Please note that the Prior Approval limit may be subject to change following the new SDR and the information below will be updated. See our Dental Reform pages for further details.
Regulation 9 is the process for obtaining funding to replace lost/broken dentures, splints, bridges and orthodontic appliances, due to an act or omission by the patient. You must obtain the Regulation 9 decision from your NHS Board before submitting the claim for processing.
After you have received the decision from your NHS Board, submit the claim and add 'Reg 9 — NHS Board decision emailed' in observations. The NHS Board letter should then be emailed to email@example.com with 'Reg 9' and the patient's name in the subject field of the email. This must be sent from your NHS email address.
If the total value is over £600 (£430 for claims prior to 1 November 2023), prior approval must still be obtained irrespective of the Regulation 9 claim. However, if the appliance or prosthesis is the only item claimed on the form and is under £600 (£430 for claims prior to 1 November 2023), prior approval is not required, unless the regulation 9 item claimed requires approval.
In some cases, the dentist may make an agreement with the patient to accept a deposit up to the whole cost of replacement, to allow the treatment to commence in advance of the health board decision and in the event that NHS funding is refused and the treatment item is provided privately. If all or part of the funding is approved, then an appropriate amount of the deposit taken should be returned to the patient.