NHS Dentistry Patient Information

[Toothsmith]

I know there are lots of dentist threads I could have added this to, but I thought this deserved a thread on it's own.

THIS (http://www.primarycarecontracting.nhs.uk/uploads/Dentistry/what_you_need_to_know_about_changes_to_nhs_dentist ry_in_england.pdf) is the governments new patient information leaflet for the new NHS dentistry regulations starting in April.

I would be interested in your comments.

Yesterday, there was a meeting between the dentist's 'negotiating' team, and Rosie Winterton, the minister with responsibility for dentistry. (I put negotiating in marks, as there has been no negotiation with dentists over this contract at all. It's 'Take it or leave it'.)

The meeting was to urge her to abandon this new contract whilst there was still a few dentists doing NHS work. A pretty good report can be seenHERE (http://www.24dash.com/content/news/viewNews.php?navID=47&newsID=3151)


EDIT :- This leaflet was updated on March 22nd 2006. Updated version is HERE (http://www.primarycarecontracting.nhs.uk/uploads/Dentistry/march_uploads/mar_06_what_you_need_to_know_about_changes_to_nhs_ dentistry_in_england.pdf)

[Agutka]

Hi there,
Here are my uneducated, middle of the night comments:

Is it me or are these new charges a bit cheap? A fraction of the charges I have been paying my private dentist. Which means no money for the dentist and they will all follow you out of the system. My favourite bits are:
You will pay one charge even if you need to visit more than once to complete a course of treatment.

If you need more treatment at the same charge level (eg an additional filling) within two months of seeing your dentist,this will be free of charge.

So someone could have ten root canals for 42.40? Or the whole mouth crowned for £189? Interesting...
If these changes mean that (on average) patients need to attendless frequently than before, this will free up time for dentists to see more patients.

Oh-oh. I hope that works out well. I suppose that's one way to free up dentists for more patients - I don't feel comfortable with this though. Two years is an awfully long time to rely on good brushing - I know very well what happens to little ignored cavities...
Also the bit about better access? Sounds to me like there will be a lot of money with nowhere to go. Maybe they will spend it quickly, efficiently, but maybe they will sit on it and negotiate where best to spend... If your practice closes it doesn't say you'll have access, it says don't worry, the money is not in NHS hands anymore. Which means what to my toothache?

I can't help feeling I am better off with my private dentist, who will not be rushing off anywhere. I'll carry on saving the cash to pay for my next visit...

Good night!

[Nile]

Toothsmith, you are a star.:j

Thank you for starting this thread and providing the link to 'What you need to know about changes to NHS dentistry in England'.

I've had a quick read through it and I'm very surprised at the following statement:

From 1 April 2006, your dentist will NOT charge you for missed appointments - but if you continue to miss appointments they may decide not to offer you treatment.

I can imagine that NHS dentists will be delighted by this.:rolleyes:

[Toothsmith]

It does mean that a mouthful of crowns will 'only' cost £189 - if you can find a dentist to do it! because the dentist will get no more credit for doing 10 crowns as one. Yet the technicians fee for doing 10 crowns will still have to be paid.

I bet it will be far more likely that the 10 crowns will be done over a few years, costing the patient £189 EACH!

(Note, the dentist doesn't get to keep the £189 - that goes back to the Government. The dentist gets 12 points towards his 'target' though. If he doesn't reach his target, next year's funding is cut.

He would get 12 points for each crown if done seperately, or 12 for the treatment, if he did 10 crowns in one treatment plan! Which would you do??)

So - loadsacrowns would cost £189, but more likely for most people, a single crown, which today costs about £60 on the NHS would more than triple in price.

The same is true for fillings. If you need loads, £42.50. If you need one £42.50.
At the moment, a single filling on the NHS is about £15.

The funniest thing I think though is for dentures. If you need a new set because they're loose or worn out, £189. If you've 'lost' your dentures though, it will only cost £56!

How many people are going to turn up at their dentist without teeth and say they've 'lost' them I wonder!!! Will someone from the Department of Health turn up at their house to 'help them look for them? :rolleyes:

[Toothsmith]

Toothsmith, you are a star.:j

Thank you for starting this thread and providing the link to 'What you need to know about changes to NHS dentistry in England'.

I've had a quick read through it and I'm very surprised at the following statement:

From 1 April 2006, your dentist will NOT charge you for missed appointments - but if you continue to miss appointments they may decide not to offer you treatment.

I can imagine that NHS dentists will be delighted by this.:rolleyes:

I know! With the rest of the NHS plagued by missed appointments, they are stopping the one thing in the one part of the whole system that actually works to control it!!!

Shows the sort of Numptys we are up against! It would be funny if it were not for the fact these people actually have the power over who lives and dies in this country!

[Alison_B]

We were told at our dentist on Tuesday that nobody would actually be registered with a NHS Dentist but you would be free to visit any, provided you could get an appointment. If you phone up with a severe toothache, unless it was an absolute emergency, you would have to go on a waiting list to get an appointment and that could take weeks. Is this the true case, or just a receptionist that was getting into a bit of a state?

[Toothsmith]

You are right about registration ending (strange the don't mention that in the glossy govenment information pamphlet!). They have been far to embarrased by how few people are registered with an NHS dentist, so are stopping registration on march 31st. No-one will be registered!

The implications of this have yet to be seen. The idea is it will 'improve access' by making everyone equal, and you will have just as much chance of seeing your dentist as the person who never goes unless they have a toothache.

First come first served.

Brilliant eh?

[Joe_Bloggs]

It is clear to me that the Government Minister trusts dentists about as far as they can spit. Where did the animosity begin ? How can it be ended ?
I offer a few wikipedea links to the terms used by Toothsmith regarding 'root canal' (http://en.wikipedia.org/wiki/Root_canal) and 'dental crown' (http://en.wikipedia.org/wiki/Crown_%28dentistry%29). The former preceeds the latter in many cases.
I would like to point out that I have total respect for Toothsmith.
J_B.

[Toothsmith]

It is clear to me that the Government Minister trusts dentists about as far as they can spit. Where did the animosity begin ? How can it be ended ?
J_B.

Thank you JB!

You are right, and the dental profession probably trusts the DoH even less!

The sad thing is that the pilot arrangements for this new contract could probably have worked very well with a few tweaks and a fair bit more funding. (It needs more funding if all the dentists who have gone private are going to come back into the system with all their patients).

These are the pilots that the Minister is refering to when she says the new arrangements have been sucessfully piloted!

The problem is that this new contract uses Units of Dental Activity to measure how dentists are performing, and set targets. The pilot arrangements used 'courses of treatment'

Whats the difference?

A 'course of treatment' could be a good talk with a patient about brushing, or a filling, or a clean up. It was a 'bum on a seat'.

A Unit of Dental Activity is awarded for actual treatment, and very badly biased towards the very simplest, minimal, treatment. There is no credit at all for prevention. so when MPs proclaim how the new contract will help 'prevention' they are either badly informed, or blatently lying.

I must admit a wry smile crosses my face every time I read the phrase "I'm lucky, I have an NHS dentist" on these pages.

Come April, I don't think that phrase will appear quite so often!

[catowen]

You are right about registration ending (strange the don't mention that in the glossy govenment information pamphlet!). They have been far to embarrased by how few people are registered with an NHS dentist, so are stopping registration on march 31st. No-one will be registered!

The implications of this have yet to be seen. The idea is it will 'improve access' by making everyone equal, and you will have just as much chance of seeing your dentist as the person who never goes unless they have a toothache.

First come first served.

Brilliant eh?

So does this mean, that if you do not have an NHS dentist at the moment, as all the NHS dentists in your area have stopped taking new patients, that they now have no list, and will see all NHS patients, providing they can get an appointment??? This would be good for me, as there are no NHS dentists in my area taking new people on (if you can get an appointment!!!), but how can that be worked with regards to patients records!!!???

[Toothsmith]

So does this mean, that if you do not have an NHS dentist at the moment, as all the NHS dentists in your area have stopped taking new patients, that they now have no list, and will see all NHS patients, providing they can get an appointment??? This would be good for me, as there are no NHS dentists in my area taking new people on (if you can get an appointment!!!), but how can that be worked with regards to patients records!!!???

Yep!

Dental records don't follow people like medical ones. You start again with each new dentist.

There will be a huge free for all right up until the system collapses! Taking with it all those who have a 'regular' NHS dentist.

Enjoy!

[catowen]

So from the 1st April, anyone who wants to see an NHS dentist can just ring their nearest one and request an appointment!!!! I guess by 2nd April the majority of NHS dentists will have turned private!!!!
Its the governments way of getting rid of all of us who dont have NHS dentists, as we all will have now - except that we might have the dentist, but wont be able to get an appointment as they will be inundated. Wonderful!!!!!!! :wall:

[Dora the Explorer]

B****r Rosie - she's a b****y pest. In my unhumble opininion.

Nothing about oral health promotion? Umpteen fillings for peanuts? Replacement set of choppers for the price of a few packets of fags? PCT's will cough up enough the cash - yeah right. Rosie has nicely set this up to fail, what's the hidden agenda?

I'm fed up to the back teeth (minus my ul8, ur8, ll8,lr8 :D ) with this government's incompetence in all areas of health particularly when I read today it's costing DOH £600,000 A DAY NOT to start the Barts hospital new build :eek: :eek: :eek:

Thanks for the headsup Toothsmith, I'd tear my hair out by the roots about the DOH, except I've had sight of the NHS wigs !!

[catowen]

B****r Rosie - she's a b****y pest. In my unhumble opininion.

Nothing about oral health promotion? Umpteen fillings for peanuts? Replacement set of choppers for the price of a few packets of fags? PCT's will cough up enough the cash - yeah right. Rosie has nicely set this up to fail, what's the hidden agenda?

I'm fed up to the back teeth (minus my ul8, ur8, ll8,lr8 :D ) with this government's incompetence in all areas of health particularly when I read today it's costing DOH £600,000 A DAY NOT to start the Barts hospital new build :eek: :eek: :eek:

Thanks for the headsup Toothsmith, I'd tear my hair out by the roots about the DOH, except I've had sight of the NHS wigs !!

I couldnt agree more, if i didnt come on this website i wouldntve known any of this, and i read the papers and watch the news, funny how the government arnt shouting this from the rooftops if its such a good thing!!!!!! Guess they know that its one big !!!! up!!!!!

[Toothsmith]

So from the 1st April, anyone who wants to see an NHS dentist can just ring their nearest one and request an appointment!!!! I guess by 2nd April the majority of NHS dentists will have turned private!!!!
Its the governments way of getting rid of all of us who dont have NHS dentists, as we all will have now - except that we might have the dentist, but wont be able to get an appointment as they will be inundated. Wonderful!!!!!!! :wall:

The best summary of the current situation I have read!!!

Go to the top of the class! :iloveyou:

[bank_of_slate]

I have to add that all the dental practices that I work with ALL the staff are very nervous about the changes and are very worried about explaining it to the patients, especially the receptionists who have to put up with violence and aggression on a daily basis!

There was a 'consultation period' for the changes which was more or less underground as Rosie Winterton's statement on the 7.7.05 was completely forgotton as the news of the terrorists attacks in London broke.

However you feel about the changes, please remember that it is NOT the receptionist's fault, any members of the public displaying aggression towards dental staff will not be tolerated.
...Linda xxx

[Tajak1000]

So does this mean, that if you do not have an NHS dentist at the moment, as all the NHS dentists in your area have stopped taking new patients, that they now have no list, and will see all NHS patients, providing they can get an appointment??? This would be good for me, as there are no NHS dentists in my area taking new people on (if you can get an appointment!!!), but how can that be worked with regards to patients records!!!???

NHS dentist closed their lists because they were full. Most operate waiting lists, a place on which is by referal by an exisitng patient of the practice only. The new contract will not improve access because:


thousans of kids are about to lose thier NHS dentist because their dentists will no longer be allowed to see them
At least 30% of exisitng NHS dentist will leave the system
The increased number of new dentists being trained won't be in the system for another five years
Many of the overseas dentist recruited by the DOH are leaving after finding working conditions intolerable
Dentists have the same rights in the new contract as to who they treat as they do now.
There will be plenty of access centres, which cost 20 times more to treat patients than exisitng NHS dentists
The money for dentists will come from Primary Care Trusts, many of which are close to bankruptcy
In three years, the money for dentistry can technically be spent on whatever the Primary Care Trust (PCT) wants - so will it be spent on teeth or a short fall in Cancer care?


So in answer to your question, no you won't find it any easier to find an NHS dentist. My PCT has verbally told me not to take any more patient on as they don't have the money.

It's a farce, and it will be the general public who will suffer.

[cubegame]

What are the implications of this for someone (me) who's just registered for an NHS dentist?

It's not a problem to find one in my area of the South East so I registered and got an appointment within 3 weeks.

Am I going to cease to be registered in just over a month?

Am I going to turn up, have a check up and then be offered the choice of a private plan or nothing?

And one final question, am I right in thinking that if my course of treatment starts BEFORE the 1st April (with my check up on March 15th) it will go to it's completion under the old charging system?

[Teerah]

What are the implications of this for someone (me) who's just registered for an NHS dentist?

It's not a problem to find one in my area of the South East so I registered and got an appointment within 3 weeks.

Am I going to cease to be registered in just over a month?

Am I going to turn up, have a check up and then be offered the choice of a private plan or nothing?

And one final question, am I right in thinking that if my course of treatment starts BEFORE the 1st April (with my check up on March 15th) it will go to it's completion under the old charging system?

Hi cubegame, the only place to find the answers to these questions is actually to contact your dental practice. They are the only ones who can tell you if they are signing up to the new contract or not. In either case, you will no longer be "registered" as this will cease to be under the new regulations.

[LondonDiva]

My PCT and the neighbouring couple have yet to finish signing their dental contract.

I can't believe they're not allowing charging for missed appts, missed appts are so out od control that I was hoping it would be extended to other NHS services like GPs and hospitals :(

[ashley0611]

Does anyone please have a link on how Scotland will be affected by this change. I visited my dentist today (NHS) and have been quoted £340 - £380 for 4 crowns to be carried out. I am now a bit confused and feel a bit hard done by.

[Teerah]

Does anyone please have a link on how Scotland will be affected by this change. I visited my dentist today (NHS) and have been quoted £340 - £380 for 4 crowns to be carried out. I am now a bit confused and feel a bit hard done by.


I believe the new contract applies to England and Wales only.

[elliejane]

I have to add that all the dental practices that I work with ALL the staff are very nervous about the changes and are very worried about explaining it to the patients, especially the receptionists who have to put up with violence and aggression on a daily basis!

There was a 'consultation period' for the changes which was more or less underground as Rosie Winterton's statement on the 7.7.05 was completely forgotton as the news of the terrorists attacks in London broke.

However you feel about the changes, please remember that it is NOT the receptionist's fault, any members of the public displaying aggression towards dental staff will not be tolerated.
...Linda xxx

Our practice has just gone private after more than 20 years of being almost solely NHS and we have had very few complaints and almost no agression from our 3500 patients, many of whom are signing up to the Denplan scheme we are recommending. They seem to know the score and understand the reasons for the dentist's decision.

It is sad though, as some patients who have been with us for a very long time feel they can't afford to pay privately. The new contract is not fair to patients or dentists though. Patients have been asking how much it will be for a private extraction and we have been telling them ONE simple private extraction is likely to be less than the new NHS charge, as ONE simple filling would be. I know the NHS price is the same for one filling as for ten, but if you go to the dentist regularly how often do you need to have ten fillings all at one go?

The new contract seems to be the one area of the NHS where people are encouraged to neglect their (dental) health.

Does the government really want dentists to leave the NHS so they can spend the money on other aspects of the Health Service? By constantly harping on the £80,000 dentists who accept their contracts are likely to earn are they trying to put the blame on the 'greedy' dentists who are leaving the NHS in droves (and they are).

Is this part of a plan, I wonder? :( :( :(

[Toothsmith]

An excellent article from THE TIMES (http://www.timesonline.co.uk/article/0,,8122-2089458_1,00.html)

[Toothsmith]

And THE SUNDAY TIMES (http://www.timesonline.co.uk/article/0,,2087-2092584,00.html)

[Dora the Explorer]

Thanks TS - I think the penny will drop for most people when they try and make their next appointment. I don't know yet which way my practice will jump. The PCT that funds it also funds the local hospital trust which has one of the biggest deficits in the country and the practice is sited next to one of the most deprived wards in the country. We live in strange times.

[Toothsmith]

The Dental Money is allegedly 'ring fenced' for 3 years. This is wonderful managementspeak for 'it can't be spent on anything else'.

One of the reasons so many dentists are deciding to bail now is because it is ONLY ring fenced for 3 years. God knows what will happen after that.

Dentistry or cancer treatment - you decide!!!!

[loopy_lou]

At my dentist they told me that they 'don't do dentures on the NHS' does this mean they will have to after 1st April????

[Dora the Explorer]

Yeah, and we all know that nhs fences have gaps !

[Toothsmith]

At my dentist they told me that they 'don't do dentures on the NHS' does this mean they will have to after 1st April????

If you are an NHS patient then you are entitled to all your treatment on the NHS. The dentist is breaking his terms of service by refusing to do certain things on the NHS. This is true now, and after April 1st.

The fact is that it will cost him more to provide a set of dentures on the NHS than he would get in fees for doing them, but it is still against the rules.

If you complained though, the likely outcome would be another dentist going fully private.

It is very sad when the only way the NHS can work is by selectively ignoring the rules. Part of the problem with the new contract is the rules are much tougher.

[SparkyG]

Have just been informed by my dental practice that they will be totally private from 1st April. A very comprehensive letter outlining their reasons, which are exactly as Toothsmith has stated.

One puzzling thing though: It states: "All current NHS registered children will continue to be treated on the NHS" Didn't think that was allowed?

I think my excellent practice (have been a private patient there for 6 years), must have some of the cheapest charges in the country!!! For example:

Check-up £15
Scale and polish £27
Composite fillings £58 - £88
Empress Veneers £310

Took my granddaughter there last month and was charged £6 (going up to £7 in April) for a child's check-up. Unbelievable!!!

[Toothsmith]

It is possible to get 'Child Only' contracts. But if you're taking on new patients, you can't just take on children of your private adults. You have to take any child that wants to come.

If you don't take on any new patients you can get away with it.

It does mean you have to dance to the tune of the new contract though, so this is why it's being totally rejected by many dentists.

[carl310166]

Can i ask Toothsmith a question?

I received a letter from my dentist this morning.

I advises that the government is introducing changes etc...

and they are offering dental plans,

option 1 for £12.99 per month

Regular examinations,scale and polish and 20% off treatments etc

option 2 for £4.99 per month

soft tissue exam etc

option 3 for £100 per year

registration etc

Is this a plan that most dentists are introducing?

Personally,i avoid the dentist if at all possible (i know)due to several bad experiences,but my wife has regular checkups etc,is it possible to give any advice as to whether this is good value?

[penrhyn]

Is this for private treatment carl?
My denplan insurance currently costs me £16 a month.

[carl310166]

Is this for private treatment carl?
My denplan insurance currently costs me £16 a month.

Hi,
Yes,i think so,but it does not include treatment.

Do you get any treatment in the 16ppm?

[carl310166]

I am wondering if it cheaper (it is MSE after all) to join HSA or similar?

[penrhyn]

Hi Carl,

Yes everything is covered under the monthly premium.
Exactly how much you pay depends on the state of your teeth when you take out the policy. This is done by your dentist at the outset so you know what your outgoings will be.

Denplans website: http://www.denplan.co.uk/

[Toothsmith]

Can i ask Toothsmith a question?

I received a letter from my dentist this morning.

I advises that the government is introducing changes etc...

and they are offering dental plans,

option 1 for £12.99 per month

Regular examinations,scale and polish and 20% off treatments etc

option 2 for £4.99 per month

soft tissue exam etc

option 3 for £100 per year

registration etc

Is this a plan that most dentists are introducing?

Personally,i avoid the dentist if at all possible (i know)due to several bad experiences,but my wife has regular checkups etc,is it possible to give any advice as to whether this is good value?

This sounds like a 'maintenance plan'. It's a sort of half way house between paying as you go and a full capitation system where treatment is all included in the monthly payment.

It's a pretty good system.

Dentists often choose the system that they feel comfortable selling to their patients. The one that they feels will be best value for money for the patient, and yet generate the income the practice needs in order to offer the level of care that they want.

If you are happy with your dentist it is best to go with the scheme they recommend. I think it would be a bad idea to search for the scheme you want whichever dentist is offering it!

Dentists rarely offer a range of schemes, as the complexity of the administration of lots of different methods would be horrendous. Explaining the ins and outs of capitation over maintenance as against fee-per-item would take so much time!Plus, each scheme has it's own admin charges to the dentist, and these get cheaper as more patients sign on. So, if one place had loads of schemes, then each would be running high admin charges, and ultimately this would cost the patient even more.

So yes, your scheme is in line with what many dentists will be offering. Those who do a scheme will almost certainly offer a fee-per-item (FPI) option as well, although there may be some that don't. Some people have insurance based schemes (Like HSA) which would mean that they could claim back the FPI charges.

If you go fee per item though, make sure any insurance you have has enough cover should a big treatment plan be needed (e.g. if you had a bad accident) or that you have enough money saved up in case the worse should happen.

Other than that, it would really be best to go with the dentist's recommendation. If you are unhappy with things at your practice generally, now may be a good time to change. Maybe even go back to a dentist who you were happy with, but you left when he/she 'went private'. (Not necessarily you Carl, I'm talking generally now)

We're not going to laugh and say 'we told you so!!' (Well not to your face!!!!!!!!)

[carl310166]

Thanks Toothsmith,very helpfull !

[Get Real]

Wow ! This thread is brilliant. . . . . amazing what subjects are now covered on the moneysaving forums.

My partner and I have just, rather reluctantly, signed up with Denplan and jointly pay £35 per month. Yet another bill to add to a growing list, but we both felt that the time had come when we needed better dental care than was available from the NHS. It only became apparent to me in recent months when I researched this topic, just how NHS dentistry has become "fix it once it's broken" and how much more private practice focuses on prevention and maintaining tooth and gum health. I only wish we had been aware of this earlier.

I'd like to say a big thank you to the OP because what he's saying is vindicating our decision to become private patients.

[bank_of_slate]

Department of Health correction in patient leaflet!!!!

The Department of health have issued a new version of the patient leaflet which is on their website.

The new one has removed the £56.70 for replacing lost/broken dentures as we 'misinterpreted' it (not that they explained it badly in the first place at all!!!!!)

To have the appliance (denture, brace etc) replaced a patient can appeal to the Business Services Authority and wait for their approval
or
pay the dentist a band 3 charge of £189 and appeal to the Business Services Authority afterwards for a full or partial refund!!
...Linda xx

[Toothsmith]

Thanks BoS.

I have put a link to the new leaflet in my original post at the start of the thread.

For those that begin on the last post of a thread, the new leaflet is HERE (http://www.primarycarecontracting.nhs.uk/uploads/Dentistry/march_uploads/mar_06_what_you_need_to_know_about_changes_to_nhs_ dentistry_in_england.pdf)

[mellyp]

people with good oral health may only need to attend once
every 12 to 24 months. - taken from the leaflet link provided by Toothsmith.


Myself and my husband signed up to Denplan with our dentist late last year and pay £26 a month (for the 2 of us), Category B of possible Categories A-E, which i would say means we have quite good oral health - tell me if i'm wrong Toothsmith!!!

We went to the dentist yesterday and my husband has a filling that has fallen out and needs to be replaced. Our last appointment was only Sep last year (6 months ago).

If we went by the information quoted above in the leaflet, he would not have to be seen until Sep this year or later!!!! UNBELIEVEABLE!!! 12 months is far too long between appointments IMO.

[Toothsmith]

Exactly right! This is a political decision, based on no evidence other than dental planning is a right !!!! up, and there aren't enough dentists to go round.

Who would be sued when the 'advice' to only attend every 24 months causes someone harm though? The DoH? NICE? No - The dentist. This is why only the brave the foolish or the desperate are having anything to do with the 'new ways of working'. The rest are going private.

I have a very well maintained, intelligent and dentally aware group of patients. I only have about a dozen that I consider good enough to go a year between check ups. I have a few others who consider themselves good enough to go a year, but I stress that I would prefer to see them twice a year, so that I can't be blamed if anything untoward happens!

I would not dare suggest a recall period of 24 months to anyone.

I honestly believe that anyone who places any value in having their own teeth should be looking for a decent dentist outside of the NHS NOW. Whilst there are still places available.

[Sofa_Sogood]

Toothsmith? Or BG's?

Can't this (or the new link) be made a sticky?

At least that way, you (or Teerah and all dentists that post?) can always be found?

Thanks :)

[Toothsmith]

ITN today will be doing a lot of pieces about dentistry.
Judging from GMTV this morning it will be quite well informed.

Did anyone else see my friend Tariq's little hand jesture whilst the Chief Dental Officer Barry Cockup (Sorry Cockcroft) was speaking???

[HappyShopper3]

I had a good dentist for 15 years and had to find another one when he left the NHS. I've been with my present dentist for a year and now he is leaving the NHS, along with the practice because of the new dentist's contract that is coming out.

So, I'm now without a dentist and here in Gloucester there are NO dentists taking on NHS patients whether you pay something towards your treatment or otherwise. The only option are the dental access centres. I registered with one today and have to wait one year to 18 months to see their dentist.

I got a leaflet from my last dentist about Denplan, but I'm really not sure if it's good value. For £9.90 a month you are only getting 2 checkups included in that price and one hygienist appointment plus all necessary xrays. Fillings are not covered by this and it states any treatment required is charged on a time basis at their private rate less 20%.

Are there other plans that cover such things as fillings, and even cosmetic work?

[Dora the Explorer]

ITN today will be doing a lot of pieces about dentistry.
Judging from GMTV this morning it will be quite well informed.

Did anyone else see my friend Tariq's little hand jesture whilst the Chief Dental Officer Barry Cockup (Sorry Cockcroft) was speaking???

Saw it - and I don't think the great British public will put it on their radar, until they get toothache.
I was interested to hear that private treatment will probably cost 33% more than previous nhs charges, which is a darn sight less than the recent power increases and not too many people marching in the streets about those.
Rosie doing her usual schtick - I wish Paxman would give her a good going over.

[Toothsmith]

There are other plans, but you would have to find another dentist who provided them.

To me, £9.90 a month seems very good value. I'd stick with it.

Avoid the sugary stuff, and you won't need the fillings!!!

[Toothsmith]

Saw it - and I don't think the great British public will put it on their radar, until they get toothache.
I was interested to hear that private treatment will probably cost 33% more than previous nhs charges, which is a darn sight less than the recent power increases and not too many people marching in the streets about those.
Rosie doing her usual schtick - I wish Paxman would give her a good going over.


Rosie is well known for 'not being the sharpest knife in the draw'

She is rarely put up head to head with anybody who really 'knows' anything.

I've been trying to get myself on telly with her for ages!

[Dora the Explorer]

Then you'll be overjoyed to know she was given a serious going over by delegates at a mental health conference last year - users, carers, docs, nurses, LA and PCT reps. It was a joy to behold and lo..........draft mental health bill scuppered !
As you know, she worked for Two Jags for years - excellent learning opportunity for communication skills !
You don't really want to be on telly with her, do you? Why lower your standards.

[Toothsmith]

January 3rd 1987.

My first day of work with an NHS Contract.

March 30th 2006.

My last day of work with an NHS contract.

[penrhyn]

Will going private help you with dating the lovely Leela?

[Toothsmith]

I'm sorry, have I missed something?

Mrs T.S. would be cross!!!

(Or should I say the CURRENT Mrs T.S would be cross!?)

[scope]

Shame I didnt know this sooner.. I've just managed to register with a NHS dentist and is nearly finished with a treatment (3 fillings).. But since my last appointment (1 filling) is next week it seems I have to pay the full £42 for the last filling, even though I have already paid for the xray, diagnosis, 2 other fillings, etc.. I rang to check if I could pay only for the filling (around £15), but the dentist havent come back to me yet.. Not just that, but I paid some £45 just to register.. Should have lived with the pain for a few more week, eh? :)

[melancholly]

just thought i'd bump this up and try to pick people's brains!

i need to have a check up with a dentist but i'm nervous - i've moved from where i lived for years and about 18 months ago tried to register with local NHS dentists (before the bizarre system change) but all said they were full. i went to a private practice who said i needed 3 fillings at some vast cost. i found another dentist who gave a second opinion - one 1 filling needed....... and this dentist (further from where i live) accepted nhs patients so i had the work done there. the filling was fine, but the surgery was just a bit old and not very modern.... there was no suggestion of a scale and polish or anything like that, and i was also wondering why this dentist could have places left for nhs patients when no-one else did.........(is that unfair?!)

so (ramble over) - how do i pick a dentist that i can trust not to quote me unecessary work and that will be good?! i've spoken to neighbours and they either haven't seen a dentist in years :eek: or use one near their work that is miles away.

[Toothsmith]

Why do you assume the 3 fillings is unnecessary?

Could it just have been that that dentist took his time and was more thorough?

He should be able to show you where the fillings are, and give you some evidence of them, either with a mirror, X-ray, or even an intra-oral camera.

Different dentists often give different treatment plans. Whether to take a drill to a tooth is a very subjective decision - it is not an exact science.

Any dentist should be able to explain the reasons behind his/her thinking though.

P.S. Thanks for finding this thread again. I was looking for it a few days ago - and couldn't find it!

[melancholly]

Why do you assume the 3 fillings is unnecessary?

Could it just have been that that dentist took his time and was more thorough?

He should be able to show you where the fillings are, and give you some evidence of them, either with a mirror, X-ray, or even an intra-oral camera.

Different dentists often give different treatment plans. Whether to take a drill to a tooth is a very subjective decision - it is not an exact science.

Any dentist should be able to explain the reasons behind his/her thinking though.

P.S. Thanks for finding this thread again. I was looking for it a few days ago - and couldn't find it!
ther first thing the dentist asked me was whether i was referred to them or whether i just noticed the surgery.... bit odd! i appreciate it's subjective, but being told that 2 teeth on opposites of my mouth needed fillings within a month versus only one that's not yet urgent is quite dodgy............. and when the one quoting more work means i pay more - you can see how it looks! i don't think this is a reflection on most dentists btw - it's just so difficult when you have to put your trust in a stranger with no insight yourself!

[Toothsmith]

That's not actually an unusual first question!

It's often quite revealing as to why a patient comes to you in particular, as opposed to anywhere else, it also can lead nicely into questions about previous dental history.

And if another patient has recommended someone, it is nice to thank that patient when they are next in.

I agree that finding a dentist you trust is a stressful journey. At the moment though I'm finding it hard to understand why you have dismissed this particular one.

Although just 'gut feeling' can be as important as anything.

My No.1 recommended way of finding a dentist is to get a personal recommendation. Particularly from somebody with nice looking teeth!!

[exel1966]

I read earlier in the thread that NHS dentists are not supposed to charge for missed appointments, but are they permitted to charge in advance for check-ups as my NHS practice has just started doing this ?

[Toothsmith]

Yes they are, but if you miss the appointment, they cannot charge again, and if you decide not to go, they must refund it.

They are entitled to ask for any NHS fees to be paid in advance.

[glitchik]

My NHS dentist seems to be saving money by withholding anaesthetic. This started after the April 2006 charging rules were implemented. Any dentist like to confirm my suspicions and explain the background?

[Toothsmith]

A cartridge of anaesthetic is very cheap. Hardly a money saving thing.

Earlier in the year there was a serious shortage of dental local anaesthetic.

This was due to a major supplier closing a production factory in one country, then realising that it's new production facility in a different country hadn't got all it's licences!

Muppets!!

As you can imagine, dental local anaesthetic cartridges are hardly a mass-market thing, and if one major producer goes down, it takes a while for other manufacturers to take up the slack.

This resulted in some quite serious difficulties for some dentists up & down the country, and even some cancelled appointments.

I think a box of 200 anaesthetic cartridges went for about £100 on Ebay when one dentist with a good stock cashed in!!! (Normal price about £30)

Some dentists sourced anaesthetic from the USA, where they use a slightly smaller cartridge (1.8ml instead of the european 2.2ml) these fit our syringes OK, but technically it was illegal, as even though it's exactly the same chemicals inside, the 1.8ml cartridge wasn't licensed for use in the UK.

Very late in the day (I.e. when the crisis was almost over) the Department of Health stepped in and licensed the 1.8ml cartridge.

Other manufactureres have upped their production now, and things are pretty much back to normal.

But that was more the reason for the shortage of anaesthetic. Not pennypinching.

[glitchik]

Thanks Toothsmith. I have a supplementary question: Why did the dentist give me some (never heard before) half-explanation about being guided by my reactions? Why did he and the "desk" no simply say: "Anaesthetic in short supply?"

[BFG]

Thanks Toothsmith. I have a supplementary question: Why did the dentist give me some (never heard before) half-explanation about being guided by my reactions? Why did he and the "desk" no simply say: "Anaesthetic in short supply?"
You don't actually need anaesthetic for a lot of fillings.

[Toothsmith]

Thanks Toothsmith. I have a supplementary question: Why did the dentist give me some (never heard before) half-explanation about being guided by my reactions? Why did he and the "desk" no simply say: "Anaesthetic in short supply?"

Because the supply problem might not have been the reason?

Did it hurt when he did it?

If it didn't then he was right! You didn't need anaesthetic.

Having the injection is not always pain free. Maybe he thought the anaesthetic would hurt more than what he had to do.

Maybe he suspected the tooth was dead. If it was the it wouldn't hurt to do, but it would tell him that maybe that tooth would need a root-filling to prevent an abscess later on. But if you did have feeling through it then it would be alive and OK.

There are loads of possiblilities. Prehaps if you ask him next time?

[Toothsmith]

I just brought this thread back to the top again with THIS (http://www.24dash.com/health/12397.htm) link.

As the numptys at the DoH introduced a system without testing it out first, they could only guess the revenue it would raise through patient charges.

This revenue is all part of NHS dentistry's funding, and it's now over £100 million short!

I bet there won't be such a trumpeting from the DoH about this as there was about the extra £100 million (over 3 years, terms and conditions apply, being a dentist is no guarentee of any extra money at all) that was announced a few months ago, which no actual dental practice has seen any trace of yet!

[MickKnipfler]

I logged onto the NHS website this morning and serched for a dentist in my area taking on NHS patients.....I found one a few miles away....called them and got a message saying that they weren't taking them on....great

How reliable is the NHS databse and do I have a RIGHT to an NHS Dentist?

[LondonDiva]

I logged onto the NHS website this morning and serched for a dentist in my area taking on NHS patients.....I found one a few miles away....called them and got a message saying that they weren't taking them on....great

How reliable is the NHS databse and do I have a RIGHT to an NHS Dentist?
No you don't have a right to an NHS dentist in the same way that your PCT must make sure you have a GP.

All they can do is give you details of availability and information. The database is fairly up to date, but it depends on the size of the dentist's NHS practice and how they've divided it acorss the year and whether (rightly imho) they are prioritising ensuring existing patients will be able to get treatment.

Your best bet is to ring your local PCT's PALS and ask them to check out the practice's claim to be operating to capacity. If they are, the practice should give you info on their waiting list for new patients and PALS will send you out a list of NHS dentists in your area.

However, a point to note is that unlike GPs, you can register with any NHS dentist ~ so you can try to register with a convinient one near work (try their PALS) or one recommended by a friend.

[MickKnipfler]

I managed to find one about 12 miles away and am booked in for Tuesday.

Thanks

[sainthalo]

I simply cant understand, and never have, why we have a right to a doctor but not a dentist.

[BFG]

I simply cant understand, and never have, why we have a right to a doctor but not a dentist.

you don't have a right to a doctor, it's just that the PCT has an obligation to get you a doctor if you need one.

Until 1st April they had no such obligation for dentistry, but this is changing......

Similar to Tony B's pledge (ha, ha, ha) you will be able to get an NHS dentist, it's just that they may be 25 miles away....enjoy

[MickKnipfler]

My new dentist is charging me the max £189.whateveritis for a crown and then another almost £30 for the hygenist....shouldn't it all be in te basic price?

[sainthalo]

My new dentist is charging me the max £189.whateveritis for a crown and then another almost £30 for the hygenist....shouldn't it all be in te basic price?

take a look here:
http://www.primarycarecontracting.nhs.uk/uploads/Dentistry/march_uploads/mar_06_what_you_need_to_know_about_changes_to_nhs_ dentistry_in_england.pdf

[MickKnipfler]

I thought 189 was the max for the course of treatment. Doesn't that include hygenist treatment?

[sainthalo]

best way to check is to ring up the PCT and check.

[Toothsmith]

My new dentist is charging me the max £189.whateveritis for a crown and then another almost £30 for the hygenist....shouldn't it all be in te basic price?


It depends if the hygienist treatment is classed as 'cosmetic'.

What form of words did the dentist use when he said you should see the hygienist?

If he said you'NEED' to see a hygienist, then all the treatment you NEED is available on the NHS, and the cost should be included within the £189.

If he said 'Your teeth would look better if you see the hygienist, but it doesn't matter if you don't want to pay for it' Then it is just being done for cosmetic reasons, and it is outside the NHS.

[MickKnipfler]

She gave me the usual brown envolope and asked me to book another appointment to have my crown fitted. Then she said, you also need to book an appointment with the hygenist. I asked is that was for a scrape and clean and she said yes.

In spite of using a sonicare, interdental brushes and floss, my teeth still scale up quite quickly

[Toothsmith]

You need to clarify why a hygienist visit is necessary.

If you NEED it, then it is available through the NHS.

If they don't want to send you to the hygienist on the NHS, then the dentist can do a clean & polish as part of the NHS treatment.

If you don't NEED a clean at all, then it is only cosmetic, and if you WANT a hygienist appointment, then you have to pay privately.

Ring the practice and ask if the cleaning can be done by somebody on the NHS.

If they offer no NHS alternative to this treatment, then a word with the PCT may be in order.

[MickKnipfler]

I'll ask them to clarify. The appointment was the dentists proposal, not mine.

[LondonDiva]

Try to sort it out calmly with the practice. If it's not clear - take careful notes can sort stuff out quickly and they can also speak to dental advisors to get an overall picture, if it's a simple misunderstanding (sort of a Thoothsmith on tap!:D) Either way, just letting them know means that the PCT will have a clearer picture of what's going on.

[MickKnipfler]

I called them today. They said that the hygenist is private not national health. The dentist could give me a clean on the NHS but the hygenist will do more. The NHS clean wouldn't be enough.

Odd really, I was only cleaned 6 months ago, the dentist said that generally my gums are healthy and I don't bleed or anything when I brush.

[Toothsmith]

Have a word with the PCT to get their view on this.

The dentist cannot say that part of his services are not available to an NHS patient (It's in his contract). The hygienist cannot be 'private only'.

If he says you NEED a hygienist clean up , and he has a hygienist, and you are an NHS patient then you are entitled to see the hygienist on the NHS, OR the dentist must spend enough time cleaning your teeth in order to cure the problem you have.

I can see where the dentist is coming from here, and I have sympathy with him, but the NHS contract is very clear.

If he didn't like it, he shouldn't have signed it. If enough dentists hadn't signed it, then a decent system would have had to be put in place.

He cannot pick and choose which bits he obeys and which bits he ignores.

EDIT P.S. Tell the practice (Nicely) you will be contacting the PCT. It might focus their thinking!

[MickKnipfler]

Thanks, I'll give them a call. They implied that the clean from the hygenist is more thorough and that an NHS clean wouldn't be enough.

Is it the whole practice or the individual dentist though that's under the NHS contract

[Toothsmith]

I was going to post THIS (http://www.hi-mag.com/healthinsurance/article.jsp?articleid=20000089947) article on this thread anyway.

Basically, due to the fact this dogs breakfast of a contract is completely untested, the tax income from patient fees is not anywhere near as much as was expected (Probably because dentists are doing bigger stuff 'privately'.)

Therefore, there is a several million quiddles shortfall in the NHS dental budget.

PCTs (Who aren't well known for being awash with spare cash) will not be able to make up the shortfall.

Therefore, expect appointments with NHS dentists to become very thin on the ground towards the end of the financial year.

[Toothsmith]

Is it the whole practice or the individual dentist though that's under the NHS contract

That is a bit difficult to answer, as it could vary, but it makes no difference to your problem.

There is a specific clause in the contract that states that if a service is provided on the premesis of a dentist, and that treatment is clinically necessary for an NHS patient, then that service will be available on the NHS to that patient.

Technically this means that if a dentist does something really expensive and technical like implants at his practice, then these too should be available to an NHS patient.

In practice, this will never happen, as there are perfectly good alternatives to implants for much lower cost.

A visit to a hygienist though is a much more basic thing.

If your dentist had said, "Well your gums are fine and I can give them a quick clean on the NHS, but if you really want them feeling beautifully clean, you can visit my hygienist for £XX," then that would have been OK.

What is wrong is for him to say "You really need a good clean up. An NHS clean up won't do the job, you'll have to pay £XX and see my hygienist"

It is all about the words he uses and the alternatives he gives. With you, he has given the wrong words, and you are entitled to the treatment he says you NEED on the NHS.

[MickKnipfler]

I'll have a chat with the PCT

[Toothsmith]

Ask for the dental lead, or dental department at the PCT.

If it's different, it's the PCT the dentist practice is in that you want, rather than the PCT area you live in.

Keep me informed.

[MickKnipfler]

Roger.......

[sainthalo]

Follow Toothsmiths advice, my dentist backed down as soon as i mentioned the PCT...

Although suddenly the 2 or 3 sessions i needed for £180 were all sorted out in one 15 minute sessionwhich was within the £15.50........ but he says i need another appointment in 3 months!

im suspicious because - did he really want £180 for a 15 minute clean? was he trying to rip me off and i never needed 2 or 3 sessions worth of scaling? or was he being truthful and i needed the scaling sessions but now he has decided to lie and say theyre not needed but you must come back in 3 months? who knows? i dont! but NHS dentists are supposed to get you in once a year if nothings wrong arent they so whats he playing at? i will never be able to figure out this dentist but i know i dont trust him.

Anyway I will never visit this dentist again as i he has behaved most suspiciously.

[sallywl]

I have travelled 3hr 30 to come to sheffield (my home town) to see my densits because i cant see one where I now live on the NHS :( its all so stooooopid!

Make me sooo mad! ....... and tired!

[Toothsmith]

Have you ever sat down and worked out how much doing that is actually costing you? (Especially if you factor in a value for your own time).

Have a look around where you live. Private dental treatment is available at all sorts of price ranges, it's not all megabucks.

Plus lots of places have monthly plans that can be reasonably cheap as well.

Should you ever have a real problem, you will be much better off going somewhere local than trapesing half way up/down the country.

[Toothsmith]

im suspicious because - did he really want £180 for a 15 minute clean? was he trying to rip me off and i never needed 2 or 3 sessions worth of scaling? or was he being truthful and i needed the scaling sessions but now he has decided to lie and say theyre not needed but you must come back in 3 months? who knows?

There are often many more than one or two treatment plans that would suit a patient.

This is why if you visit more than one dentist you often get several different plans of what to do.

One 15 min visit would clean up the teeth which would bring down any inflammation around your gum. Essentially, you would leave the practice healthy, which is all the NHS wants. And bringing you back in 3 months time would again be the right thing to do there so as not to give it too long if things are reoccuring.

2-3 half hour visits with the hygienist would really give the teeth a good clean, in segments, possibly with anaesthetic as well.

Also at these appointments, the hygienist could go through toothbrushing with you, modify your techniques and really teach you where you were going wrong and how to put it right yourself.

In my opinion, all good and 'necessary' things, but not according to the people who put together the NHS dental service.

Trying to survive on the NHS is a numbers game. The only way you can keep your practice functioning and solvent is to get a big throughput of patients with as simple treatments as you can get away with.

Explaining absolutely everything with 100% accuracy is an impossibility in those circumstances.

I think your dentist is a good one, trying his best to operate an impossible system. My sympathy is tempered by the fact that he DID sign it though, and as such, he should operate it in accordance with the rules he has signed up to.

If dentists who felt they could not do this hadn't signed, then it would all have collapsed, and a decent public dental service would have to have been put in place.

[sainthalo]

I'm going to accept your advice Toothsmith because you have been my dental angel for some time now (whether you know it or not!) - thank you.

You are probably right he is a good guy but i do feel cheated by him. I'll reflect on it for the next few months, having never had any dental work necessary in 30 odd years i will hopefully not be a big customer anyway so he wouldnt miss me either way.

I do wish the NHS would sort their act out. This contract with 100 million shortfall is not sustainable, its ridiculous and is not working for the patients either as their is a monetary incentive for NHS dentists to reduce the level of care in some cases as we have seen on this forum.

[sallywl]

Have you ever sat down and worked out how much doing that is actually costing you? (Especially if you factor in a value for your own time).

Have a look around where you live. Private dental treatment is available at all sorts of price ranges, it's not all megabucks.

Plus lots of places have monthly plans that can be reasonably cheap as well.

Should you ever have a real problem, you will be much better off going somewhere local than trapesing half way up/down the country.

I do get to see my family too, I am going to re-assess once we are settled in our new house, but i am not a fan of dentists anyway well its not them, its what they do :rolleyes: so would be a big thing for me changing dentists.

[Toothsmith]

I do get to see my family too, I am going to re-assess once we are settled in our new house, but i am not a fan of dentists anyway well its not them, its what they do :rolleyes: so would be a big thing for me changing dentists.


Fair enough, but can you imagine having to do it because you are in pain and can't face the 300 mile journey?

The best time to change dentists is when everything is fine, and you can really take your time and explore all the options.

I had a patient in last week who had a badly broken tooth because her dog jumped up at her as she was brushing it.

We are all just one silly incident off a major problem.

I would put some thought to it if I were you.

[MickKnipfler]

I called the PCT. They said, ask the dentist to explain what the hygenist is doing that can't be done on the NHS and then ask them to write it down. They said it doesn't sound right.

After all....£28 can hardly be a lot of private treatment!

[Toothsmith]

It was pretty obvious to all of us in the dental game that this sort of thing was going to happen towards the end of the financial year, but I really didn't think anyone would run out of UDAs by the end of November!

LINK (http://www.granthamtoday.co.uk/ViewArticle2.aspx?SectionID=833&ArticleID=1907835)

Expect to see a lot more of this between now and April.

[MickKnipfler]

My crown fell off this morning. I only prodded it with an interdental brush. Surely that shouldn't push it off

[Toothsmith]

No - but when the cement seal goes, anything will bring it off.

This happens from time to time, just get it put back on pretty sharpish. (I don't mean it's an emergency, but ring up the practice on Monday.)

[Frugal Foxy]

My last 3 NHS dentists have done v.bad work (as confirmed by the next dentist I saw). I am happy to go private but don't trust any of them. I've read lots on the web and investigated generally but how do I know what they say is true. Is there a site listing good and bad dentists? How do I find one I can truly trust? I'm desperate.

thanks

[Toothsmith]

If you 'don't trust any of them', then you'll never, by your own admission, find one you truly trust!

What was wrong with the one you saw after the 3 'bad' ones?

There is no one 'right' way to do dentistry.

Different dentists have their own favorite treatments and materials and philosophies about how to deal with patients and the challenges they present.

The more you chop and change about, the more you will experience these differences, which will make you doubt if the way your previous dentist did things was 'right' and give you a sense of distrust.

Then, a different dentist will be different again, and your head will go into a complete spin.

The very best way to find a dentist is by recommendation. Ask a friend/colleague/relation who they go to, why they go there, how long they've been going there and if they are happy.

If they are, it's a fair chance it's a 'good' dentist.

Go and visit the practice yourself, and if you are happy with the place, book an appointment.

Hopefully, the dentist should be able to give you a good explaination of what's going on in your mouth, as well as short term treatment needs and longer term goals.

If you are happy with this, go for it. If not, why not?

Ask yourself why you were unhappy and is it anything that can realistically be addressed? (If you feel something was amis, was it just your predjudices, or was it something real. Why would your friend be so happy to go there for so long?)

If you feel your concerns were real, then start again and look for someone else. If it might just be your attitude, then it is probably time to give someone the benefit of the doubt and get on with building a long lasting relationship.

Also bear in mind that when dealing with people, nothing goes 100% right 100% of the time.

There may well be times, particularly in the early stages before the dentist has got to know you and your teeth that things don't go 100% to plan.

If all you do at these times is run off and look for another dentist, then no dentist will ever really get to know you and your teeth, and you will be setting yourself up for a whole life of unsatisfactory dental experiences.

Break the vicious circle now and find a dentist somebody else trusts, and go for it.

[Toothsmith]

A joke from a dental journal today

Daily Mail Health Correspondent To Secretary of State for Health

"Mrs Hewitt, can you tell me how many 'F's there are in NHS dentistry?"

" There is no 'F' in NHS dentistry!"

"Can I quote you on that?"



Sorry!!

[Toothsmith]

From today's Sunday Telegraph (http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/12/17/nhs17.xml)

Notice the comment at the end from our beloved Chief Dental Officer.

"The decision as to whether a child receives treatment rests with the orthodontist, and is made on a clinical basis."

Yeah right - after you changed the rules and clinical criteria for who gets paid and who doesn't!!!

Barry Cockroft is now known as 'Comical Barry' within dentistry, after the Iraqi information minister who was telling the media how the Americans were being beaten back as their tanks rolled into Bagdad!

[Toothsmith]

Yorkshire Post (http://www.yorkshiretoday.co.uk/ViewArticle2.aspx?SectionID=55&ArticleID=1945685)

So - Patients who have to pay NHS dental charges aren't paying enough!

Maybe because for regular patients, who only need the odd thing doing every now and again, it can be cheaper to pay privately for a single filling rather than the £42.40 NHS charge, or £189 for a single crown.

NHS managers are urgently investigating the reasons for the deficit and have been urged to take "corrective action" with dentists to maximise revenue.

This may well include setting cash targets as well as UDA targets for dentists to achieve.

Patients who are exempt from dental charges may well find it harder and harder to be seen, as PCTs target fee paying patients above the less well off patients.

[BFG]

The setting of cash targets would be illegal since it would mean discriminating against people who don't pay.

[Toothsmith]

It would only be illegal if dentists did it!

If it's the DoH wanting to do it, they just re-write the rules!!

[Home alone]

It would only be illegal if dentists did it!

If it's the DoH wanting to do it, they just re-write the rules!!

You might be surprised at the pressure PCTs are putting on contract holders to meet that shortfall. Then again, perhaps your not.

[Toothsmith]

Your right - I wouldn't be surprised at all!

[zenmaster]

NHS or Private? All the same to me.

If you 'don't trust any of them', then you'll never, by your own admission, find one you truly trust!
I don't ... and I haven't. I have spent thousands (probably into 5 figures) over the past 20 years or so and my teeth are still carp. I have had work done, undone and done again. So I just stopped going and took the pain.

I hate that my teeth look a mess but another visit would probably cost me at least another £2,500. If I was to gain a Hollywood smile from it then I might, so to speak, bite the bullet. But I won't - I will just have a set of moderately bad teeth instead of very bad teeth.

After I had my first few thousand quids worth of work done I should have signed up for Denplan there and then, but I didn't and now there is no way on earth I would be accepted.

What I find particularly galling is that, as Toothsmith says, you have to pay £70 for an initial visit with xrays to be told that you need £800 worth of work. To get a second opinion/quote for the job you have to go to another dentist and pay another £70. So you are £140 down without so much as a scrape and polish to show for it.

I have considered dental tourism. A friend of mine apparently had 2 fillings and a root canal done whilst on a visit to the Ukraine for just a little under £20. It's a long way to go for a checkup though.

With due respect to Toothsmith and others who sound like they might be dentists I'm afraid that, in my opinion, members of the dental profession stand alongside used car dealers, cowboy builders and estate agents in the roll of honour.
No - but when the cement seal goes, anything will bring it off.

This happens from time to time, just get it put back on pretty sharpish.
I've had 2 crowns in my wallet for a couple of years now. They both fell out within a week of each other (more quality workmanship!).

I guess it's too late now? Can I just stick them back in with superglue?

[BFG]

I guess it's too late now? Can I just stick them back in with superglue?

Of course you can....in the same way that you can incise your own abcess or maybe stitch up that gash in your head or set your own broken finger, if you want.

You can do anything you want to your own body, but most people might suggest that a qualified medical/dental person would be a better solution.

[Toothsmith]

I have had work done, undone and done again. So I just stopped going and took the pain.



I take it that this has all been with different dentists?

No-one has really had a chance to learn about your mouth, and no-one has really been able to analyse what is going wrong.

Everybody's mouth is different. Nobody eats exactly the same things at exactly the same time with exactly the same bite force. Nobody's teeth are in exactly the same position as somebody elses.

By and large, for the vast majority of people, that's OK, and what works for one will also work for somebody else.

There are some that fall outside this envelope though, and can have quite severe problems.

By not getting things seen to promptly, you are not helping your own case though, and I would suspect that there are a few diet/habit/lifestyle issues that would need looking at as well.

One thing is certain though. If the reasons for the repeated failures are not investigated, then anything you have done, anywhere in the world, will also fail.

[Toothsmith]

More Muppetry (http://news.scotsman.com/health.cfm?id=127692007) from north of the border. And they don't even have the 'New Contract' yet!!

[irishwench69]

I know this is nothing new, but thought you'd be interested in the latest good press about the new contracts :rotfl: :rotfl:

http://www2.netdoctor.co.uk/news/index.asp?id=125933&D=1&M=2&Y=2007

IW x

[Linedanger]

Hope I'm posting this in correct area. My 1st forum post.
To add my little dental tale and my distrust in private dentists.

In Dec 2005 I went(for 1st time) to new dentist in my area.
I had a problem with a loose front tooth and ill fitting dentures, which was hurting when I ate.
He wanted to charge me £1400 to extract the tooth and provide a new set of dentures on same day. He did an X-Ray on 1st apptmt.
I didn't really want to pay that much. We made another appointment for a few weeks later.
In the meantime, my loose tooth fell out whilst eating, so my pain was gone.
I found a local dental technician, who did my new set of dentures for £180.
I did keep the appointment and paid £25 for the X-ray.

I consider that the Dental Practice was trying to rip me off, for over £1000, for a few hours work. I felt like standing out in front of the dentists, with this tale around my neck, to alert other clients what they are risking.

Yes, Dentists do need regulating, and more of their patients must stop trusting them, and demand more reasonable charges, or look for a dentist who will provide the NHS services. They are only after as much of your money as they think you are gullible enough to pay. They should also be made to clearly display a full list of their charges.

I will be using an NHS dentist in future (if I can find one).

[Toothsmith]

Interesting one this!

You say dentists need MORE regulation, and yet the place you were happy with is operating ILLEGALLY.

It is illegal for denture technicians in this country to provide new dentures direct to the public as they are not appropriately qualified.

If you stood outside the technicians lab with a placard around your neck saying "This technician provided me with a nice set of dentures very cheaply" I'm sure he would hurry you along more quickly than the dentist who probably has a fee guide in his practice anyway!

If I could skirt around the cross infection controls I have to adhere to (Which the technician won't) and have to pay qualified and registered support staff (Which the technician won't) and have indemnity insurance (Which the technician won't) and be registered with the General Dental Council as a Dentist (Which the technician won't) and have full surgical dental equipment to buy and maintain (Which the technicain won't) and have emergency resuscitation equipment on the premesis and be current in how to use it (Which the technician won't)................. (You get the idea?)

Plus - I'd be extremely surprised if the taxman knew anything about your £180!

If I was allowed to have a market stall and do dentures there, I could probably knock them out quite cheaply.

But that's hardly MORE regulation is it??

[Linedanger]

Perhaps my non-expert terminology is incorrect, for what the false tooth shop does.
But this is the same dental laboratory that does the work for many dentistry practices, and employs 4/5 full time staff. The specific one I saw, has more than 25 years of experience and learned his trade from the previous owner, who had been in business for many decades, going back to the forties.
My dentist's time would have been minimal.
£1400 for a set of false teeth is indefensible.

[domdent]

I dont like providing full dentures but I still set my fees at a level to cover the lab bill £200 to £300 materials £70 and the time aprox 1 1/2 hours of surgery use.Some colleagues overcharge to avoid doing them , or quote high for a particular patient as they may give the 1st impression of being very difficult.

Then there is the aftercare , warranty that has to be built into the price.

Some practices use more expensive labs and spend longer doing complex jaw assessments.

To compare a professional estimate with an illegal provision of a denture is a bit strange.Like comparing a quote for building work from a registereed building company and a cowboy builder who uses a mobile phone as is contact,doesnt pay tax , no indemnity insurance etc.

A denture technician cannot offer implants if the dentures dont work.

I once saw a patient who had paid more than my private fee for a set of dentures from a technician they didnt fit (and never would) , she needed implants which she could not afford.

[Toothsmith]

Perhaps my non-expert terminology is incorrect, for what the false tooth shop does.
But this is the same dental laboratory that does the work for many dentistry practices, and employs 4/5 full time staff. The specific one I saw, has more than 25 years of experience and learned his trade from the previous owner, who had been in business for many decades, going back to the forties.
My dentist's time would have been minimal.
£1400 for a set of false teeth is indefensible.


Nevertheless, He has still operated illegally. Providing dentures to the public is 'the practice of dentistry' Only dentists are allowed to do that.

Your dentist told you that the price was £1400, and you exercised your right to say 'No thank you'

You were not hoodwinked or misled.

Did your technician tell you he was operating illegally? I think not. He did mislead you.

Who is the real villan here?

[pulp]

NHS dentistry in England:information for patients

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073466

New leaflet supercedes 272054 What you need to know about changes to NHS
Dentistry in England

[BFG]

NHS dentistry in England:information for patients

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073466

New leaflet supercedes 272054 What you need to know about changes to NHS
Dentistry in England

Exactly the same...it's just that the prices have gone up.

[Toothsmith]

http://news.bbc.co.uk/1/hi/england/lincolnshire/6988635.stm

On the BBC's website today.

Now, £2m opening 10 practices = £200k each!

I know for a fact you cannot build and equip a dental practice for £200k, so there is significant other money here.

But - as well as that, this money has ensured that these practices, and others in the area are fully staffed - so obviously not all of the £2m has gone into building and equipment.

But - not only that, but 55,000 people have also been taken off the NHS waiting list with this money!!! :rolleyes:

Even if every penny was spent on patient treatment, that would mean that an average spend of £36.36p per patient!!!! And I assume a fair proportion of these people haven't been to the dentist for a while and need a fair bit doing!

The Bliar legacy?

They just can't stop spinning!