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By Sarah Modlock
Dental treatment in Britain - and England in particular - is the most expensive in Europe. Getting a filling can cost up to 19 times more than in other EU countries, according to recent research by the Institute for Medical Technology Assessment at Erasmus University in the Netherlands. An English filling costs £117 on average, compared to £6 in Hungary, the cheapest European country. Italy and Spain have relatively high prices (£101 and £94, respectively) but the cost falls to £50 in Germany and £34 in France. The example used by the researchers was the price for filling in a molar for a 12-year-old girl. It included the cost of x-rays, materials, drugs, overheads and the dentist's time. Britain's decline towards 19th century oral health will affect much more than just our appearance. While the wealthy spend more than £360 million a year on cosmetic dentistry such as whitening and veneers, the majority are facing a whole range of problems. "Poor oral health can have a profound effect on general health and the quality of life," explains Dr Poul Erik Petersen, of the WHO Global Oral Health Program. "The experience of pain, endurance or dental abscesses, problems with eating, chewing and missing, discoloured or damaged teeth, has a major impact on people's daily lives and well being." Gum disease also increases the risk of mouth cancer, and pancreatic cancer in men. NHS decay It is now virtually impossible to find an NHS dentist, and if you do manage to shoehorn your way onto a list you could still be charged 80% of the cost of treatment, unless you are a child, pregnant or on benefits. A survey by the Citizens Advice Bureau found that 7.5 million Britons have failed to gain access to an NHS dentist in the past two years. In one quarter of the country, no NHS dentists are allowing new patients to join their lists. Last March the government admitted that two million patients who wanted NHS treatment were unable to get it. Many believe the government changes in April 2006 have made things much worse. Dentists are now paid a fixed fee in exchange for completing a certain number of units of NHS dental activity a year. More than 2,100 refused to sign the new contracts and opted out of the NHS. Our dentists are trained at a cost of £175,000 by the NHS, so they should be expected to work within the sector for a number of years. If you want to find an NHS dentist currently taking on patients, go to the NHS Choices website (www.nhs.uk) and carry out an online postcode search for your nearest practitioner. Dental tourism The growing nightmare of finding an NHS dentist and the cost of private care is driving nearly half a million Brits travel abroad for dental treatment each year. Among the countries benefiting from this boom because of their low-cost dental care are Hungary, Poland, Turkey, Croatia, Macedonia, Bulgaria and even Thailand. Savings on some treatments can be as high as 80%, although you need to factor-in the flights and accommodation. Dr Nigel Carter, the chief executive of the British Dental Foundation says they advise people not to go abroad for dental work. "If things go wrong, then it is certainly not a cheaper alternative," he warns. If this appeals to you then do plenty of research and look at one of the specialist tour operators. Ask about their vetting procedures and keep asking questions until you are happy that you won't come home in pain or without half your teeth. Newspapers and magazines are filling up with tales of patients returning home in constant pain and paying a small fortune for corrective work. Dental plans So what are the options if you want to spread the costs of dental care? Maintenance schemes are one of the cheapest options but they typically only cover a couple of check-ups, two hygienist visits and some x-rays. For this you can expect to pay around £10 to £14 a month. Dental accident insurance is usually included but these schemes are essentially a way of spreading payments over a year rather than having to pay at the time of your visit. Capitation schemes are not as scary as they sound and are run directly by about a third of dentists. Like maintenance plans, these schemes do not cover you for unexpected problems with your teeth but are a way of helping spread the cost of predetermined treatment, although a built-in insurance policy will cover you for very serious problems such as oral cancer. Before you are accepted for a capitation scheme the dentist will expect you to pay for an initial consultation and any treatment required to bring your dentistry up to a minimum level. Then the dentist assesses how much further work he thinks you will require in the next 12 months and arrives at a monthly payment to cover the cost. The average across the country is around £18 a month but you can expect to pay around £30 if you require a lot of dentistry. Dental cash plans to cover NHS, private care or a mixture of both are available from Boots, Tesco, Universal Provident; Dencover, HSA; and Western Provident Association. HSA's dental plans, for example, offer a choice of three premium levels on schemes, with prices starting at £7 a month per adult and £1 for children. For a monthly £12 fee, you can claim up to £50 for maintenance work, such as a check-up or scaling; £500 for treatment such as fillings and so on, and up to £750 for emergencies. Dental plans also emphasise the need for preventative care by encouraging regular check-ups - something which everyone could do with. With these schemes you should also be offered a discount for families of around 15% and if you take the policy out before you are 65, you can continue with it until you are 80. But it's very important is to check the wording and limitations, which may exclude pre-existing conditions and have a maximum payout per tooth. Most dental plans are likely to carry a three-month qualifying period for treatment and there may also be limits on the value of claims as well as the number of times a year you can claim. There will be a maximum that you can claim back per year, but most health plans are flexible with what kind of dental treatment is included, so you may be able to receive a contribution towards certain cosmetic treatments. Dental insurance will typically cover you just for treatment needed following an accident or emergency, and is usually sold as an add-on to an existing insurance policy. There are usually four different policy options covering general dental treatment, dental emergencies, dental injuries - for example, where teeth have been damaged by an external blow to the face - and serious dental problems such as oral cancer. Check for exclusions and definitions of things such as 'routine treatments'. Dental loans are offered by some dentists and are usually interest-free. These are usually provided through the same companies that offer cash plans and capitation schemes. Make sure you are dealing with an authorised lender. Useful links: |
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