NHS Tooth Extraction Cost: £76.60 Simple, Hospital if Surgical

A simple NHS tooth extraction in England costs £76.60 as part of Band 2. The single charge covers the extraction and any other Band 2 work in the same course. Surgical extractions and complex wisdom tooth cases are often referred to NHS hospital oral and maxillofacial surgery, which is free at point of use for the patient. This page covers simple vs surgical extractions, the wisdom tooth pathway, post-extraction replacement options, and how NHS extraction fees compare with private and across the UK nations.

Simple vs surgical extraction

The distinction between simple and surgical extraction is clinical, not arbitrary. A simple extraction can be carried out with forceps after local anaesthetic and does not involve incision, bone removal, or sectioning of the tooth. The vast majority of routine adult extractions of well-erupted teeth fall into this category. Simple extractions are within the scope of NHS primary care dentistry and are charged at Band 2 (£76.60 in England) regardless of the tooth removed.

A surgical extraction involves any combination of: an incision through the gum tissue, removal of overlying bone to access the tooth, sectioning the tooth into pieces to facilitate removal, or use of more substantial instruments than forceps. Surgical extractions are needed when a tooth is fractured at the gum line, deeply impacted (unerupted), severely angulated, or near important anatomical structures like the inferior dental nerve (which runs below the lower molars) or the maxillary sinus (which sits above the upper molars).

A surgical extraction can be carried out by an NHS general dental practitioner in the practice if the case is within their training and the practice has the necessary equipment. Surgical extractions in primary care are charged as Band 2 (£76.60). If the dentist assesses the case as exceeding primary care scope, the patient is referred to NHS hospital oral and maxillofacial surgery. The hospital portion is free at point of use; the patient pays only any Band 2 charge from the original primary care course (the extraction itself happens at the hospital, not the practice).

Reasons a primary care NHS dentist might refer rather than extract include: deeply impacted teeth (especially mandibular third molars), proximity to the inferior dental nerve, medical complexity (anticoagulant use, uncontrolled cardiac conditions, immunosuppression), patient dental anxiety requiring sedation, age and frailty considerations, and the patient's preference for sedation or general anaesthetic.

Wisdom tooth removal on the NHS

Wisdom teeth (third molars) are a special case. NICE guidance (TA1, 2000, periodically reviewed) restricts the prophylactic removal of asymptomatic wisdom teeth on the NHS. NHS-funded wisdom tooth removal is reserved for teeth that are symptomatic, infected (pericoronitis), causing pathology in adjacent teeth, or otherwise clinically problematic. Prophylactic removal of a fully erupted, asymptomatic wisdom tooth simply because it might cause problems in future is generally not NHS-funded.

When wisdom teeth do meet the NICE criteria for removal, the route depends on complexity:

• Fully erupted, simple extraction: Band 2 in primary care (£76.60 England).
• Partially erupted but accessible, local anaesthetic suitable: usually Band 2 in primary care (£76.60).
• Impacted, requires bone removal or sectioning, local anaesthetic suitable: surgical Band 2 in primary care or referred to hospital depending on practice scope.
• Deeply impacted, near anatomical structures, requires sedation or general anaesthetic: referred to hospital oral and maxillofacial surgery (free at point of use).

The hospital wisdom tooth pathway can have a waiting list of several months for non-urgent cases. Urgent cases (severe pain, recurrent infection, abscess) are prioritised. Patients with severe pain who cannot wait for hospital surgery sometimes pay privately for faster treatment; the private cost for a single surgical wisdom tooth extraction is typically £400 to £800 under local anaesthetic, or £1,500 to £3,500 under sedation or general anaesthetic in a private hospital.

After the extraction: replacement options

A missing tooth can be left as a gap, or replaced. Whether replacement is clinically necessary depends on the tooth's position, the patient's bite, and aesthetic considerations. Replacement options funded on the NHS include dentures and bridges. Implants are rarely NHS-funded.

If the replacement is part of the same course as the extraction, the entire course is charged at Band 3 (£332.10) and absorbs the extraction. If the replacement is a separate later course, both the extraction (Band 2, £76.60) and the replacement (Band 3, £332.10) are charged: total £408.70. The single-course route is cheaper but requires the dentist to plan accordingly.

NHS hospital oral surgery: how it works

NHS hospital oral and maxillofacial surgery is a consultant-led service that handles dental cases beyond primary care scope. Referrals come from general dental practitioners (NHS or private), GPs, and emergency departments. The service is free at point of use for the patient. There is no additional patient charge for the hospital portion of treatment, regardless of complexity.

The pathway typically involves: referral letter from the primary care dentist, triage by the hospital department (clinical urgency assessment), first outpatient appointment with the consultant or specialist registrar, treatment planning, and the surgical procedure. Surgery can be carried out under local anaesthetic in the outpatient clinic, under sedation in a day-case unit, or under general anaesthetic in an inpatient operating theatre depending on complexity.

Waiting times vary by region and by clinical urgency. Urgent cases (severe pain, infection, malignancy suspicion) are seen within days to weeks. Routine cases (asymptomatic impacted teeth meeting NICE criteria, benign cysts) typically wait several months. Patients can ask the referring dentist about local waiting times and whether private secondary care would be substantially quicker; the trade-off is the substantial private fee for what is otherwise NHS-funded surgery.

Frequently asked questions

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