If you need a lot of NHS dental work, you may now pay much less for it. Since 23 June 2026, the NHS in England has offered “care pathways” to adults with serious tooth decay or gum disease. A care pathway is one planned package of treatment over 6 or 12 months. Most people pay a single Band 2 charge for the whole thing: £76.60.
They are new, and your dentist decides if you qualify. So if you have been told you need a lot of work, ask.
What a care pathway is
Before June 2026, a lot of treatment was often split into separate courses of treatment. Each course could mean a new charge. A care pathway puts all of that work into one plan with one charge.
The plan is written for you. It sets out what the dentist will do, what you need to do at home, and when they will check your progress. You have to agree to it before it starts.
Who can get one
You must be 16 or over. There are 3 pathways:
| Pathway | Who it is for | How long it lasts |
|---|---|---|
| 1 | Decay in 5 or more teeth | 6 months |
| 2 | Decay in 5 or more teeth, and gum disease that is getting worse | 12 months |
| 3 | Serious gum disease, diagnosed for the first time | 6 months |
“Decay” here means decay that has gone through the outer layer of the tooth. “Serious gum disease” is what your dentist will call Stage III or Grade C periodontitis. You cannot tell which pathway you need yourself. The dentist decides at your examination.
You can only be on one pathway at a time.
What it costs
Most people pay one Band 2 charge of £76.60 for the whole pathway. That is the same charge as a single filling.
If you also need Band 3 work, such as a crown or a denture, you pay one Band 3 charge of £332.10 instead. That covers the pathway and the Band 3 work together.
There is one more rule. If you need Band 3 work within 3 months of finishing a pathway, you only pay the difference between the 2 charges. That is £255.50, not the full £332.10.
The government says a care pathway could save a patient up to £225. Here is how that adds up. Say your treatment would have been split into 3 separate Band 2 courses. You would have paid £76.60 three times, which is £229.80. On a pathway you pay £76.60 once.
If you normally get free NHS dental treatment, nothing changes. You still pay nothing. Our guide to who gets free NHS dental treatment has the full list.
What you get
Every pathway includes treatment, advice on preventing more problems, and check-ups to see how you are doing.
- Pathway 1: fillings or extractions on at least 5 teeth, help from a hygienist, a check on your progress at 3 months (this can be done remotely), and a final review at 6 months.
- Pathway 2: the same as pathway 1, plus at least 3 stages of gum treatment over 12 months.
- Pathway 3: at least 2 stages of gum treatment, advice on looking after your gums, and a review.
Gum treatment usually starts with a deep clean by a hygienist or therapist. Further stages depend on how your gums respond.
Some work, such as crowns and bridges, is usually left until the decay or gum disease is under control. That is normal, and it protects the new work.
How to ask for one
If your dentist has told you that you need a lot of work, ask: “Do I qualify for an NHS care pathway?”
Not every practice is offering them yet, as far as we can tell. The British Dental Association has warned that pathways involve a lot of paperwork, and some practice software was not ready when they started. We do not yet know how many London practices offer them. If your practice says no, ask why. If they do not offer pathways at all, you can ask another NHS practice. There are no catchment areas.
Finding an NHS practice with space is still the hard part. We list London practices last reported as taking new NHS patients, by borough. Our guide to finding an NHS dentist explains the steps.
What the rules do not say
NHS England’s guidance leaves some things to each practice. Ask about these before you agree:
- When you pay. Some practices take the charge at the start, others at the end.
- Missed appointments. The guidance does not say what happens if you miss one. Ask the practice what its policy is.
- What happens at the end. When the pathway finishes, normal check-ups start again. Each one is a new course of treatment with its own charge.
Frequently asked questions
How much does an NHS dental care pathway cost?
£76.60 for most people, which is one Band 2 charge. If you also need Band 3 work such as a crown, you pay one Band 3 charge of £332.10 instead. If you get free NHS dental treatment, you pay nothing.
Who qualifies for an NHS care pathway?
Adults aged 16 and over with decay in 5 or more teeth, serious gum disease diagnosed for the first time, or both decay and gum disease that is getting worse. Your dentist decides.
How long does a care pathway last?
6 months for pathways 1 and 3. 12 months for pathway 2, which covers decay and gum disease together.
Can my children go on a care pathway?
No. Care pathways are for people aged 16 and over. NHS dental treatment is free for everyone under 18 anyway.
Do care pathways apply in Scotland, Wales or Northern Ireland?
No. Care pathways are part of the NHS dental contract in England. The rest of the UK has its own rules.
Does every NHS dentist offer care pathways?
We do not know yet. The guidance does not say that every practice must offer them. Ask your practice. If it does not offer them, you can ask another NHS practice.
Sources: NHS England, “NHS dentistry: care pathways guidance” (June 2026); Department of Health and Social Care press release, 16 December 2025. Charges are for 1 April 2026 to 31 March 2027. For all NHS charges, see our NHS dental charges guide. For the other changes to NHS dentistry this year, see the 2026 NHS dental contract changes.