The limitations of home visits

Home visits are a last resort. They are for patients who genuinely cannot attend a dental practice — where the alternative would be no care at all. Wherever possible, we recommend being seen in a dental surgery, because treatment at home is more limited and carries more risk. This page explains those limitations honestly, so you can make an informed choice.

Why home treatment is more limited

Although we provide home visits to help those who cannot come to our surgery, treatment at home is often more difficult and may be compromised. Lighting, positioning, technique, equipment and materials can all be affected by working outside a clinical setting. In practice, what we offer at home is examinations (without x-rays), scale & polish, fillings, extractions, and dentures — including repairs, relines and adjustments. More complex, surgery-based treatment (and anything needing x-rays) still requires a practice.

The clinical limitations

• No x-rays. We cannot take x-rays at home, which limits our ability to diagnose problems and increases the risk of misdiagnosis, unnecessary treatment, or treatment not achieving the desired result.
• Positioning & access. We cannot lie the patient flat or move around them as we would around a dental chair, so access — and therefore care — can be compromised.
• Managing decline, not reversing it. We are often caring for failing teeth and deteriorating dentitions — relieving pain, helping with eating, and stabilising where we can. “Transitional dentures” (adding teeth to a denture as natural teeth are lost) are a sensible compromise, but they are still a compromise.
• Some treatment still needs a practice. More complex or surgery-based work, and anything requiring x-rays, cannot be done at home — so occasionally we may have to recommend extracting a tooth that, in a fully equipped surgery, might have been saved.
• Limited materials, time & equipment. Vital equipment such as dental suction is not available on home visits. If, for example, bleeding is heavier than expected after an extraction, the lack of stitches, suction and clinical staff can add risk to the patient’s health.

Why a quote can only ever be provisional

There are an unlimited number of reasons a quote may change. Common ones include:

• Assessment. The dentist’s opinion may differ from what you expected, and the treatment plan (and price) will reflect that.
• Blood thinners. Please tell us immediately if the patient is on blood thinners — an extraction may then need extra treatment such as collagen pads and stitches.
• Treatment that cannot proceed. Occasionally we attend but cannot proceed (e.g. unable to obtain adequate consent, access, or due to complex medical history). The plan may be aborted and the call-out and assessment fees remain payable.
• Aborted treatment. Limitations such as no x-rays, restricted access or movement, or no suction mean treatment sometimes has to be stopped partway, or extra procedures become necessary, affecting the cost. If treatment is aborted due to complications, fees are not refunded.
• Dentures — special trays. Dentures from a single impression are less accurate; a second impression using a custom special tray may be needed (£35 per denture).
• Dentures — extra adjustment visits. It is normal to need extra visits to adjust fit or bite. We quote a minimum of 4 visits to make a denture as standard, but additional visits may be required and are chargeable, including further call-out charges.
• Dentures — fewer visits. Sometimes a denture can be relined, adjusted or have teeth added, or needs fewer visits — and the cost is reduced accordingly.
• Change of location. If treatment starts in hospital and continues at home after discharge (or the visit address changes), the price of call-outs will vary to meet our standard home rates.
• Other. These are the most common reasons; others may apply to your individual circumstances and we will always discuss them with you.

You always have the choice of the practice

Patients can choose to be treated by a specialist, or in a clinical practice, at any time — just discuss it with us. If a patient could be transferred to a clinical practice (for example by patient transport services) but chooses to use our home-visit service instead, they must understand and accept the limitations described here. The decision about where treatment happens rests with the patient.

Because home visits require significant time, we often cannot offer specific appointment times and may need some flexibility when arranging and keeping appointments.

Useful oral-health information

You may find these helpful:

• NICE guidelines — oral health for adults in care homes (NG48)
• Government guidance — Delivering Better Oral Health (prevention toolkit)

Appointments, notice & deposits

We require 48 hours’ notice (not including weekends) to change or cancel any appointment. We take deposits for appointments; if proper 48-hour notice is not given on time, these deposits become non-refundable. Full payment for the course of treatment is required in advance of the first visit.