NHS Dental Bands and Charges 2026/27: UDAs Explained for Dentistry Interviews

As a practising NHS dentist, I encounter the Unit of Dental Activity (UDA) system every day at work. It dictates how I plan treatments, how my practice is funded, and often, the ethical dilemmas I face in the surgery.

If you are applying to dental school, the UDA system explains much of the financial and political pressure on the career you hope to join, and understanding it will strengthen any interview answer about NHS dentistry. If you came here for the price of an NHS dental band, the 2026/27 charges are in the first section below.

Quick summary: patients in England pay a fixed charge for each course of NHS treatment, set by its band: Band 1 £27.90, Band 2 £76.60 or Band 3 £332.10 from 1 April 2026. The practice is paid differently. Each band earns it a set number of Units of Dental Activity (UDAs), the currency NHS England uses to measure and pay for dental work, and each practice has a yearly UDA target and a fixed budget to deliver it.

NHS Dental Charges 2026: Band Costs and UDA Values

NHS dental bands explained: what each band covers

There are three NHS dental charge bands in England, plus a separate urgent (emergency) charge. You pay one charge per course of treatment, even if you need several appointments to complete it:

• Band 1 (£27.90): examination, diagnosis, X-rays, a scale and polish if clinically needed, and advice on preventing future problems. The dentist earns 1 UDA.
• Band 2 (£76.60): everything in Band 1 plus fillings, root canal treatment, extractions, gum treatment and fissure sealants. The practice earns 3 UDAs (Band 2a), 5 UDAs for root canal treatment on a front tooth or premolar or work on three or more teeth (Band 2b), or 7 UDAs for root canal treatment on a molar (Band 2c).
• Band 3 (£332.10): everything in Bands 1 and 2 plus laboratory-made items such as crowns, bridges and dentures. The dentist earns 12 UDAs.
• Urgent care (£27.90): treatment to stop pain or stop a problem getting worse, charged at the same rate as Band 1. Since 1 April 2026 the practice is paid £75 for each urgent course instead of 1.2 UDAs.

A few rules decide what you pay. If a course of treatment includes work from different bands, you pay only the highest band charge. Further treatment within two months is free if it falls in the same or a lower band. Repairing a denture, removing stitches and stopping bleeding are free. These rules are set out on the NHS dental charges page.

These figures apply to England only. Wales moved to a new set of charges on 1 April 2026, priced by care package (for example £37.50 for urgent care and £27.21 for an adult new patient assessment). In Scotland examinations are free, and adults aged 26 and over pay 80% of the fee for other treatment, up to £384 a course. In Northern Ireland patients pay 80% of the fee, also up to £384. The NHSBSA charges page lists the current figures for England and Wales. For the bigger picture on how the four systems differ, see our guide to UK healthcare system differences.

For an interview you need the structure more than the prices. The table below sets out the 2026/27 charges (from 1 April 2026) next to the UDAs the practice earns for each band, including the 2026 changes. Before 1 April 2026 the charges were £27.40, £75.30 and £326.70.

Note: the patient pays the charge in the second column, while the practice is credited with the UDAs or payment in the third.

NHS Dental Bands Table (2026/27 Charges)

Dr Sonal's tip: notice Bands 2b and 2c. Since November 2022 the NHS has paid 5 or 7 UDAs for root canal treatment and for work on three or more teeth, because those courses take far longer than a single filling. The patient still pays the same Band 2 charge. Mentioning this at interview shows you understand how the contract works. You do not need to learn the prices, only the principles behind UDAs.

What Is the UDA System in NHS Dentistry?

A Unit of Dental Activity (UDA) is the metric used to monitor and remunerate NHS dental activity. It was introduced in the 2006 General Dental Services (GDS) contract to replace the old "fee-per-item" system.

Think of UDAs as points. NHS England gives a practice an annual target, for example 10,000 UDAs, and a fixed budget to deliver them.

• If the practice hits the target: They keep the full funding.
• If they miss the target: They face "clawback" (financial penalties).
• If they exceed the target: They are generally not paid for the extra work.

How much is one UDA worth?

The value of a single UDA is not fixed nationally: it is negotiated for each practice contract and historically ranged from roughly £15 to over £40, averaging around £28 to £30. Because the patient charge is set centrally but the UDA rate is not, two dentists can be paid very different amounts for identical work. To stabilise struggling contracts, the NHS Dental Recovery Plan raised the minimum UDA value from £23 to £28 in 2024, though the British Dental Association argued this was still below the real cost of delivering care. Critics say a low, fixed UDA value is exactly why so many practices have handed back NHS contracts, fuelling so-called "dental deserts".

Why is the UDA system controversial?

The controversy arises because dentists are paid for hitting targets, with little link to the time spent or the quality of the work. A course with fillings on three teeth earns 5 UDAs, and so does a course with fillings on ten teeth, which can take several long appointments. Band 3 earns 12 UDAs whether the patient needs one crown or several crowns and a denture. This creates an environment where "churning" through patients can become a financial necessity.

The "Swings and Roundabouts" Concept

This is the most critical concept to discuss in an MMI station regarding NHS management. The 2006 contract relies on the philosophy of averages, known as "Swings and Roundabouts."

• The "Swing" (The Win): Sometimes, a Band 2 treatment is quick. For example, a small buccal filling might take 15 minutes. The dentist earns 3 UDAs easily and "profits" on time.
• The "Roundabout" (The Loss): Other times, a Band 2 course is long. A patient who needs ten fillings over several visits earns the practice 5 UDAs, the same as a patient who needs three, so the dentist is effectively working at a financial loss for those extra hours.

The Ethical Flaw

In theory, these cases average out. In reality, as the UK population ages and retention of teeth improves, the "roundabouts" (complex, time-consuming cases) often outweigh the "swings."

Interview Application: This system financially disincentivises dentists from taking on high-needs patients, potentially leading to "dental deserts" where practices hand back their NHS contracts because they cannot stay solvent.

If you are asked about this in an MMI, link it to the wider workforce picture: just as the UDA system pushes dentists away from the NHS, similar contract and morale pressures are driving doctors out of the NHS. Showing you understand professional regulation also helps, so be ready to reference the 9 GDC standards that govern how dentists must balance commercial pressure against patient interests.

Critical Terminology In Dentistry: Clawback and Exemptions

To sound like a future colleague, you must use the correct vocabulary when discussing contract mechanics.

1. What is Clawback?

Clawback is the recovery of funds by the NHS from a dental practice. If a practice fails to achieve at least 96% of its annual UDA target, the NHS demands reimbursement for the undelivered UDAs.

• Consequence: This creates immense pressure on associates to work faster to avoid a Breach of Contract notice.

2. Who is Exempt from NHS Charges?

While the practice always earns UDAs, not every patient pays the fee. The following groups are fully exempt:

• Under 18s (or under 19 if in full-time education).
• Pregnant women and mothers up to 12 months post-partum.
• People receiving, or whose partner receives, Income Support, income-based Jobseeker’s Allowance, income-related Employment and Support Allowance, Pension Credit Guarantee Credit or Universal Credit within the earnings limits, and people with a full HC2 certificate from the NHS Low Income Scheme.

What changed in the NHS dental contract in 2026?

In December 2025 the government confirmed the first changes to the 2006 contract since Band 2 was split in 2022, after a consultation in summer 2025. NHS England's guidance, published on 26 March 2026, covers eight areas. Most started on 1 April 2026, and the complex care pathways followed on 23 June 2026. These are the changes that matter for an interview:

Several things did not change. Patients still pay one of three band charges, which rose in the usual April uprating. The UDA is still the unit most NHS dental work is paid in, and the £28 minimum UDA value set in April 2024 was not part of the package. Every new payment also comes out of each practice’s existing contract value, so the changes move money within the budget without adding to it.

For the background, the criticism and how to use it at interview, read our guide to NHS dental contract reform 2026. The same funding pressures run through other dentistry hot topics such as dental amalgam fillings.

A Potential Improvement To The UDA System? Flexible Commissioning

To fix the rigid UDA system, the NHS, in some areas, has shifted power to local Integrated Care Boards (ICBs). Instead of a "one-size-fits-all" contract from London, ICBs can now use "Flexible Commissioning."

This allows them to "slice off" a percentage of a practice's UDA target (e.g., 10%) and reinvest that money into specific initiatives that improve health outcomes but earn zero traditional UDAs.

How it works (The "Currency Exchange"):

Think of it as an exchange rate. Instead of a dentist earning money by delivering 3,000 UDAs (drilling), the ICB pays them the same amount to dedicate 300 hours to specific care that takes longer but saves the NHS money in the long run.

Real-World Flexible Commissioning Examples:

• Urgent care: in February 2025 the government asked ICBs to provide 700,000 extra urgent appointments from April 2025, aimed at areas with the fewest NHS dentists. From 1 April 2026 urgent care became part of the national contract: larger practices must deliver a set number of urgent courses and are paid £75 for each one.
• "Starting Well" (Prevention): Funding is ring-fenced for dentists to visit primary schools for Supervised Toothbrushing schemes. This pays for prevention rather than surgical intervention.

Why this matters:

By removing the UDA target for these specific groups, dentists are financially safe to spend 45 minutes with a nervous, high-needs patient without worrying about "working at a loss."

To sound like a future leader, you must also critique the solution. Critics (like the BDA) argue that Flexible Commissioning is just "rearranging the deckchairs." It uses the existing limited dental budget. It takes money from the "routine check-up" pot to pay for the "high needs" pot, which might inadvertently reduce access for everyday patients. The "Postcode Lottery":

Because each ICB decides its own priorities, a dentist in Cornwall might be paid to visit care homes, while a dentist in London is not. This creates unequal access depending on where a patient lives.

Model Dentistry Question & Answer on the UDAs & NHS Dental Contract

"What are the main disadvantages of the current NHS dental contract?"

Model Answer

The NHS contract is based on Units of Dental Activity (UDAs). A practice is given a fixed budget to hit a target number of points each year. Dentists earn these points according to the treatment band: a check-up earns 1 point (Band 1), while fillings or extractions earn 3 points (Band 2).

The main disadvantage is that the system pays based on the category of treatment, not the time or difficulty involved.

A course of treatment with fillings on three teeth earns 5 UDAs, and so does a course with fillings on ten teeth that may take several hour-long appointments. This creates a financial imbalance. If a dentist has a day full of complex cases, they earn much less per hour than if they were doing simple work, despite working harder.

This structure can unintentionally discourage dentists from taking on high-needs patients who require complex, time-consuming work, because it makes it much harder to hit their annual targets.

The NHS has tried to fix this in stages. Since 2022, Bands 2b and 2c have paid 5 UDAs for root canal treatment on a front tooth or premolar or work on three or more teeth, and 7 UDAs for molar root canal treatment. From June 2026, patients with severe decay or gum disease can be treated on a care pathway paid as a 6 or 12 month package. Both changes reward harder work, but the UDA itself remains.

Why is it so hard to find an NHS dentist?

You can understand the bands and UDAs perfectly and still be asked the question patients care about most: why is it so hard to find an NHS dentist? For 2027 entry, connect the mechanics of the contract to the access problem and to what the government has done about it.

Patient charges rise most Aprils, but the bigger problem sits with the practice. When the UDA value does not cover the cost of the care, NHS work can lose money, so some practices hand contracts back or move to private care. The result is what the media call “dental deserts”: areas where no local practice takes on new NHS adult patients, leading to long waits, long journeys, some people attempting DIY dentistry and others travelling abroad for treatment (“Turkey teeth”).

The 2024 NHS Dental Recovery Plan

The Dental Recovery Plan (February 2024) aimed for 1.5 million extra treatments in 2024/25. Its main measures were a new patient premium (£15 or £50 per eligible new patient), a “golden hello” of £20,000 over three years to recruit 240 dentists to under-served areas, a rise in the minimum UDA value from £23 to £28, and mobile dental vans. In November 2024 the National Audit Office found it was unlikely to reach its target: the first golden hello dentist was not appointed until October 2024, and no vans had been bought. The 700,000 extra urgent appointments came later, announced in February 2025 for April 2025.

The 10-Year Health Plan and the graduate “tie-in”

The commitment with the most direct effect on you is in the 10 Year Health Plan (July 2025): newly qualified dentists will be required to work in the NHS for a minimum period. Ministers have said they intend it to be at least three years, but the length and start date have not been confirmed. Alongside it, the government plans the first sustained expansion of dental training since 2007, with funded places in England rising from 809 to 859 from 2027/28, and has promised fundamental contract reform by the end of this Parliament. Supporters say a tie-in protects the roughly £200,000 of public money spent training each dentist; critics, including the British Dental Association, say it tackles retention without fixing the contract that drives dentists out. Be ready to argue both sides and give your own view.

As always, charges and reform details change each April, so quote the direction of travel confidently in an interview, but check the exact current figures on nhs.uk before an exam or application.

NHS dentistry questions at dentistry interviews

Dentistry interviews run from November to February, and NHS dentistry comes up in panel interviews and MMI stations, sometimes as a role play with an actor playing a patient. Below are realistic questions, each with the points a good answer covers. Practise them out loud, ideally in one of our dentistry mock interviews, or work through them over several sessions with dentistry interview coaching.

What is a UDA, and what are its drawbacks?

Define it in one sentence: the unit NHS dental work in England is measured and paid in, with a set number per band. Give one drawback with an example, such as a quick filling and a long premolar root canal before 2022 both earning 3 UDAs, and one attempt to fix it, such as the Band 2 split or the 2026 care pathways. Aim for about a minute; the model answer above shows the shape.

Why is it hard to find an NHS dentist in some parts of England?

Link the contract to access: when the UDA value does not cover the cost of care, practices cut NHS work or hand contracts back. Add workforce and geography, since rural and coastal areas have fewer dentists. Then say what has been done (the 2024 recovery plan, the urgent appointments from April 2025 and the 2026 contract changes) and finish with your view on whether it is enough.

Role play: a patient is annoyed that they paid £76.60 for one filling when a friend had four fillings for the same price.

Listen first and acknowledge the frustration. Explain in plain words that NHS charges are set nationally by band and cover the whole course of treatment, so the charge does not depend on the number of fillings, and that further treatment in the same band within two months is free. Do not criticise the system or colleagues, and offer to pass on a complaint if they still want to make one. The GDC standards expect clear information about costs before treatment.

Should NHS dental treatment be free, like a GP appointment?

Weigh both sides. Charges bring money into the dental budget and may reduce missed appointments, but they can put off people on low incomes who fall just outside the exemptions, and untreated decay costs more to fix later. Mention that under 18s and pregnant women already pay nothing in England and that Scotland does not charge for examinations, then give your own view with a reason.

From April 2026 larger NHS practices must set aside urgent appointments. Is that a good idea?

For: people in pain are seen sooner, fewer should end up at A&E or their GP with toothache, and £75 a course is well above the 1.2 UDAs it replaced (about £34 at the £28 minimum UDA value). Against: the money comes from within the existing contract, routine check-ups may be squeezed, and urgent care without a regular dentist can mean repeated short-term fixes. Name both, then suggest what would help.

Would you rather work in NHS or private dentistry?

Many dentists do both, so a mixed answer is credible. Show you know the trade-offs: NHS work reaches patients who could not pay privately and comes with structured early training, while private work usually allows more time per patient. Mention the planned requirement for new graduates to work in the NHS for a minimum period, and link your answer to something you saw on work experience.

For more practice, our NHS dentistry hot topics guide covers the issues these questions draw on, the dental school interview question bank has questions for every station type, and the dentistry ethical scenarios guide has worked answers to ethics stations.

Related guides

• NHS Dental Contract Reform 2026: What's Changing & Why It Matters: the companion guide to the 2026 reforms.
• The 9 GDC Standards & Principles: how dentists must balance commercial and patient interests.
• Dental Amalgam Fillings: NHS Dentistry Hot Topics: another dentistry interview topic that comes up often.
• Dental Tourism & NHS Crisis: Turkey Teeth Trends: how NHS access problems push patients abroad.