Avoiding criticism over dental charges and exemptions

Confusion about dental charges and NHS exemption is a common cause for patient complaints, but there are ways to avoid the pitfalls.


Patients might complain about dental charges for a number of reasons.

  • Dentists might have failed to explain dental charges properly.
  • There has been confusion about a patient's exemption from NHS charges.

GDC guidance

The GDCs 'Standards for the dental team' says that dental professionals:

  • "must give patients clear information about costs", including a written and costed treatment plan and explanation of which treatments can be provided under the NHS and which privately
  • must provide patients with clear information about charges in their practice literature, and on their website
  • should tell patients if treatment is guaranteed, under what circumstances and for how long
  • should display a list of dental fees in their practices in an area where it can be "easily seen by patients".

DDU advice

In our experience, confusion or disagreement over dental fees can be a factor in the practice losing a valued patient and, in some cases, facing a GDC investigation.

To avoid problems, we advise reflecting on how you communicate charges and your practice's fee policy. Our recommendations include the following points.

Update your website and literature

  • Clearly set out services and charges in practice notices and on your website.
  • State whether you currently accept NHS patients and give details of payment arrangements, such as if patients are expected to pay for their treatment in advance or on completion.
  • Provide practice information in accessible formats when required.

Explain the treatment plan in full

  • Provide a written treatment plan that includes costs and whether the patient has chosen to have some elements of treatment on a private basis and the charge. Keep a copy with the patient's records.
  • Warn the patient in advance if you believe further treatment might be needed and advise them of possible extra costs.
  • Get the patient's consent if you need to revise your treatment plan. Give them an amended plan in writing and include a revised cost estimate.

Ask for proof of NHS exemption

  • Patients who claim exemption from NHS charges when they are not eligible could have to pay a penalty in addition to their treatment cost. If a practice has helped the patient apply for free treatment, the patient could blame them and make a complaint.
  • Make sure you understand the rules around patients' entitlement to free treatment or help with NHS charges and ask patients for proof of their exemption status.
  • Patients are responsible for completing any relevant forms and claiming for free treatment or assistance. It is important not to advise the patient about their entitlement, as this could raise their expectations and lead to a complaint if they're found not to be exempt.
  • The NHS advises that if patients aren't sure whether they are entitled to exemption, they should pay and ask for a receipt, as they may be able to claim a refund later.

Don't put pressure on the patient

  • Make sure you don't put pressure on patients to accept private treatment. For example, it is not acceptable to tell NHS patients that they can only have a particular treatment privately when that treatment is also available on the NHS.

Consider providing a 'cooling off' period before expensive or extensive procedures begin, so patients don't later feel they were rushed into a costly decision.

This page was correct at publication on 24/08/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.