​Dentists call for charges shake up

5 April 2017

a-tax-on-teeth-cover.jpgChildren and vulnerable patients risk losing out on access to free NHS dental treatment because of poor promotion and signposting of charge exemptions says the British Dental Association (BDA), as polling shows that just 74% of parents are aware that routine check-ups are free for children aged under 18.

Following the latest 5% rise in NHS dental charges in England (from 1 April) dentist leaders have called on government to end the 'confusion by design' that's helping keep young and vulnerable patients away from their right to free NHS dentistry.

  • A poll of 910 GB parents of children aged under 18 years old by YouGov found just 74% of parents thought routine dental check-ups are free for children under 18. Only 69% thought fillings are free for under 18s. Only 54% thought the same for orthodontic work (i.e. braces).
  • Younger parents demonstrated less awareness on free check-ups for their children, with awareness at 67% among parents aged 25-34, and falling to 62% among parents aged 18-24.
  • 42% of parents have delayed a routine dental check-up for themselves because of dental treatment costs – Nearly 1 in 10 parents (8%) admit to doing the same for one or more of their children aged under 18– even though no charges apply. Tooth decay is the number one reason for hospital admissions among children.
  • Freedom of Information requests from the NHS Business Services Authority now show that 117,882 fines have been issued for misclaiming free dentistry since May 2014. However nearly 9/10 (86.7%) of all appeals against penalties are now being won.  

Dentists accuse government of failing to promote free access, and of using heavy handed tactics through the £100 penalty fines levied on those 'inappropriately' claiming access. Official figures show that nearly 9 out of 10 appeals against these penalties are now being won. The BDA has said these fines are hitting a wide range of groups including those with dementia, Special Educational Needs (SEN) and their carers who are often unable to complete the required paperwork accurately.

In a new report launching to mark the latest increase in NHS charges the BDA has said government must reassess their approach to minimise barriers to care and end the inflation-busting increases that are now plugging holes in the budget left by declining state investment. The BDA estimate charges will overtake direct funding as the principle source of revenue for the service in England within a generation.

Henrik Overgaard-Nielsen, the BDA's Chair of General Dental Practice said:

"NHS charges exist to discourage patients from seeking dental treatment, and now appear to be delivering results even among those who don't need to pay. 

"Nearly 5 million children are failing to attend at an NHS dentist each year and extractions are surging. The fact so many parents are simply unaware these check-ups are free of charge shows just how little energy the government is putting into prevention.

"We have vulnerable patients who either cannot navigate the bureaucracy or are simply never made aware of their entitlements. What looks like confusion by design is leaving parents in the dark and dementia patients on the receiving end of £100 fines. Britain faces deep seated dental health inequalities, yet Ministers' top priorities are keeping demand down and the revenue rolling in.

"These charge hikes don't put a penny of extra investment into the service and reform is required so no one in real need has to think twice about seeking our care."

Polling: Summary

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 910 parents of children aged under 18 years old. Fieldwork was undertaken 29 - 31 March 2017. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Parents were asked which, if any, of the following NHS dental treatments do you think are available for free for children aged under 18

Bridges - 29%

Crowns - 32%

Fillings - 69%

Root canal treatment - 40%

Scale and polish (i.e. provided by a hygienist) - 46%

Braces - 54%

Tooth removal/ extractions - 66%

Routine dental check-up - 74%

Fluoride varnish/ fissure sealant application - 40%

Parents were asked have you EVER delayed a routine NHS dental check-up for yourself or any of your children aged under 18 because of the dental treatment costs

For myself:   

Yes - 42%

No - 54%

For one or more of my children aged under 18:

Yes - 8%

No - 88%

Freedom of Information Request:  The NHS Business Services Authority (BSA)

For the period April 2014 to March 2017 117,882 total penalty charges were issued.

For the period May 2014 to July 2016 30,225 appeals against penalty charges were made, 26,216 appeals were successful, with an appeal success rate of 86.7%.

Oral health and the economics of charges