TL;DR
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows that navigating the world of private medical insurance (PMI) in the UK can feel complex. One of the most common questions our clients ask is about dental care. This comprehensive guide explains exactly what you need to know.
Key takeaways
- An Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a hernia, appendicitis, or a broken bone.
- A Chronic Condition: A condition that continues long-term and has no known cure, such as diabetes, asthma, or high blood pressure. PMI does not cover the ongoing management of chronic conditions.
- A Pre-existing Condition: Any illness, disease, or injury you had symptoms of, or received advice or treatment for, before your policy began. These are also excluded from standard PMI cover.
- Surgical removal of impacted wisdom teeth: Specifically, when the tooth is stuck in the jawbone and requires a complex surgical procedure, not a simple extraction in the dentist's chair.
- Treatment for oral cancer: Diagnosis and surgical treatment for cancers of the mouth, tongue, or jaw are typically covered under the cancer care provisions of a comprehensive PMI policy.
As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr knows that navigating the world of private medical insurance (PMI) in the UK can feel complex. One of the most common questions our clients ask is about dental care. This comprehensive guide explains exactly what you need to know.
WeCovr explains when dental treatment is included
The short answer is that standard private medical insurance policies in the UK do not typically cover routine or major dental treatment. PMI is designed to cover the costs of unexpected, acute medical conditions, not foreseeable expenses like dental check-ups.
However, there are important exceptions and optional extras that can provide the dental cover you're looking for. In this guide, we'll break down how PMI can cover dental surgery, what optional 'add-on' plans include, and how they compare to standalone dental insurance.
First, What is Private Medical Insurance Really For?
Before we dive into the dental details, it's crucial to understand the core purpose of PMI. Private health cover is designed to give you peace of mind and faster access to high-quality medical care for acute conditions that begin after your policy starts.
- An Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include a hernia, appendicitis, or a broken bone.
- A Chronic Condition: A condition that continues long-term and has no known cure, such as diabetes, asthma, or high blood pressure. PMI does not cover the ongoing management of chronic conditions.
- A Pre-existing Condition: Any illness, disease, or injury you had symptoms of, or received advice or treatment for, before your policy began. These are also excluded from standard PMI cover.
Understanding this 'acute condition' principle is key to seeing why routine dental care isn't usually included.
The Big Question: Is Dental Treatment Covered by Standard PMI?
As a rule, no. Insurers view most dental work—from your six-month check-up to a filling or a crown—as routine maintenance for your body. It's a predictable, budgetable expense, much like an MOT for your car. PMI is there for the unexpected 'crashes' (like needing a joint replacement), not the routine servicing.
Therefore, you will find that nearly all standard private medical insurance UK policies list 'routine dental treatment' in their list of general exclusions.
However, this is not the end of the story. There are two main situations where your dental health can be covered through PMI.
When Your PMI Policy Can Cover Dental Treatment
While routine care is out, there are specific, significant circumstances where your core PMI policy may step in to cover dental-related procedures.
1. Dental Surgery Following an Accident or Injury
This is a key area of cover. If you suffer a significant injury to your face or mouth, your PMI policy will often cover the necessary surgery to repair the damage. This cover is for treatment performed by a specialist, usually in a hospital setting.
Real-Life Example: Imagine you are cycling and have a fall, resulting in a broken jaw and several damaged teeth. The surgery to set your jaw, and potentially to surgically implant new teeth (if it's part of the reconstructive surgery), would likely be covered by your core PMI policy because it's treatment for an acute injury. However, a simple replacement crown for a single chipped tooth from a minor knock would likely not be covered.
2. Medically Necessary Oral Surgery
Certain complex dental procedures blur the line between dentistry and medicine. If a consultant maxillofacial surgeon deems a procedure medically necessary and it's performed in a hospital, your PMI is more likely to cover it.
Common examples include:
- Surgical removal of impacted wisdom teeth: Specifically, when the tooth is stuck in the jawbone and requires a complex surgical procedure, not a simple extraction in the dentist's chair.
- Treatment for oral cancer: Diagnosis and surgical treatment for cancers of the mouth, tongue, or jaw are typically covered under the cancer care provisions of a comprehensive PMI policy.
- Jaw realignment surgery (Orthognathic surgery): When needed to correct severe functional problems with biting or breathing.
The key distinction is that these are surgical procedures to treat a diagnosed medical condition, not routine dental work.
Your Main Option for Everyday Dental Cover: The 'Add-On'
For everyday check-ups, hygienist visits, fillings, and crowns, you need to look beyond a standard PMI policy. The most common solution is to purchase a dental and optical add-on (sometimes called a 'bolt-on') for an extra monthly fee.
Most major UK insurers, including AXA, Bupa, Aviva, and Vitality, offer these optional extras. They are a convenient way to bundle your health and dental cover together.
What Do Dental Add-Ons Typically Cover?
Cover is usually tiered, with basic plans offering lower limits and comprehensive plans covering a wider range of treatments.
| Feature | What It Typically Covers | Typical Annual Limit (Example) |
|---|---|---|
| Routine Care | Dental check-ups, scale and polish, X-rays. | £150 - £400 |
| Restorative Treatment | Fillings, root canals, extractions, crowns, bridges, dentures. | £250 - £1,000+ |
| Dental Emergencies | Urgent treatment needed to relieve pain (often outside normal hours). | £100 - £300 per incident |
| Dental Injuries | Treatment required after an accident (separate from core PMI cover). | £500 - £10,000+ |
| Oral Cancer | Contribution towards diagnosis and treatment. | Often paid in full up to a high limit. |
| Orthodontics | Braces and other teeth-straightening treatments. | Often excluded or only available on top-tier plans with strict limits. |
Important Note: These add-ons always come with annual financial limits. For example, a plan might cover 100% of your costs for fillings up to a limit of £500 per year. Any costs beyond that limit would have to be paid by you.
PMI Add-ons vs. Standalone Dental Plans: Which is Right for You?
The other route is to ignore the PMI add-on and buy a completely separate dental insurance policy from a specialist provider like Denplan or Bupa Dental Care.
Here’s a comparison to help you decide:
| Aspect | PMI Dental Add-On | Standalone Dental Plan |
|---|---|---|
| Convenience | High. One policy, one provider, one monthly payment. | Lower. A separate policy and provider to manage. |
| Cost | Can be cost-effective, often from £10-£40 per month extra. | Can be more expensive for equivalent cover, but sometimes cheaper for basic plans. |
| Coverage Scope | Good for general care, but limits can be lower than specialist plans. | Often more comprehensive, with higher limits for major work like implants and crowns. |
| Waiting Periods | Common. You may have to wait 1-3 months for routine care and 3-6 months for major work. | Also common. Waiting periods are standard across the industry to prevent immediate large claims. |
| Choice of Dentist | Usually allows you to visit any UK dentist (private or NHS). | Some plans (capitation schemes like Denplan) are tied to a specific network of dentists. |
| Claiming | Usually a 'pay and claim' system. You pay the dentist and claim the money back from the insurer. | Varies. Can be 'pay and claim' or direct settlement with the dental practice. |
The WeCovr View: For many people, a PMI add-on provides a fantastic blend of convenience and value, covering the essential treatments most families need. However, if you know you require extensive and expensive work (like multiple implants or complex orthodontics), a top-tier standalone plan might offer better value despite the higher cost. An expert PMI broker like WeCovr can help you compare the costs and benefits to find the perfect fit for your needs and budget, at no extra cost to you.
The Reality of NHS Dentistry in 2025
A key driver for considering private dental cover is the well-documented pressure on NHS dental services. Many people across the UK find it incredibly difficult to register with an NHS dentist.
- Access Issues: According to recent analysis by organisations like the British Dental Association, millions of people are unable to get the NHS dental appointments they need, creating a significant access crisis in many parts of the country.
- "Dental Deserts": Some areas have so few NHS dentists taking on new patients that they have been labelled "dental deserts."
This situation means that many are forced to pay for private treatment out-of-pocket, even if they would prefer to use the NHS. A private dental plan can make these costs predictable and manageable.
WeCovr's Focus on Your Overall Wellbeing
We believe that true health cover is about more than just reacting to illness; it's about supporting your overall wellbeing. That’s why, when you arrange your private medical insurance with us, you get more than just a policy.
- Complimentary Access to CalorieHero: All WeCovr PMI clients receive free access to our AI-powered calorie and nutrition tracking app, CalorieHero. Maintaining a healthy diet is fundamental to good health, including your oral health, as high-sugar diets are a leading cause of tooth decay.
- Multi-Policy Discounts: We value your loyalty. When you take out a PMI or life insurance policy through us, we can offer you exclusive discounts on other types of cover you might need, helping you protect your family and your finances more affordably.
Our high customer satisfaction ratings are built on this holistic approach—providing expert advice, great value, and tangible benefits that support a healthier lifestyle.
Key Things to Check Before Adding Dental Cover
If you decide to add a dental plan to your PMI, be sure to check the small print. Here are the crucial questions to ask:
- What are the annual limits? Know exactly how much you can claim for routine and restorative work each year.
- Are there waiting periods? Don't get caught out. Check how long you have to wait before you can claim for different types of treatment.
- Is there an excess? Find out if you need to pay an excess on dental claims, and whether it's separate from your main PMI policy excess.
- What are the exclusions? Cosmetic treatments like teeth whitening and veneers are almost always excluded. Check for any other specific exclusions.
- How does the claims process work? Is it a simple 'pay and claim back' system, or does the insurer settle bills directly with certain dentists?
- Does orthodontics cover include existing treatment? Most plans will not cover orthodontic treatment that has already started.
Is cosmetic dentistry like teeth whitening covered by PMI or dental add-ons?
What is the difference between a dental insurance plan and a dental cash plan?
Can I add a dental option to my PMI policy at any time?
Does a PMI dental plan let me see an NHS dentist?
Get Your Free, No-Obligation PMI Quote Today
Understanding the nuances of dental cover within a PMI policy can be tricky. The best way to find the right level of protection for your health and your smile is to speak with an expert.
At WeCovr, we do the hard work for you. We compare policies from all the leading UK insurers to find a plan that fits your unique needs and budget—including the most suitable dental options. Our advice is independent, and our service is completely free.
Contact WeCovr today for a free, no-obligation quote and discover how affordable comprehensive private health and dental cover can be.
Sources
- Office for National Statistics (ONS): Mortality, earnings, and household statistics.
- Financial Conduct Authority (FCA): Insurance and consumer protection guidance.
- Association of British Insurers (ABI): Life insurance and protection market publications.
- HMRC: Tax treatment guidance for relevant protection and benefits products.
