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Patients, plans and complaints
An NHS dental course that moves up a band: what the practice may charge, the balance to collect and what to do if the patient stops
One charge per NHS dental course in England: the April 2026 band charges, the balance when a course moves up a band, and what if treatment stops.
A patient pays £27.90 at the front desk after an examination, and the dentist then finds a tooth that needs a crown. What does the practice ask for at the next visit? The answer is not a second charge. It is the difference, and the arithmetic is worth having on the desk before the patient asks.
What the regulations say
Regulation 4 of the National Health Service (Dental Charges) Regulations 2005 sets the three charges. On the page we read they are "£27.90" for Band 1, "£76.60" for Band 2 and "£332.10" for Band 3, and NHS.uk lists the same figures. Paragraph 6 says that "only one charge may be made for any one course of treatment or urgent course of treatment provided, notwithstanding that a number of individual treatments may be provided".
NHS.uk puts it in plainer words for patients: if you need a mix of treatments from the same band, you pay that band's charge once. It describes Band 2 as including fillings, extractions and gum management, and Band 3 as including crowns, dentures, bridges and orthodontics, with each band including everything below it.
So the charge for the course is the charge for the highest band whose components are in it. What the patient has already paid is a part payment towards that one charge, not a separate charge.
We did not find a sentence in the regulation that says "collect the balance". That is our reading of paragraph 6, and a practice that collects the full band charge at the first visit and a second charge later is not following it.
The balance for each move
| Paid at first visit | Course ends up in | Patient owes at the end |
|---|---|---|
| Band 1, £27.90 | Band 2 | £48.70 (76.60 - 27.90) |
| Band 2, £76.60 | Band 3 | £255.50 (332.10 - 76.60) |
| Band 1, £27.90 | Band 3 | £304.20 (332.10 - 27.90) |
The check is that the two steps add up to the long one: 48.70 + 255.50 = 304.20. A patient who pays £27.90 and ends in Band 3 has therefore paid in total £332.10, exactly the same as someone who was told on day one that they needed a crown. The balance is 10.9 times the first payment (304.20 / 27.90), which is why the patient needs to hear it before the second appointment, not at the desk.
Say it at the treatment plan
NHS.uk says a patient should get a written treatment plan for Band 2 and Band 3 work. The plan is the place to say that the figure is the charge for the whole course and that anything paid so far counts towards it. Our guide to how long NHS dental treatment is guaranteed covers the two-month and 12-month timings that patients mix up with this one, and the patient complaint checklist is where a disputed balance will end up if the plan was silent.
If the patient stops part-way
Paragraph 7 says that where a course is discontinued the charge is the one payable "for the components of the course of treatment which have been completed but not for any components which are incomplete". In practice, a patient who has paid Band 1 and then decides against the crown after the dentist has done a filling is in Band 2, not Band 3. One who has had the crown prepared but not fitted has an incomplete component, so the Band 3 charge is not yet due on that item. We have not seen guidance on how to treat a half-finished crown, and the practice should ask NHS England or the NHSBSA about it before charging.
What we could not confirm
- Whether any NHS body requires the balance to be taken in a particular way (card, receipt wording, timing). We found none.
- Refund rules where a patient has overpaid. We did not locate them.
- The exemption rules, which sit elsewhere and which we did not read for this guide. Check the evidence in the usual way before taking any payment.
- Wales, Scotland and Northern Ireland, which have different charges. The figures here are England only.
A script for the front desk
- At the examination, say the charge is for the whole course and that it may rise if the plan changes.
- Write the amount paid on the treatment plan and on the receipt.
- When the plan changes band, send the revised plan with the new total and the balance, using the table above.
- At the final visit, take the balance and note the date the course was completed.
Overlyft can set up an AI assistant that checks each treatment plan against the amount already paid, works out the balance and drafts the revised plan for the dentist to approve before it goes to the patient.
This is general information, not legal or financial advice.
Where this comes from: The National Health Service (Dental Charges) Regulations 2005 (SI 2005/3477), regulation 4, as revised on legislation.gov.uk (charges of £27.90, £76.60 and £332.10; paragraph 6, one charge per course of treatment; paragraph 7, discontinued courses); NHS.uk, "How much will I pay for NHS dental treatment?" (page last reviewed 13 March 2025, which lists the same charges); NHSBSA knowledge base article KA-02003 (England charges from 1 April 2026). All read on 6 October 2026. We could not confirm from the primary source any wording on collecting a balance, on refunds, or on a two-month rule inside the regulations; the page we read for regulation 4 contains no such sentence. Not legal advice.
AEO Lookup editorial team
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