Do You Have to Pay Twice? The NHS 12-Month Dental Guarantee Explained (2026 UK Guide)

Last updated: August 2026. Sources: NHSBSA, NHS.uk, legislation.gov.uk, the General Dental Council, NHS Inform Scotland, the Welsh Government and Northern Ireland's Business Services Organisation. NHS dental charges for England are correct as of 1 April 2026, and all sources were verified on 3 August 2026.

TL;DR If an NHS filling, root filling, inlay, onlay, porcelain veneer or crown fails within 12 months, the same practice must repair or replace it free of charge. Four exceptions apply. Dentures and bridges are not on that list, though repairs to them are always free. Private treatment is covered by consumer law instead.

A crown comes loose four months after it was fitted. A filling drops out over the weekend. You paid £332.10 for that crown, and now the practice is quoting you for a new course of treatment. Do you really have to pay again?

Usually not. There is a statutory guarantee written into English NHS dental charging law, and it is one of the least publicised patient rights in dentistry. The NHS.uk page on dental costs does not mention it at all. This guide sets out exactly what is covered, for how long, and what to do when a practice asks you to pay anyway.

The short answer: when you do not pay twice

English NHS dental charges are governed by the National Health Service (Dental Charges) Regulations 2005. Regulation 6 is the provision that matters here, and its wording is unusually plain [2]:

"Subject to paragraphs (2) and (3), where a provider of relevant primary dental services has provided a restoration to a patient as part of a course of treatment or an urgent course of treatment for which the relevant charge calculated in accordance with regulation 4 has been made, or would have been made if the patient was not exempt from being charged, and within the relevant period that restoration has to be repaired or replaced to secure oral health, no charge may be made or recovered for the repair or replacement of the restoration."

-- National Health Service (Dental Charges) Regulations 2005, regulation 6(1) [2]

"The relevant period" is defined in the very next breath as "the 12 month period beginning on the date on which the restoration was provided and ceasing 12 months after that date" [2].

Note the phrasing: no charge may be made or recovered. This is a full exemption, not a discount, and not a fee recalculated at a different rate.

Which treatments are guaranteed for 12 months

The NHS Business Services Authority, which administers dental charging, publishes the list of what it calls "guaranteed items" [1].

Band charges shown are the England rates that took effect on 1 April 2026: Band 1 £27.90, Band 2 £76.60, Band 3 £332.10, with urgent care charged at the Band 1 rate of £27.90 [5]. For the full breakdown of what falls into each band, see our complete guide to NHS dental charges.

Two conditions attach to the guarantee. It must be the same treatment, and it must be the same practice:

"Guaranteed items can only be replaced with the same treatment and must be replaced at the practice where the initial treatment took place."

-- NHSBSA, guidance on guaranteed items of NHS dental treatment [1]

The four exceptions that cancel the guarantee

Regulation 6(2) removes the guarantee in four situations, and NHSBSA restates them in patient-facing language [1][2]. The guarantee does not apply where:

1. Private treatment has been carried out on the same tooth since the original restoration was placed. Mixing a private procedure into a tooth that carries an NHS restoration breaks the chain.
2. The restoration was intended to be temporary, and you were told so at the time. The regulation requires that this was "recorded on the patient record", so it is not enough for the practice to assert it after the event.
3. You were advised that a different type of restoration was more appropriate but chose the one you were given anyway. Again, the advice has to have been recorded at the time.
4. The repair or replacement is needed because of trauma. A crown knocked out in a fall is not a failed crown.

The recording requirement in exceptions 2 and 3 is the practical protection for patients. If a practice tells you a filling was "always meant to be temporary" but nothing in your notes says so, ask to see the entry.

The 2-month rule is a different thing entirely

Patients and reception staff routinely confuse the 12-month guarantee with a separate rule that lives in the same regulation. They do different jobs.

"If you have to go back to your dental practice within 2 calendar months of completing a course of treatment and need further treatment from the same charge band or lower, you do not have to pay."

-- NHSBSA, guidance on further treatment within two months [3]

NHS.uk carries the same rule in near-identical words [4]. Here is how the two compare.

There is now a third mechanism worth knowing about. An amendment in force from 23 June 2026 added regulation 6(4A), which means that where a Band 2 course of treatment completes and the same provider starts a complex care pathway within three months, no charge applies to that pathway [2].

What the guarantee does not cover, and the better rule that often applies instead

Dentures and bridges are conspicuously absent from the guaranteed-items list. NHSBSA's guidance does not mention them at all, so it would be wrong to say they are formally excluded, but equally you cannot claim the 12-month guarantee for them [1].

Here is the part most patients do not know. A repair to a denture or a bridge is free anyway, to everybody, permanently. NHSBSA classifies a short list of treatments as "charge exempt", meaning no band charge attaches to them at all [6]:

• Issue of a prescription
• Repair of a denture
• Repair of a bridge
• Removal of sutures
• Arrest of bleeding

On dentures specifically, NHSBSA is explicit that a repair is "free of charge to the patient irrespective of the charge paying status" and that "there is no time limit after the original denture was made for claiming a repair" [7]. So a cracked denture base or a snapped clasp costs nothing, whether it happened last week or nine years ago, and whether or not you normally pay for NHS dentistry.

A full replacement is a different matter. If a denture, obturator, bridge or orthodontic appliance has to be replaced because it was lost, stolen or broken through the patient's own act or omission, regulation 11 lets the practice charge 30 per cent of the Band 3 charge, which works out at £99.63 at 2026 rates. That replacement can only be done at the practice that originally made and fitted the appliance, and only prisoners are exempt from the charge. Normal wear and tear is not covered by this fault-based charge, and neither are laboratory-made bite guards and night guards [8].

If you are weighing up the cost of new dentures or a bridge from scratch, our guides to denture costs and dental bridge costs set out the NHS and private prices.

Does the guarantee follow you if you change practice?

No, on the published guidance. The guarantee is tied to the practice that did the work, because guaranteed items "must be replaced at the practice where the initial treatment took place" [1]. A new practice was never part of the original NHS claim and has no published route to honour another practice's guarantee.

Two situations are genuinely unresolved in public guidance, and it is worth being honest about that rather than guessing:

• If your original practice has closed or handed back its NHS contract, no NHSBSA guidance we could find addresses what happens to an in-force guarantee. There is no documented portability route. If you are in this position, ask NHSBSA and your new practice directly rather than assuming either answer.
• If the practice is still open but the NHS contract has changed hands, regulation 6(2)(a) removes the guarantee where "a person other than the provider ... who carried out the original restoration has provided treatment on the tooth" [2]. That wording suggests a change of contracting provider could break the guarantee, but no patient-facing guidance confirms that reading, so treat it as an open question and not a settled rule.

If you are moving practice for other reasons, our guide on how to find a good dentist in the UK covers what to check before you register.

Exemptions, and what happens if charges rise mid-guarantee

If you were exempt when the original work was done. Regulation 6(1) is drafted to cover you either way. It applies where the relevant charge "has been made, or would have been made if the patient was not exempt from being charged" [2]. In other words, the guarantee attaches to the restoration, not to whether money changed hands. On exemptions generally, NHSBSA confirms that if you are receiving a qualifying benefit or hold a valid exemption certificate at any point during a course of treatment, you do not pay [9]. Under-18s, under-19s in full-time education, pregnant women and women who have had a baby in the previous 12 months, and people on qualifying benefits or holding an HC2 certificate are the main exempt groups. Our guide to free NHS dental treatment sets out the full eligibility rules.

If band charges have gone up since your original course. They rose on 1 April 2026 [5], and they change most Aprils. The plain wording of regulation 6(1) is that "no charge may be made or recovered", which is an exemption rather than a fee pegged to any particular year's rate, so a mid-guarantee increase should be irrelevant. We should flag that no NHSBSA guidance addresses this exact scenario head-on, so this reading rests on the regulation itself rather than on a published official answer.

Private treatment: the rights you have with or without a guarantee

There is no statutory guarantee period for private dental work. If a private practice advertises a five-year guarantee on crowns, that is a contractual promise it has chosen to make, and its terms are whatever the practice has written down. Ask for them in writing before you pay.

What you always have, regardless of any guarantee, is the Consumer Rights Act 2015. Private dentistry is a trader supplying a service to a consumer, so the Act applies. Three sections matter:

• Section 49 treats every contract to supply a service as including a term "that the trader must perform the service with reasonable care and skill" [10].
• Section 55 gives you the right to repeat performance:

"The right to require repeat performance is a right to require the trader to perform the service again, to the extent necessary to complete its performance in conformity with the contract."

-- Consumer Rights Act 2015, section 55(1) [11]

The trader must do this within a reasonable time, without significant inconvenience to you, and must bear the cost of labour and materials [11].

• Section 56 gives you the right to a price reduction, including a full refund where appropriate, if repeat performance is impossible or the trader failed to provide it within a reasonable time. Any refund must be paid within 14 days of the trader agreeing you are entitled to it, by the same payment method, with no fee deducted [12].

Citizens Advice puts the same principle in plainer terms: "The Consumer Rights Act 2015 says that services must be provided with reasonable care and skill" [19].

For a wider comparison of what you get on each route, see our NHS versus private dentist cost comparison.

Five questions to ask before you accept a private guarantee

1. How long does it run, and does it start from fitting or from final review?
2. What voids it? Missed check-ups and hygiene appointments are common conditions.
3. Does it cover the laboratory work, the clinician's time, or both?
4. Does it survive if the clinician leaves the practice?
5. Is it in writing in the treatment plan, or only mentioned verbally?

If a private practice will not put things right

The General Dental Council funds the Dental Complaints Service, which handles private dental complaints only and is free to use. It "was established in 2006 to provide a free and fair mechanism for resolving patient complaints about private dental care" and can secure refunds, a contribution towards remedial treatment, or an apology and explanation [13]. Complaints must normally be brought within 12 months of the treatment, or within 12 months of you becoming aware of the problem [13]. It cannot help with NHS treatment.

If your NHS practice charges you anyway

This happens, usually through genuine confusion at reception rather than anything worse. A calm, specific script works better than an argument.

1. Check the dates. Find the date the original restoration was fitted, not the date the course of treatment ended. The 12 months runs from fitting [2].
2. Confirm it is a guaranteed item. Fillings, root fillings, inlays, onlays, porcelain veneers and crowns only [1].
3. Ask which exception is being applied. If the practice says the restoration was temporary or that you were advised against it, ask to see the contemporaneous entry in your record. Regulation 6(2)(b) requires it to have been recorded at the time [2].
4. Name the rule. Ask the practice manager to check regulation 6 of the National Health Service (Dental Charges) Regulations 2005, or NHSBSA's guidance on guaranteed items. Staff can verify both in minutes.
5. Do not pay under protest and hope. If you have already paid and you should not have, ask the practice for a refund directly. If treatment is still ongoing the practice should refund you; if the course is complete, form HC5(D) is the route for reclaiming charges you should not have paid [9].
6. Escalate if needed. NHS complaints go to the practice first and then to NHS England, not to the Dental Complaints Service, which handles private care only [13].

Scotland, Wales and Northern Ireland

The 12-month guarantee described above sits in English charging regulations. Do not assume it travels. Each nation runs its own system, and the public guidance is markedly thinner outside England.

Scotland. NHS dental examinations are free for everyone, and all treatment is free for everyone under 26. Adults aged 26 and over who are not otherwise exempt pay 80 per cent of the treatment cost, "capped at a maximum of £384 per course of treatment" [14]. On a guarantee equivalent, NHS Inform is silent. Citizens Advice Scotland does state that free "repair or replacement of failed fillings or crowns fitted in the last year - unless private work has been done on the tooth" is available [15], which mirrors the English rule closely. That is patient-facing guidance rather than the Statement of Dental Remuneration itself, so ask your practice to confirm the position for your treatment.

Wales. From April 2026 Wales moved to a care-package model, and the English three-band structure no longer describes Welsh charging. The Welsh Government's position is that "people who pay for NHS treatment will have their costs capped at a maximum of £384, regardless of how much care they need" [16]. Around half the Welsh population is exempt from charges altogether. No Welsh equivalent of the 12-month guarantee is documented in the current official guidance we checked, so we are not going to state one exists.

Northern Ireland. Charges work differently again. The Business Services Organisation, which administers Health Service dental charges in Northern Ireland, states that "the patient is required to pay 80% of the gross cost of the treatments up to a maximum of £384" [17]. Repair of dentures, arrest of haemorrhage and emergency home visits are free to all patients [17]. No Northern Ireland guarantee equivalent appears in the guidance we checked. What nidirect does confirm is a broader consumer-style right: patients are "entitled to refuse payment for the treatment if it is proved to be unsatisfactory" [18].

Frequently asked questions

Do I have to pay again if my NHS filling falls out?

Not if it fails within 12 months of being placed and the same practice repairs it. Regulation 6(1) says no charge may be made or recovered for repairing or replacing the restoration inside that period. The exceptions are private work on the tooth since, a restoration flagged as temporary, advice you overruled, or trauma.

Does the NHS dental guarantee cover dentures?

Dentures are not on the NHSBSA guaranteed-items list, which covers fillings, root fillings, inlays, onlays, porcelain veneers and crowns. However, a repair to a denture is separately free to every NHS patient with no time limit at all, regardless of whether you normally pay charges. A full replacement is treated differently and may be chargeable.

Are crowns guaranteed on the NHS?

Yes. Crowns appear explicitly on the guaranteed-items list, for 12 months from the date the crown was fitted. The guarantee applies at the practice that fitted it, and only for the same treatment. It falls away if private work has since been done on the tooth, if the crown was temporary, or if the failure resulted from trauma.

How is the 2-month rule different from the 12-month guarantee?

The 2-month rule means any further treatment in the same or a lower charge band is free if you return within two calendar months of completing a course. It does not have to relate to the original work. The 12-month guarantee is narrower and deeper: it covers repairing or replacing one specific restoration that has failed.

Does my guarantee transfer if I move to a new dentist?

No. NHSBSA guidance says guaranteed items must be replaced at the practice where the initial treatment took place, so a new practice has no published mechanism to honour it. If your original practice has closed, the guidance does not address that scenario at all, so contact NHSBSA and your new practice rather than assuming you have lost the entitlement.

What if NHS charges go up before my guaranteed repair?

It should make no difference. Regulation 6(1) states that no charge may be made or recovered, which is a complete exemption rather than a fee calculated at any particular year's rate. No NHSBSA guidance addresses this precise scenario, so this rests on the wording of the regulation itself rather than on a published official answer.

Do private dentists have to guarantee their work?

No. There is no statutory minimum guarantee period for private dentistry, and any guarantee offered is a voluntary contractual promise on the practice's own terms. Separately, the Consumer Rights Act 2015 always applies, giving you the right to have work redone or to a price reduction or refund where redoing it is not possible.

Who do I complain to about private dental treatment?

The Dental Complaints Service, funded by the General Dental Council, handles private dental complaints free of charge. It can secure refunds, a contribution towards remedial treatment, or an apology and explanation. Complaints should normally be made within 12 months of the treatment or of becoming aware of the problem. It cannot deal with NHS treatment.

Is emergency dental treatment covered by the guarantee?

The guarantee applies to restorations provided as part of a course of treatment or an urgent course of treatment, so a restoration placed during urgent care can be covered. Urgent care itself is charged at the Band 1 rate of £27.90 in England. A restoration placed as a deliberately temporary measure falls outside the guarantee.

Does the guarantee apply if I was exempt from charges?

Yes. Regulation 6(1) covers restorations where the charge was made "or would have been made if the patient was not exempt from being charged". The guarantee attaches to the restoration rather than to the payment, so exempt patients are protected on the same terms as paying patients within the same 12-month period.

Find a dentist who will honour your guarantee

The 12-month guarantee only works if you can get back through the door of the practice that did the work. If yours has closed its list, handed back its NHS contract, or you have simply lost confidence in it, the practical problem is finding somewhere else.

Search for a dentist near you on Dentists Closeby to compare GDC-registered practices in your area, see who is taking new NHS and private patients, and check what each one offers before you book. If you are pricing up a specific treatment first, our guides to filling costs, crown costs and root canal costs show the NHS and private figures side by side.

Sources

1. What are 'guaranteed items' of NHS dental treatment? -- NHS Business Services Authority, accessed 2026-08-03
2. The National Health Service (Dental Charges) Regulations 2005, regulation 6 -- legislation.gov.uk, SI 2005/3477, accessed 2026-08-03
3. Further NHS dental treatment within two months -- NHS Business Services Authority, accessed 2026-08-03
4. How much will NHS dental treatment cost? -- NHS, accessed 2026-08-03
5. What are the NHS dental charges? -- NHS Business Services Authority, charges effective 1 April 2026, accessed 2026-08-03
6. What is a 'charge exempt' course of dental treatment? -- NHS Business Services Authority, accessed 2026-08-03
7. What can I claim for repairing a denture? -- NHS Business Services Authority, accessed 2026-08-03
8. What is Regulation 11? -- NHS Business Services Authority, accessed 2026-08-03
9. Does my exemption need to cover the whole course of dental treatment? -- NHS Business Services Authority, accessed 2026-08-03
10. Consumer Rights Act 2015, section 49 -- legislation.gov.uk, accessed 2026-08-03
11. Consumer Rights Act 2015, section 55 -- legislation.gov.uk, accessed 2026-08-03
12. Consumer Rights Act 2015, section 56 -- legislation.gov.uk, accessed 2026-08-03
13. Dental Complaints Service -- General Dental Council, accessed 2026-08-03
14. Receiving NHS dental treatment in Scotland -- NHS Inform, last updated 27 July 2026, accessed 2026-08-03
15. NHS dental treatment -- Citizens Advice Scotland, accessed 2026-08-03
16. Written statement: new contract to improve access to NHS dentistry -- Welsh Government, 11 February 2026, accessed 2026-08-03
17. Dental charges and fees -- Business Services Organisation, Northern Ireland, accessed 2026-08-03
18. Dental costs -- nidirect, Northern Ireland Government, accessed 2026-08-03
19. If you're unhappy about poor service -- Citizens Advice, accessed 2026-08-03