It is legal requirement that a patient must check and carry a printed copy of all referrals to our clinic. If using either clinics web form then you must print a page for the patient when prompted. We have several options to refer to our clinics:

  • Via this website – please select the appropriate web form below and complete
  • Via post – please print off this PRINTABLE FORM
  • Via fax to the appropriate clinic (Patient must also carry a printed copy using this PRINTABLE FORM)
  • Via telephone to the appropriate clinic (Patient must also carry a printed copy using this PRINTABLE FORM)

Fortwilliam Web Form Ballymena Web Form Printable Referral Form

General Referral Information for Dentists

You can refer using our online form, by fax, by mail or even by telephone and referral-letter packs are available from the practice. Any radiographs that you can provide will save on radiation exposure and minimize patient’s costs. All treatment charges will be thoroughly discussed with the patient and a written estimate given, so there is no chance of any misunderstanding. Patients are always advised to attend recall appointments with you and, except during active therapy, they are reminded to continue seeing your hygienist.

Private fees guide 2016

Treatment Fee (£)
Specialist Consultation Implant £90
Exam + report (legal etc) £150
Panoral radiograph (no exam or report) £40
CT Scan- single arch £100
CT Scan- both arches £150
CT Scan inc report £200
Impacted Wisdom Tooth CT Scan £50
Biopsy/ Bact.Sample £90- £120

Surgery/ Implants/ Extractions/Augment

Treatment Fee (£)
Forceps Extraction £90
Flap/Bone Extraction £120
Multiple Extraction £400 max
Wisdom Teeth extraction £150
Buried Canine/ Supernumerary £200
Canine Exposure £200
£250 (if gold chain needed)
Ortho. Extraction £90- single tooth
£120- 2 teeth
£150- 3 teeth
£200- 4 teeth
Frenectomy £90
Implant Placement £1000
Exposure/ Impression £500
Restoration £450
Small Graft £300
Medium Graft or Separate Graft £600
Sinus Graft £1000
Free Gingival Graft £200
Wisdom Tooth Lower £150
Apicectomy £225
Oral Antral Fistula £200

Prosthodontics/ Crowns/ Bridges/ Dentures

Treatment Fee (£)
Crown Bonded/ Comp From £450
Core & Post From £150
Bridge unit (Br Bridge Retainer) From £450
(Bp Bridge Pontic) From £450
Full Arch Bridge (On Implants) From £10000
Denture retained by two Implants From £3000


Treatment Fee (£)
Consultation £90 if 1 tooth £150 if more than 2
Review £35
Root Canal Treatment £400- £550
Root Canal Re- Treatment £500- £650
Surgical Endodontics £400- £600
Core Filling £100
Investigation £200
Remove Post £200
Remove File £200


Treatment Fee (£)
Assessment (including x-rays) £125
Periodontal Treatment (2 sessions) £600 (£300/session)
Periodontal Treatment (4 sessions) £960 (£240/session)
Periodontal Review Visit £75
Soft Tissue Graft (Ctg/Fgg) £450
Periodontal Flap Surgery From £400
Crown Lengthening £350 (+ 50 each additional tooth)


Treatment Fee (£)
IV Sedation £120 for paying patient (NHS & PRIVATE)
Exempt Patients IV sedation £60
RA Sedation £60 for all patients