anxiety measures, and delay usually raises the bill, not lowers it. Roughly 7% of adults have tried some form of DIY dentistry, including self-extractions and filling kits bought online. That route rarely ends well.
What each treatment typically costs
Prices below come from a 2026 review of published private price lists across hundreds of UK practices. The middle figure is the typical charge; the range shows what most practices ask. Central London, especially around Harley Street, sits at the top of every range.
| Treatment | Typical private price | What it usually covers | Good fit for | Watch out for |
|---|
| Check-up | £79 (£58–£99) | Examination, sometimes X-rays | Every starting point | X-rays often billed separately |
| Scale and polish | £89 (£75–£115) | Hygienist appointment | Gum maintenance | Airflow and deep cleaning cost more |
| Filling | £150 (£110–£200) | White composite filling | Small to medium decay | Silver amalgam sometimes cheaper |
| Root canal | £550 (£380–£725) | Pulp treatment, usually excludes crown | Infected or dying pulp | Molars cost more; redo work costs far more |
| Crown | £700 (£495–£895) | Lab-made crown and fitting | Cracked, heavily worn teeth | A bite check is not always included |
| Extraction | £195 (£150–£255) | Simple removal | Unsalvageable teeth | Surgical or wisdom teeth cost more |
| Bridge, per unit | £800 (£600–£950) | Fixed replacement anchored to neighbours | One or two missing teeth | Needs healthy supporting teeth |
| Denture | £715 (£550–£900) | Full or partial set | Several missing teeth, tight budget | Reviewed and replaced periodically |
| Composite bonding, per tooth | £250 (£200–£300) | Resin added and shaped | Chips, small gaps, minor alignment | Stains, chips, needs refreshing |
| Porcelain veneer, per tooth | £782 (£650–£969) | Custom ceramic layer | Discoloured or uneven front teeth | Irreversible enamel removal |
| Whitening | £395 (£350–£477) | In-clinic or custom trays | Healthy but dull teeth | No effect on crowns or fillings |
| Implant with crown | £2,770 (£2,500–£2,998) | Implant, abutment, restoration | Single missing tooth, good bone | Bone graft (£400–£750) and scans often extra |
| All-on-4, per jaw | £14,500 (£12,000–£16,000) | Four implants supporting a full arch | Most or all teeth gone | Maintenance and repairs add up over years |
| Aligner course | £2,848 (£2,000–£3,500) | Full treatment, retainers sometimes extra | Crowding, gaps, bite issues | Retainers are the part people forget to budget for |
Treat these as anchors, not quotes. Two practices can list the same crown at £495 and £895 because one bundles the lab fee, the X-ray and a review appointment and the other does not.
The NHS side of the ledger
NHS charges in England are set nationally and updated each April: Band 1 is £27.90 for an examination, diagnosis, X-rays where needed and a scale if clinically necessary. Band 2 is £76.60 and adds fillings, root canal work and extractions. Band 3 is £332.10 and covers crowns, bridges and dentures. You pay once per course of treatment rather than per appointment, which is the best value in the whole system. Scotland, Wales and Northern Ireland run separate arrangements, so check locally before assuming.
What Band 3 does not buy is implants. NHS implant funding is largely restricted to exceptional clinical need, such as reconstruction after head and neck cancer surgery, major facial trauma or congenital conditions affecting oral function. Ordinary tooth loss from decay, gum disease or age does not qualify, whatever your income. The NHS alternative is a denture or a bridge, and that is a genuinely different treatment rather than a cheaper version of the same one. A denture rests on the gum and does nothing to slow the bone loss that follows extraction; an implant replaces the root and keeps the jaw stimulated.
Matching the fix to the actual problem
For a cracked or heavily worn tooth, the choice sits between bonding at £200–£300 and a crown at £495–£895. Bonding suits small chips on back teeth with light bite forces. A crown is the safer call when a root canal has left the tooth brittle. Ask whether the quote includes the laboratory fee and a temporary crown, because both appear as surprise extras more often than anyone would like.
One case reported by Which? is worth remembering: a man had a routine crown replaced, ended up in pain with exposed tooth roots, was moved between practices inside the same corporate group, and finished with a bill above £2,000. If a molar crown is being fitted, ask who makes it and whether your bite will be checked at a separate visit.
For a missing tooth, the spread is huge. A denture runs £550–£900, a bridge £600–£950 per unit, and an implant with its crown generally £2,500–£2,998. Implant costs are driven by the brand of fixture, whether a bone graft is needed, the 3D scan, surgical time and three to nine months of appointments. When a clinic advertises All-on-4 at £12,000 per jaw, ask how many implants that includes and what ten years of maintenance will add.
A case from Cheshire shows the pattern to resist. A mother of four found her practice had stopped taking NHS patients, paid £90 for an emergency repair she was not convinced had worked, then faced repeated pressure to have several teeth removed at roughly £120 each. Pressure is not a treatment plan.
For gaps and crooked front teeth, composite veneers at £296–£432 per tooth, porcelain at £650–£969, and a full aligner course at £2,000–£3,500 sit in different categories. Aligners move teeth. Veneers and bonding only change the surface. If your bite is off, cosmetic work layered on top tends to fail early, so straighten first if the budget only stretches to one thing.
Gum problems come before everything else. Deep cleaning and periodontal treatment are usually quoted separately, and no crown, bridge or implant survives long on unstable gums.
Getting a fair price without an argument
Ask for a written plan with every item priced separately, then compare inclusions rather than headline numbers. Check the dentist's registration with the General Dental Council; it takes two minutes and shows qualifications and any conditions on their practice. Get a second opinion on anything above roughly £1,000, particularly implants and full-mouth plans. Ask, in writing, who redoes the work if it fails and at what cost. If a monthly payment plan is offered in the chair, take the paperwork home and compare the total payable over the term, not the monthly figure, and check whether it covers treatment or maintenance only.
If private work goes wrong, the Dental Complaints Service deals with private patient complaints. Keep records and receipts. Student clinics at dental schools in London, Manchester, Birmingham, Leeds, Cardiff and Dundee treat patients under supervision at reduced cost; appointments run longer and waiting lists exist, which makes them a reasonable option for planned restorative work. For pain with no dentist, NHS 111 can point you to an urgent dental centre. Community dental services run by hospital trusts support adults with severe anxiety or complex medical needs, including sedation where clinically appropriate.
Before you book, photograph the tooth and note when it hurts, whether that is cold, heat or biting. Book an examination only, with no treatment on the first visit. Put your two quotes side by side and mark what is missing from each. Decide what needs fixing now and what can wait six months. Set a ceiling before you sit in the chair, and say it out loud.
A quote is an opening offer, not a diagnosis. The examination is where the real information sits, and it is the cheapest line on any treatment plan you will ever see.
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