Am I entitled to a bridge on the NHS?

[mazza1985]

Hi there

Back in 2003, when I was 17, I had a root canal done and it failed (ok, I whimped out at the pain!), and the tooth (upper 2nd right) was pulled. I was given a temporary denture, and told to return after 8 weeks foe a maryland bridge (I have a MASSIVE phobia of needles)

Simultaniously, my orthodontist decided my braces needed putting back on as my teeth shifted.

The next time I went to my dentist, I explained to him about the fuxed brace, and he told me it was not possible to have a maryland bridge with a brace as it is just glued on to the teeth at the back. We decided he was gonna keep filing down the denture as my teeth moved and eventually give me a bridge.

In 2004 I had to move to cornwall in an emergancy - please dont ask details as I really dont wish to go into it- and struggled to find a dentist. I still had my braces on , and still had the denture, until in 2005 it fell out my mouth when I was laughing, and was lost on the beach, nowhere to be found! I went to the dental access clnic in Plymouth, and they removed my brace and made me another denture, took a mould of my mouth and said they were gonna sort out another bridge for me.

Unfortunately for me I had a freaky ex byfriend who actually would not let me go back to the dentist! I moved to bristol (and escaped the ex) in 2006, and had a really really REALLY bad year, so my teeth were the last thing on my mind! In the middle of 2007 I started trying to find a nhs dentist, and finally got one in september this year.

I have asked my dentist for a bridge, and he has said no because I have a denture, even though it is pretty obvious it is a denture, and because I refuse to take it out in front of my partner as I am so ashamed and embarressed, which means I never take it out beause we live together, Im constantly getting fungal infections underneath the plate! Where as my boyfriend, who is with a different dentist, is having a back tooth removed and has been offered a bridge on the NHS!

I dont understand why, if my boyfriend is entitled to one, Im not? Is it worth me fighting my case?

[Toothsmith]

If there is a medical reason for a bridge to be necessary, then you're entitled to it on the NHS.

I can think of very few reasons for a bridge to be necessary though.

The dentist is entitled to provide you with the simplest treatment necessary to get you dentally fit, and from what you say, that would probably be a new denture.

Could you go and see your boyfriend's dentist? He sounds like he's prepared to be a bit more flexible, and put patient's interests above the 'rules'.

[tirednewdad]

The only reason that i can think of where a bridge might be neccessary is if it is effecting your diet. If you are getting a lot of fungal infections then you need to look at how you are looking after the denture
Take it out at night (probably what your worried about)
Clean it everyday
Antifungal cream to deal with the immedaite problem.

Depends on your age but the younger you are the more likely you will find a NHS dentist who is sympathetic to your bridge.

You also said that your teeth got into a bit of a mess last year. Now i have to admit, if i had a patient who's teeth were a bit of a mess and they asked for a bridge i would probably refuse- even if i'd done all the work first to put things right.
I would want the patient to show a long term comitment to looking after their teeth well for a long period of time before considering anything like a bridge. This might take a number of regular check-ups with little work needed before committing to it.

The best advice i can offer you,is too talk it through with your dentist, brush your teeth really well, floss everyday. If they still refuse then find someone else.

[coldstreamalways]

What if they make you a bridge and then you have to move away again or have a bad year? Then the dentist can't even cover the cost of making the bridge as he hasn't fitted it and therefore can't claim his UDA's or whatever ridiculous NHS system the government has forced into action now.

I would agree with Toothsmith and TND, you almost certainly need to show some commitment before getting a bridge even privately, let alone on the NHS. Bridges need maintenance too and if you're not looking after your denture properly, that's not a good start.

[mazza1985]

The only reason that i can think of where a bridge might be neccessary is if it is effecting your diet. If you are getting a lot of fungal infections then you need to look at how you are looking after the denture
Take it out at night (probably what your worried about)
Clean it everyday
Antifungal cream to deal with the immedaite problem.

Depends on your age but the younger you are the more likely you will find a NHS dentist who is sympathetic to your bridge.

You also said that your teeth got into a bit of a mess last year. Now i have to admit, if i had a patient who's teeth were a bit of a mess and they asked for a bridge i would probably refuse- even if i'd done all the work first to put things right.
I would want the patient to show a long term comitment to looking after their teeth well for a long period of time before considering anything like a bridge. This might take a number of regular check-ups with little work needed before committing to it.

The best advice i can offer you,is too talk it through with your dentist, brush your teeth really well, floss everyday. If they still refuse then find someone else.

Where does it say that my teeth got into a mess last year? I decided to find a dentist for a rountine check up, as I had not been for 2-3 years. It turned out I did need a small filling, but that was on my bottom jaw anyway. I do brush my teeth twice a day, use mouthwash and floss!

The issue with my denture is the fungal infections, which would be resolved if I had a bridge as I wouldnt be sleeping with my denture in due to the sheer embarresment of having a front tooth missing at 23! The reason why I have a denture is because there was not time to have a bridge made in Cornwall.

And as for having a bad year I apologise to my previous dentist that I was nearly murdered by my ex and attacked maliciously in front of his children, but quite frankly my teeth were the last thing on my mind to be honest with you! And I still would have made payment if it had been asked for? So I get penalised for having a bad life, is that it?

I havnt even been offered a better denture! Its blatant that the one I have is exactly that- false. And its not even like the dentist wouldnt get paid for doing it- if its about necessity, because its one tooth they could turn around and say I dont need one at all!

If its the sad case that a 23 year old cannot get a bridge on the nhs for a FRONT tooth then I might as well quit my job and stop paying NI contributions- whats the point?

[knitknack]

aaaaaaaaaaaaaaa

[alison999]

The issue with my denture is the fungal infections, which would be resolved if I had a bridge as I wouldnt be sleeping with my denture in due to the sheer embarresment of having a front tooth missing at 23! The reason why I have a denture is because there was not time to have a bridge made in Cornwall.

I havnt even been offered a better denture! Its blatant that the one I have is exactly that- false. And its not even like the dentist wouldnt get paid for doing it- if its about necessity, because its one tooth they could turn around and say I dont need one at all!

If its the sad case that a 23 year old cannot get a bridge on the nhs for a FRONT tooth then I might as well quit my job and stop paying NI contributions- whats the point?

Unfortunately with NHS dentistry they will only fund the work you clinically NEED, not what you want. Have you thought about saving and having one done privately? Very little of your NI contributions actually go towards dentistry which is why its in the mess it is now. If your boyfriend really loves you he probably wont care if you take your denture out at night (its dark anyway) and if you plan on being with him forever then the sooner he gets used to it the better! You have to put your health before beauty

[mazza1985]

Im on a very tight budget (actually my outgoings are £200 more a month than what I currently have coming in) so actually I cant afford private.
When I start my new job (£5k more a year) next year I intend on going on denplan.

My argument is that clinically it IS necessary due to anxietys about taking it out and the resulting infections caused by that. My boyfriend doesnt care, but thats not the issue- the issue is that I care, call me vain, I probably am, but who doesnt want to look their best?

And actually, I have contacted PALS who think I have a good case for one! I wanted to know is it possible, and it seems like it is so Im going to fight my corner for it now!

[feelinggood]

Mazza, another option might be to look at over coming the anxiety issue, instead of aiming to get a bridge. Have you spoken to your GP about how you feel? If it is affecting your life to the point where you are damaging your health (and if you are getting infections, perhaps you are) then hopefully your GP should be able to refer you to someone who can help.

[dmg24]

Im on a very tight budget (actually my outgoings are £200 more a month than what I currently have coming in) so actually I cant afford private.
When I start my new job (£5k more a year) next year I intend on going on denplan.

My argument is that clinically it IS necessary due to anxietys about taking it out and the resulting infections caused by that. My boyfriend doesnt care, but thats not the issue- the issue is that I care, call me vain, I probably am, but who doesnt want to look their best?

And actually, I have contacted PALS who think I have a good case for one! I wanted to know is it possible, and it seems like it is so Im going to fight my corner for it now!

I have had crowns fitted due to psychological issues, so it is definitely possible.

Hope you get it sorted x

[tirednewdad]

[quote=mazza1985;16545421]Where does it say that my teeth got into a mess last year?

Sorry i missread. Your post. When you said you were having a really bad year- i thought you were talking about your teeth.

What i said would still apply generally though. Your dentist has to offer you an NHS option of a bridge providing Oral care is excellant. He can do this either at his surgery or by refferal to another dentist. Ring the local health board who could well back you up.

[alison999]

I have contacted PALS who think I have a good case for one! I wanted to know is it possible, and it seems like it is so Im going to fight my corner for it now!

But they are not dentists, if the dentist believes the bridge doesnt have a good prognosis then he doesnt have to do it. I agree about seeing your GP about your anxiety. The problem with the infections is that they are being caused because YOU wont take your denture out at night, going against your dentists advise.

[Toothsmith]

The other thing about providing a bridge is that it will damage teeth either on one or both sides of the gap.

Even something like a Maryland (stick-on) bridge does a little damage.

A dentist wouldn't be oing his/her job right if they chopped up teeth at the drop of a hat to provide treatments that they are not sure are in the best interests of their patients.

I have quite a few ladies with dentures who keep them in 24/7 despite my advice. None of them throw up repeated candidal infections.

With a well fitting denture, and good mouth cleaning, there really shouldn't be any problem.

Obviously, I haven't seen you, but from what you describe, if you walked into my surgery tomorrow, I'd probably suggest a new denture as a first step, with the possibility of a bridge later on if mouth cleaning was then good enough to keep it all healthy. But I don't have to worry about what is and isn't allowed on the NHS - just what's best for patients.

The 'psycological' reasons for needing a bridge really aren't worth persuing unless you're prepared to get psyciatric reports. (?sp!) Believe it or not, 'needing' a treatment for psycological reasons is a well trodden path, and one the NHS is on to!

I think being 23 and having a front tooth missing IS reason enough to qualify for a bridge - just not necessarily yet. I would go with it for now. It probably is in your best interests for now.

[mazza1985]

The other thing about providing a bridge is that it will damage teeth either on one or both sides of the gap.

Even something like a Maryland (stick-on) bridge does a little damage.

A dentist wouldn't be oing his/her job right if they chopped up teeth at the drop of a hat to provide treatments that they are not sure are in the best interests of their patients.

I have quite a few ladies with dentures who keep them in 24/7 despite my advice. None of them throw up repeated candidal infections.

With a well fitting denture, and good mouth cleaning, there really shouldn't be any problem.

Obviously, I haven't seen you, but from what you describe, if you walked into my surgery tomorrow, I'd probably suggest a new denture as a first step, with the possibility of a bridge later on if mouth cleaning was then good enough to keep it all healthy. But I don't have to worry about what is and isn't allowed on the NHS - just what's best for patients.

The 'psycological' reasons for needing a bridge really aren't worth persuing unless you're prepared to get psyciatric reports. (?sp!) Believe it or not, 'needing' a treatment for psycological reasons is a well trodden path, and one the NHS is on to!

I think being 23 and having a front tooth missing IS reason enough to qualify for a bridge - just not necessarily yet. I would go with it for now. It probably is in your best interests for now.

Thanks for your comments, its not repeated infections I've just had a couple in the last year, and I'm just really annoyed at the moment as my mouth is so sore im finding it difficult to brush my teeth properly.

Im aware that bridges cause damage to teeth, which is why I've been willing to wait to have one done. I've actually been looking at financing it privately but my credit rating is so poor I just cant get finance!

I just feel really let down, I was promised it one minute and now it has been taken away! I could switch dentists but I've already paid £44 for fissure sealents and cannot afford to start again.

Also, if my dentist suggested a new denture, I would refuse as it would be the same cost to me to get a bridge done! If the dentist had said "ok, well we will moniter it for 18 months and then if you have looked after everything to a high standard I will consider it" then that would have been but he wont consider it at all, yet he wants to do fissure sealents which arent clinically necessary anyway!

*sighs* :-(

[Toothsmith]

I would try changing dentists. Your BF's sounds a bit more tuned in.