Money: All mouth and no insurance

Make sure the premiums are worth it before you bite the bullet and buy dental cover, writes Amanda Jarvis

Three quarters of the dentists in Britain no longer accept new NHS patients. If you are looking for a dentist, you may have no option but private treatment.

NHS fees are set by the government and are standard throughout the country. Most patients have to pay 80 per cent of the cost of treatment up to a maximum of pounds 340. Dentists are paid a fee for the NHS treatments they carry out, but many have opted out in favour of more lucrative private work.

Private dental bills can run to thousands of pounds. You can take out insurance or you can take out a dental plan thatspreads the cost of treatment; this may seem appealing but may not be cost-effective.

Each adult patient spends an average of pounds 33.78 a year on NHS dental treatment, according to the British Dental Association (BDA). Charges for private treatment are higher - average hourly rates for consultations are between pounds 96 and pounds 120 - but if you look after your teeth and visit your dentist only once or twice a year, you will probably end up paying far more for insurance.

There are three types of insurance you can consider. Capitation plans are the most popular and aim to spread the cost of treatment. You register with a dentist who belongs to a scheme and pay an agreed monthly premium, depending on how much treatment the dentist thinks you are likely to need, between pounds 5 to pounds 25 a month. The dentist makes an assessment of how much you should pay, based on the state of your teeth and the level of cover you want.

Capitation schemes only cover you for a range of routine treatments such as check-ups, fillings, X-rays and preventive care. If you need work that is not covered under the scheme, premiums will increase or you will have to pay for treatment at the dentist's standard rate.

Some insurers allow you to opt for different levels of cover. Densure, for example, has a basic plan, costing pounds 7.85 a month, which covers only routine work. Its comprehensive plan, at pounds 17.85 a month, includes root canal fillings, crowns, bridgework repairs and some surgical treatment.

Some capitation schemes include an element of insurance. Denplan, for example, will pay out pounds 600 a claim for emergency treatments worldwide from any dentist and up to pounds 10,000 per claim for treatment resulting from a motor accident or sports accident.

Ordinary dental insurance schemes work like any other type of scheme where you pay a premium and claim on your policy if you need treatment. You can choose any dentist. But any dental problems that existed before you joined the scheme will not be covered.

Boots offers two levels of insurance. Level one covers 100 per cent of NHS charges and level two will pay out 75 per cent of private charges.

You can also buy cover as part of private medical insurance.

A much cheaper alternative is a cash plan. These schemes reimburse some of the costs of medical and dental treatment. You pay regular monthly premiums and if you need treatment, the insurance pays out a proportion of dental bills (both private and NHS) up to an upper limit.

The disadvantages of taking out dental insurance are the same as with any type of insurance - you pay premiums each month for treatment that you many never need.

But if you only visit your dentist once or twice a year, it works out cheaper to pay for treatment as you go. And if you are faced with a large bill, your dentist may allow instalments.

n Contacts: Boots, 0845 840 1111; Bupa, 0800 230230; Cigna, 0800 056 0544; Complete Direct Care, 0181-848 1028; Densure, 01255 746868; HSA, 01264 353211; MIA Clinident, 01438 746868; PPP Denplan, 01962 828000; WPA, 01823 623380.

DENTAL PLANS

Capitation schemes

Joining Insurance Cost per

fee included month

Bupa pounds 15 yes pounds 8 to pounds 18 average

Cigna - no pounds 9.28 to pounds 15.47 av

Densure pounds 15 no pounds 7.85 to pounds 17.85

MIA Clinident - pounds 26.40 pounds 5 min, pounds 12 average

PPP Denplan - yes pounds 7.30 to pounds 18.40

Insurance schemes

Boots Level 1 - - pounds 7

Boots Level 2 - - pounds 15

WPA - - pounds 1.80 to pounds 8.53

The patient doesn't bite

LIKE many people, Malcolm Dunn, 37, is registered with a dentist who no longer accepts new NHS work. But he decided it was easier to stay with the practice than to look around for another dentist.

"I used to visit the dentist every six months and the hygienist every quarter, but this year I've had lots of problems which have cost me a fortune, so I considered taking out dental insurance."

Mr Dunn, advertisement director for a large London publishing firm, has spent pounds 406 on his teeth this year. He had an abscess, which cost pounds 60, he broke a tooth and had to have it crowned which cost pounds 226 and because he grinds his teeth at night, he has had to have a plate made up to wear at night to prevent this, costing pounds 120.

Mr Dunn decided against insurance after speaking to the dentist: "He explained that my teeth are in fairly good state at the moment and the recent problems were just bad luck. The practice does not belong to a capitation scheme and the dentist pointed out that even if I had belonged to a scheme, the work that I had done would not have been covered."

Mr Dunn has decided to carry on without a dental plan, and pay for treatment when it's needed from savings.