The National Health Service (Primary Dental Services and Dental Charges) (Amendment) (No. 2) Regulations 2026
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Change 1
7 Insertion of regulation 17B (complex care pathways)
After regulation 17A insert— Complex care pathways 17B (1) Where the contractor has determined that a patient satisfies the entry criteria for a complex care pathway as described in paragraphs (2) to (4) and should receive this course of treatment, the contractor must provide the patient with the dental services described in the appropriate entry of Table C in Schedule 2. (2) The entry criteria for complex care pathway 1 are that the patient— (a) is aged 16 years or older; and (b) has five or more teeth with caries into dentine that require treatment. (3) The entry criteria for complex care pathway 2 are that the patient— (a) is aged 16 years or older; (b) has five or more teeth with caries into dentine that require treatment; (c) has generalised unstable disease affecting at least 30% of all teeth; and (d) has unstable periodontal disease, as evidenced by one of the presentations described in paragraph (5). (4) The entry criteria for complex care pathway 3 are that the patient— (a) is aged 16 years or older; (b) has a periodontal probing depth of— (i) 5mm or more; (ii) between 5mm and 4mm with bleeding on probing; or (iii) less than 4mm and bleeding on probing with a first diagnosis of Stage I Grade C periodontal disease; (c) has generalised unstable disease affecting at least 30% of all teeth; and (d) has a first diagnosis of either— (i) Stage III periodontal disease, which includes any of the grades of disease listed in paragraph (6); or (ii) any of the diseases specified in paragraph (7). (5) The presentations that evidence unstable periodontal disease are— (a) periodontal probing depth of 5mm or more; (b) periodontal probing depth of between 5mm and 4mm with bleeding on probing and a diagnosis of Stage II Grade B periodontitis, or of a higher classification; or (c) periodontal probing depth of less than 4mm and bleeding on probing with a diagnosis of Stage I Grade C periodontitis. (6) A reference to Stage III periodontal disease includes Stage III of either Grade A, Grade B or Grade C periodontal disease. (7) The diseases referred to in paragraph (4)(d)(ii) are— (a) Stage II Grade C; (b) Stage IV Grade A; (c) Stage IV Grade B; (d) Stage IV Grade C. (8) All references to stage and grade of periodontal disease in this regulation are to be read in accordance with the system of classification provided in the flowchart titled “Implementing the 2018 Classification of Periodontal Diseases to Reach a Diagnosis in Clinical Practice”, produced by the British Society of Periodontology and Implant Dentistry and published in 2024. (9) The date of commencement of the complex care pathway is the date of the initial examination and assessment of the patient at which it is determined by the contractor that the patient satisfies the criteria for the complex care pathway and should receive this course of treatment. (10) A contract must contain terms giving effect to what is specified in this regulation and in Schedule 2 in so far as those terms are relevant to complex care pathways. .
7 Insertion of regulation 17B (complex care pathways)
After regulation 17A insert— Complex care pathways 17B (1) Where the contractor has determined that a patient satisfies the entry criteria for a complex care pathway as described in paragraphs (2) to (4) and should receive this course of treatment, the contractor must provide the patient with the dental services described in the appropriate entry of Table C in Schedule 2. (2) The entry criteria for complex care pathway 1 are that the patient— (a) is aged 16 years or older; and (b) has five or more teeth with caries into dentine that require treatment. (3) The entry criteria for complex care pathway 2 are that the patient— (a) is aged 16 years or older; (b) has five or more teeth with caries into dentine that require treatment; (c) has generalised unstable disease affecting at least 30% of all teeth; and (d) has unstable periodontal disease, as evidenced by one of the presentations described in paragraph (5). (4) The entry criteria for complex care pathway 3 are that the patient— (a) is aged 16 years or older; (b) has a periodontal probing depth of— (i) 5mm or more; (ii) between 5mm and 4mm with bleeding on probing; or (iii) less than 4mm and bleeding on probing with a first diagnosis of Stage I Grade C periodontal disease; (c) has generalised unstable disease affecting at least 30% of all teeth; and (d) has a first diagnosis of either— (i) Stage III periodontal disease, which includes any of the grades of disease listed in paragraph (6); or (ii) any of the diseases specified in paragraph (7). (5) The presentations that evidence unstable periodontal disease are— (a) periodontal probing depth of 5mm or more; (b) periodontal probing depth of between 5mm and 4mm with bleeding on probing and a diagnosis of Stage II Grade B periodontitis, or of a higher classification; or (c) periodontal probing depth of less than 4mm and bleeding on probing with a diagnosis of Stage I Grade C periodontitis. (6) A reference to Stage III periodontal disease includes Stage III of either Grade A, Grade B or Grade C periodontal disease. (7) The diseases referred to in paragraph (4)(d)(ii) are— (a) Stage II Grade C; (b) Stage IV Grade A; (c) Stage IV Grade B; (d) Stage IV Grade C. (8) All references to stage and grade of periodontal disease in this regulation are to be read in accordance with the system of classification provided in the flowchart titled “Implementing the 2018 Classification of Periodontal Diseases to Reach a Diagnosis in Clinical Practice”, produced by the British Society of Periodontology and Implant Dentistry and published in 2024. (9) The date of commencement of the complex care pathway is the date of the initial examination and assessment of the patient at which it is determined by the contractor that the patient satisfies the criteria for the complex care pathway and should receive this course of treatment. (10) A contract must contain terms giving effect to what is specified in this regulation and in Schedule 2 in so far as those terms are relevant to complex care pathways. .
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