The State of Dental Health Across the UK
The latest official statistics from England's Adult Oral Health Survey paint a sobering picture. Four in ten adults with natural teeth showed obvious tooth decay when examined, a level not seen since the late 1990s. Nearly two thirds had some sign of decay under a broader measure. And while fewer people than ever are losing all their teeth, more of us are living with worn, cracked or heavily filled teeth that eventually need more than a simple filling to survive.
Access is the other side of the problem. Only around half of adults now visit the dentist for a routine check-up, and a large share of those who do not say it is because they simply cannot find an NHS dentist. In some regions, particularly rural parts of Somerset, Devon and Cumbria, patients report travelling long distances or being forced to join long waiting lists. The result is that many people wait until pain forces them into the surgery, by which point the restoration needed is more complex and more expensive than it would have been a year earlier.
Understanding Your Restoration Options
Crowns
A crown is a full cover that fits over a tooth that has lost too much structure for a filling to hold. It is the standard solution after root canal treatment, for heavily decayed back teeth, and for teeth cracked or weakened by grinding. Research cited in dental literature shows crowned root-filled teeth survive far better than those restored with fillings alone, with survival rates around 94% at five years compared to 63% for direct restorations.
On the NHS in England, a crown falls under the Band 3 charge of £332.10 from April 2026, which covers the whole course of treatment including any check-up, X-rays and other work needed alongside it. Scotland takes a different approach, with residents paying 80% of the cost capped at a set limit, while Wales caps a course of treatment. Privately, costs depend heavily on material and location. A porcelain-fused-to-metal crown typically costs £500 to £900, all-ceramic runs £700 to £1,200, and zirconia can reach £800 to £1,500. London practices tend to charge 30% to 50% more.
Bridges
A bridge replaces a missing tooth by anchoring a false tooth to crowns fitted on the neighbouring teeth. A three-unit bridge, which covers one missing tooth with two supporting teeth, is a single Band 3 charge of £332.10 on the NHS. Privately, a basic bridge starts around £900 and can climb to £2,500 depending on materials and the number of units. A resin-retained or Maryland bridge, which uses a metal wing bonded to the back of adjacent teeth, is a less invasive option for front teeth and typically costs £500 to £1,200 privately.
Inlays and Onlays
These are the middle ground between a filling and a crown. An inlay fits inside the biting surface of a back tooth, while an onlay extends over one or more of the cusps. They are made in a laboratory and bonded onto the tooth, making them stronger and more durable than a direct filling for moderately damaged molars. On the NHS they sit in Band 3 at £332.10, the same as a crown. Privately, composite inlays run £300 to £600 per tooth, ceramic versions £400 to £800, and gold £500 to £1,000. Some practices now offer same-day milling with CEREC technology, which means no temporary filling and no second visit.
Implant-Supported Restorations
Implants are the only option that replaces the root as well as the crown. The NHS does not fund implants for standard cases, so almost all implant treatment in the UK is private. A single implant including the crown typically costs £2,000 to £3,200 outside London, rising to £3,500 to £5,500 in the Harley Street area. Full-arch and full-mouth reconstructions range from roughly £7,500 to £18,000 per arch depending on the region.
| Treatment | NHS Cost (England) | Typical Private Cost | Best For | Key Advantage | Main Drawback |
|---|
| Crown (PFM) | £332.10 Band 3 | £500–£900 | Heavily damaged or root-treated teeth | Strong, durable, NHS available | Less natural appearance than ceramic |
| Crown (all-ceramic) | £332.10 Band 3 (front teeth) | £700–£1,200 | Front teeth where looks matter | Excellent aesthetics | Higher cost privately |
| Crown (zirconia) | Not typically NHS | £800–£1,500 | Back teeth needing strength and looks | Extremely tough, metal-free | Premium price |
| Three-unit bridge | £332.10 Band 3 | £900–£2,500 | Single missing tooth | Fixed solution, no surgery | Requires grinding healthy adjacent teeth |
| Inlay/onlay (ceramic) | £332.10 Band 3 | £400–£800 | Moderate decay on molars | Preserves more natural tooth than a crown | Needs skilled lab work |
| Single implant + crown | Not funded | £2,000–£5,500 | Missing tooth with healthy bone | Replaces root, protects jawbone | Surgery, longer treatment time |
What to Consider Before You Choose
The NHS Route
If you can access an NHS dentist, the Band 3 charge is remarkable value, especially if you need multiple restorations in one course of treatment. A single fee covers any number of crowns, bridges and dentures planned together, which can save thousands compared to private care. One important detail: NHS crowns on back teeth are typically porcelain-fused-to-metal, and if you want a premium all-ceramic or zirconia upgrade for cosmetic reasons, you will usually pay a private supplement on top of the Band 3 charge. Always ask your dentist to write down exactly what material the NHS is providing and what an upgrade would cost before treatment begins.
There is also the 12-month guarantee. If an NHS crown or bridge needs repair or replacement within a year of being fitted, there is no additional charge. This applies to most NHS laboratory-made restorations.
The Private Route
Private treatment buys you choice, speed and often a wider range of materials. The trade-off is cost, and the variation between practices is significant. A crown that costs £700 in Leeds might be £1,100 in central London. It is always worth getting itemised quotes from two or three practices, and asking what is included: consultation, X-rays, temporary restorations, and any follow-up adjustments can all add to the headline price.
Sarah from Manchester, a 52-year-old teacher, needed two crowns and a bridge after years of putting off treatment. Her NHS practice had closed its list, so she went private and was quoted £4,200 at the first practice she visited. A second practice, recommended by a colleague, offered the same plan for £2,900. The difference came down to material choices and lab fees, not the quality of the dentistry. She chose zirconia crowns for the back teeth and a ceramic bridge for the front, and spread the cost through a payment plan offered by the practice.
Financing and Support
Few people budget for dental restoration, which is why most private practices now offer staged payment options. Some run interest-free plans over 6 to 12 months, and third-party finance such as Denplan and similar schemes is widely accepted. If you are on a low income, pregnant, or under 18, you may qualify for free NHS treatment entirely. It is also worth checking whether you qualify for help with health costs through the NHS Low Income Scheme, which can cover dental charges.
Practical Steps to Get Started
-
Find out your current status. If you have an NHS dentist, book a check-up today and ask about your treatment plan. If you do not, search your local health board or NHS 111 options for practices accepting new patients, and check again regularly as lists do open up.
-
Ask for a written treatment plan. Whether NHS or private, you should receive a clear plan listing every restoration, the material to be used, and the total cost. Get the answer in writing before any work begins.
-
Compare at least two private quotes. If you are going private, the difference between practices can be hundreds of pounds for identical work. Ask what the quote includes, and whether same-day CEREC options would save you a visit.
-
Ask about multiple restorations in one course. On the NHS, planning all your crowns and bridges within one course of treatment means a single Band 3 charge. This is the rule that saves patients the most money.
-
Check the guarantee and aftercare. NHS restorations carry a 12-month repair guarantee. Private practices vary, so confirm what happens if a crown or bridge fails within the first year.
-
Consider timing. Dental restoration is not urgent in most cases, so you have room to plan around work and holidays. Winter months are often quieter at private practices, which can mean more flexible appointments.
Making the Right Call for Your Smile
The landscape for dental restoration in the UK is changing. Decay is rising again, NHS access remains uneven, and private prices keep climbing in the south-east. But the fundamentals have not changed: a well-made crown or bridge, fitted by a dentist you trust, will serve you for a decade or more with proper care. The patients who get the best outcomes are not necessarily the ones who spend the most. They are the ones who ask questions, compare written quotes, understand what their NHS entitlement covers, and make a plan before pain forces the decision. Whatever your situation, start with a conversation and a written plan, and the rest becomes manageable.
研究の知恵