Charges for private dental treatment

[ltlmiles5]

I brought my 4-year-old for sedation two weeks ago under NHS treatment. However, when I insisted on a white filling, I was told that the whole treatment would have to be regarded as private, instead of just paying for the white filling. As we didn't want her to have mercury in her mouth (amalgam fillings), we ended up paying £180 for a filling in her tooth!

1) £120 sedation charge
2) £50 white filling
3) £10 X-ray

Is this normal practice for all NHS patients who opt for a white filling undergoing sedation? Or is it just a peculiarity of my dental practice?

It cost an absolute fortune, and even the tooth fairy won't be able to match that when she comes for it in 10 years or so!

[Toothsmith]

It's very complex to explain properly, but this has been done 'by the book'.

Sedation is rarely done on the NHS in general practice. White fillings aren't available on the NHS (Do you know all the properties of the chemicals in them BTW?)

Not sure about the x-ray, but I've a feeling there is a 'same tooth' rule. If the tooth is going to be restored privately then the x-ray is private too. I gave up with NHS regulations years ago!

[catowen]

My daughter has just had an amalgam filling, would it have been better for her to have had a white one? It was done on the NHS, but if it could cause problems, i would be prepared to pay privatly (we are with a private practice, although they treat the children as NHS) they didnt give me the option of what type of filling i would like for her!!!

[Toothsmith]

NO filling material is 'safe'.

Amalgam has mercury in it - this is known to be a poison and scares the proverbial out of people.

Now I know a load of nutters are going to come crawling out now - they always do! - But the mercury reacts with the silver alloy and forms a perfectly stable compound (In much the same way as the highly explosive sodium reacts with the highly caustic chlorine to form something we all sprinkle liberally on our chips). A tiny bit of mercury vapour is released when fillings are placed, and when they are removed, but small doses of atomic mercury can be safely excreted from the body.

Some people react to amalgam, but this is not common, always mild, and in 99 cases out of 100 it is due to the traces of nickle in the alloy, not the mercury!

What is much more dangerous are organic mercury compounds such as methyl mercury, which are found a lot in fish. Therefore the average fish supper will do you more harm than a filling. :p

White composite fillings contain a substance called BIS-GMA. This is the resin that holds it together. This is a nasty little chemical, and has caused contact dermatitis in several dentists, which can be a career threatening problem! They also contain artificial oestrogens; the 'gender bending' chemicals that hit the papers a few years ago when they were short of news.

Another white filling material is Glass Ionomer. These are quite good materials for baby teeth they release flouride (More nutters decend!! :rolleyes: ). They have high amounts of lead salts in them though!!

It always strikes me as amusing that the filling material that has been around the longest, and has the best safety data, as well as clinical effectiveness (amalgam) is the one most pilloried in the papers. It's only because everybody knows that mercury is poisonous. Very few people have heard of BIS-GMA!

My strategy is to hopefully find fillings when they are very tiny and use Glass Ionomer or Composite (To give the kids lead poisoning or turn them all female!). This is because these materials are better suited to tiny holes. With amalgam, you need certain dimensions before you have the material thick enough to last, and also, it does not support undermined tooth very well, so cavity walls have to be straighter. this can result in more tooth than necessary being drilled away. I also tend to do all this on the NHS, although strictly it isn't allowed. However, my kids patients are all from my private adults, so I cross subsidise. This is one of the things that is going to be banned by the great new contract, as you are not allowed to insist that parents become private patients in order to see the kids on the NHS

If a hole was of a certain size anyway, or a kid was in the habit of needing lots of fillings, I would always use amalgam. It is more stable, and more decay resistant than composite, and wears a whole lot better than Glass Ionomer.

I would do exactly the same if it was a child of mine (Although I'd slap myself around the head for not spotting it as a tiny cavity - and then again even harder for feeding them too much sugar!).

The last filling I had - 4 years ago - was an amalgam.

[catowen]

Thank you Toothsmith, that has made me feel better!!!! My son, who will eat sweets until the cows come home (if i let him!!!) has perfect teeth, but my daughter who eats all her fruit, and only has sweets if she really feels like it, has had nothing but problems with her teeth (including falling over and knocking the front 2 out when she was 3!!!) Our dentist (who at the moment only treats the children if the parents are private!!!) says shes just unlucky!!!! Mind you, keep double checking how they are both brushing now, we dont want anymore cavities if we can help it!!!!
Thanks again, your advice on dentistry is excellent.

[ltlmiles5]

THank you very much Toothsmith for your excellent replies. It's always good to know what is going on 'behind the scenes'. I'll have to have my husband have a read as he is dead against amalgam fillings.

Thankfully my 4-year-old doesn't need any more fillings. She does like her sweets and chocs, which we are trying to keep an eye on her intake especially now.

[Tajak1000]

Thank you Toothsmith, that has made me feel better!!!! My son, who will eat sweets until the cows come home (if i let him!!!) has perfect teeth, but my daughter who eats all her fruit, and only has sweets if she really feels like it, has had nothing but problems with her teeth (including falling over and knocking the front 2 out when she was 3!!!) Our dentist (who at the moment only treats the children if the parents are private!!!) says shes just unlucky!!!! Mind you, keep double checking how they are both brushing now, we dont want anymore cavities if we can help it!!!!
Thanks again, your advice on dentistry is excellent.

The differance between your two kids may (I cannot say this for definite without seeing them) be down to differant bacteria.
Tooth decay is caused by the effects of acid created by bacteria that live on the teeth. the acid is created when sugar is eaten, which is why sugar is BAD. Differant bacteria have differant effects, and there are some people that simply have very low levels of the harfull bacteria.

There are saliva tests available to check for the commonest types of damaging bacteria.

[Undisputedtruth]

I'm sorry to say there is no need for young children to have fillings today. Dentistry has moved on in the 21st Century. There is no need to use drills and injections anymore.

Ozone is used to treat tooth decay. Further information can be found on this link http://www.the-o-zone.cc/ozone.htm

Sadly NICE has refused to recommend the treatment to NHS until it has long term data on its effectiveness. NICE will review the decision in 2008. Again sadly, thousands of young children suffering from fillings in the meantime.

[Toothsmith]

If I had a pound for every gizmo that would 'do away with injections and the drill...' since I've been qualified , and before, I wouldn't need to drill teeth any more!!

Ozone certainly has it's uses, but it is not a miracle cure.

The website is the company's, and the machines sell for £10000+ a pop.

[Undisputedtruth]

If I had a pound for every gizmo that would 'do away with injections and the drill...' since I've been qualified , and before, I wouldn't need to drill teeth any more!!

Ozone certainly has it's uses, but it is not a miracle cure.

The website is the company's, and the machines sell for £10000+ a pop.

Some of the better Dentists uses Ozone in the UK so hardly a gizmo. True, the machine cost around £10000 but work out to an affordable £20 a week for the next 10 years so it is not that expensive. The treatment cost is similar to that of fillings and is not as evasive as drilling a tooth.

Undisputedtruth

[Toothsmith]

I have looked into Ozone and still need to be convinced!

I'm a bit more impressed by photo activated disinfection, which does a very similar job.

'Some of the better dentists' is quite a contentious phrase!!!!

[ltlmiles5]

It would be excellent if drilling could be done away with, or limited to rare instances, as it alwalys sounds scary, to anyone!

When I was young in malaysia, they drilled into my tooth when I was about 7, without any injections etc, and that scarred me for a long time! It was only after I was 16 and started wearing braces, and had to see the dentist every week that I got over my fear of dentists!

[Undisputedtruth]

I have looked into Ozone and still need to be convinced!

I'll be surprised if you were convinced after slamming Ozone as a £10,000 gimmick.


'Some of the better dentists' is quite a contentious phrase!!!!

The dentist featured on the tv programme 10 years younger uses Ozone.

NICE will be reviewing Ozone in 2008 once they have some long term data so it might be available to the NHS sometime in the future. I didn't recall anyone from NICE saying Ozone was an expensive gimmick though.

I find it incredible that the conventional treatment of teeth decay is rather an hit and miss affair. Fluoride has made our teeth denser making it difficult for dentist to identify decayed teeth on x-rays. It makes me wonder how many normal teeth have been ruined by dentists eager to use the drill and fill method.

By the way Toothsmith, does your Surgery uses air abrasion or is this an expensive gimmick?

Undisputedtruth

[Toothsmith]

Air abrasion is incredibly messy!!!!

[Undisputedtruth]

Air abrasion is incredibly messy!!!!

Small price to pay if it means that more of your tooth is preserved!!!

Undisputedtruth

[Toothsmith]

You can make very little holes with small drills and care.

I do agree with you over air abrasion, I just don't like it. The difference between one of my little holes and a little air abrasion hole does not, to me, justify the mess and airbourne particles.

Others do like it and good luck to them, it is a good technique.

There are many things in many professions that look like really good ideas on paper. The practicalities are different, and sometimes the manufacturers claims are a bit on the 'creative' side.

Another good example is digital x-rays. All the advertising blurb for them extol the virtues of 1/10 of the radiation of normal x-rays.

When you look deeper though, you find the manufacturers are comparing their product against 'A' speed X-ray films. These went out with the Ark, and most practitioners are using 'E' speed and some are on to 'F' speed. The comparison with these film speeds means that digital X-rays use only very slightly less radiation.

Again - hardly worth the £15-£17k investment.

Part of being a professional is being able to look beyond the hype for the undisputed truth.

[Undisputedtruth]

Part of being a professional is being able to look beyond the hype for the undisputed truth.

Hmmm, part of being a professional patient is the ability to look beyond the hype of dentists in this country!!!!!

Undisputedtruth

[Toothsmith]

I find it very hard to see where you're coming from. :undecided

Are we agreeing or having an argument? :confused:

You seem to be on the side of high priced whizzy gadgetry that is totally unproven but could easily help a dentist justify very high bills. :huh:

You seem impressed by this technology because it appears in the practice of a dentist who is 'on the telly'. Despite the fact he seems keen to do highly expensive treatments in the mouths of people who up until recently have totally neglected their teeth. There is no mention on these telly shows about a long term committment to that patient. Who pays the care and maintenance costs of these people once the telly cameras have packed up and moved on to a garden makeover show? :think:

Yes hype does need to be sorted out from fact. Which one of us is doing that?

If however we are in agreement..... :kisses3:

[Undisputedtruth]

I hope I have not rattled your cage. I feel no need to argue. Though you seem to dismiss new technology very quickly. However I would take your views and advice more seriously if you had actually used products such as Ozone rather than virtually saying it must be rubbish because I can't afford it for my surgery. As for the treatment being expensive for the patient then I would have to say that ltlmiles5, see start of thread, would saved £125 had his daughter used the Ozone treatment (£25). In fact his daughter might not needed treatment at all if the Ozone's tooth decay probe had diagnosed that no treatment was needed. Remember, detecting tooth decay by using x-rays is often unreliable because the rays have difficulting in penetrating a more denser tooth caused by adding fluoride in water.

I fully agree with you about patients taking preventative measures and building relationships with dentist. Unfortunately this may result in patients not getting the best deal, quality of treatment and choice. For example if I was one of your patient and took your word as gospel then I may not know that there may be better treatments for me.

Undisputedtruth

[Toothsmith]

Though you seem to dismiss new technology very quickly.

Do you know how long Ozone has been around? 3 years at least.

In that time I have been to one sales presentation about it (Which sounded very like your posts) and about half a dozen lectures on Minimally Invasive Dentistry where opinions (From senior academic lecturers and professors) varied from 'completely useless' to 'unproven'. I do not think it's 'completely useless' but it is by no means a cure all.

If that is a bit of a quick judgement, I'm sorry!


However I would take your views and advice more seriously if you had actually used products such as Ozone rather than virtually saying it must be rubbish because I can't afford it for my surgery.

Where did I say that - or even imply it? If a piece of technology came along tomorrow for £50,000 with scientific backing and proven effectiveness, it would be in my surgery within a week - well a month tops. That's what banks are for. If I had bought every 'revolutionary' toy that ever was invented for dentistry, I'd not have a cupboard big enough for the ones discredited after a few years.


As for the treatment being expensive for the patient then I would have to say that ltlmiles5, see start of thread, would saved £125 had his daughter used the Ozone treatment (£25).

My understanding of Ozone is that it's done over 3 applications 6 weeks apart. That's £75 plus the cost of the remineralizing pastes. That's assuming the little girl co-operates with having the tubes & suction cup attached to her tooth (Yes I know it's simple and painless, but if the kid's nervous it may still be very difficult) So that would be 3 sedation sessions as well. £360

Then, of course, there could easily be the filling charge in a couple of years when it's found the Ozone hasn't worked.

In fact his daughter might not needed treatment at all if the Ozone's tooth decay probe had diagnosed that no treatment was needed.

Unless they bundle them together now (And they didn't 5 months ago) the Ozone machine doesn't come with a 'tooth decay probe' This is a seperate machine called a Diagnodent. The first lecture I attended where these machines were discussed was over 7 years ago, so sorry if I'm being a bit quick to dismiss things again, but they were not regarded as very accurate then. They give a LOT of false positives.

Over the past few years, better protocols for calibrating them have come into existance, but it can take a lot of time to get an accurate reading for each tooth.

Remember, detecting tooth decay by using x-rays is often unreliable because the rays have difficulting in penetrating a more denser tooth caused by adding fluoride in water.

Detecting decay on X-Rays is unreliable because of the very fast films that are used nowadays. The older, slower films had much better contrast. We're onto F speed films now, I was training at the time of C speed. The Lecturers I had thought they were rubbish, and wanted to go back to A speed! It's all to do with regulations and radiation doses!

Flouride is NOT added to the UKs water supply - unless you come from Birmingham, or one or two other smaller places which I forget exactly where.

I fully agree with you about patients taking preventative measures and building relationships with dentist. Unfortunately this may result in patients not getting the best deal, quality of treatment and choice. For example if I was one of your patient and took your word as gospel then I may not know that there may be better treatments for me.


I am glad you have a dentist you are happy with.

[Toothsmith]

I have just re -read the HealOzone website you posted.

I notice it mentions Julian Holmes at the end.

True, he did do a PhD on Ozone and championed it. He has since left dentistry, and was last heard of in South Africa doing something in Corporate Entertaining.

Ozone has not made him his fortune!

I did a quick Google, as I'd not heard of him in a while, and came up with THIS (http://www.dentalblogs.com/archives/hedge/fourth-dentistrytogo-podcast-with-dr-julian-holmes/) which has a very interesting little comment at the end.

I went down the list a little, and then came across THIS (http://www.gdc-uk.org/NR/exeres/626D2F09-A2A9-4DA9-AAF3-304B1AB0EFF0.htm) which seemed to back up part of the claim!

there is also quite a good article HERE (http://www.buzzle.com/editorials/8-7-2002-24069.asp) from 2002 which puts the other side of the ozone case.

[Undisputedtruth]

Shame you couldn't come up with any research using Google to say the Ozone doesn't work or not effective. I was looking forward to it.

Your Google search on Julian Holmes is interesting but does not detract the effectiveness of the Ozone treatment. Of course you might say that if Julian was corrupt then Ozone treatment was corrupt as well. But it is like saying that if Tony Blair is a liar then everyone in the UK is as well! Anyway, Ozone is undergoing clinical trials through the FDA so we will see whether Ozone is a viable form of treatment or not.

The Podcast with Julian Holmes was excellent and it was interesting to hear there were no reported cases of superbugs, MRSA, etc in Cuba & Russia where they use Ozone as a disinfectant.

Undisputedtruth

[SparkyG]

I do not profess to understand the benefits or disadvantages of ozone therapy, but Kavo are doing themselves no favours by continuing the association with Holmes.

The fact that the GDC has taken the very severe step of an interim suspension, and renewed it twice while investigating speaks volumes. Holmes had fled to S Africa with patients money, leaving many in pain and having to pay out thousands for remedial treatment. I speak with personal experience.

Who would believe in an alternative therapy with such a doubtful proponent?

[Toothsmith]

It is not my job to prove it's effectiveness or not.

It is my job to weigh up the evidence and decide if a treatment is in the best interests of my patients.

If there is not enough evidence either way, then all I am doing is using my patients as unpaid Guinea Pigs. Worse - they are paying me to be guinea pigs.

THIS (http://www.dentalwatch.org/questionable/healozone.html) is an article about the NICE findings.

It does not say it's good, it does not say it's bad. It says it needs MORE WORK.

I draw your attention to the key questions:-

********************************************
Key Questions
It is well known that ozone gas can kill bacteria. But the key question is whether brief exposure to ozone gas has any practical value in dental practice. The National Institute for Health and Clinical Excellence (NICE)—an independent British organization that reviews medical technology—has evaluated the evidence related to caries by asking and answering several questions:

For managing pit and fissure caries, is the HealOzone procedure more effective than the combination of oral hygiene, diet advice, chlorhexidine/fluoride varnish, and fissure sealant? If so, is it a cost-effective alternative?

For managing non-cavitated root caries, is the HealOzone procedure more clinically effective than the combination of oral hygiene, diet advice, and varnish? If so, is it cost-effective?

For managing cavitated caries, how often, if at all, is ‘HealOzone procedure’ an alternative to fillings?

For managing cavitated caries, does the application of ozone gas and of a remineralising solution to the cavity before restoration prolong the life of a filling? If so, is it cost-effective?


*************************************************

It may be the best thing since sliced bread but no-one has proved it yet.

It hasn't been shown to be any more effective than any other methods of minimising fillings that we have at the moment.

As soon as it is shown to, I will have one!


Every assumption you have made about this machine so far has been wrong.

You thought it was a 'new' treatment - It's been around for years

You say it can do away with drilling - It can't

You thought it was a 'one hit fix' - It isn't

You think it works all by itself - It doesn't - diet change & pastes are needed too

You think it's the only way to deal with early decay - It isn't

You think it's the price that puts me off wanting one - It isn't

You thought it had a decay probe on it - It doesn't

You thought the UK's water was fluoridated - It isn't

And you still sign yourself Undisputedtruth! :rotfl:


I am really happy your dentist has one of these machines - even though he either explains it's use badly to you or is using it incorrectly. I hope you will be very happy with the black marks you have all over your teeth (Because arrested decay doesn't turn white again).

In a few years time, if anyone manages to prove it works I may well join the ranks of happy healozone users. At the moment though, I find diet advice, fissure sealants and fluoride varnishes work in exactly the same way!

[Dora the Explorer]

Well, although this looks like a private, robust discussion I'm joining in ;)
Now I know a load of nutters are going to come crawling out now
Not me TS, I don't believe in bad science; I've got some amalgam fillings which I think are probably decades old and I mixed pounds of the stuff 45 years ago when I was a chairside assistant, and nothing's dropped off yet :rotfl:

it was interesting to hear there were no reported cases of superbugs, MRSA, etc in Cuba & Russia where they use Ozone as a disinfectant.
You are having a laugh - this is absurd. Of course there are cases, they're not reported because Cuba is a closed country and Russia is incapable of accurate record keeping and consequent reporting in it's current state.

[tonytooth]

I too have been following this post and would like to comment, if i may..
I do not understand why toothsmith's practices/policies are being questioned and attacked.
It seems crazy that this guy is giving up a fair bit of time on these boards to help people out, and is being ridiculed...
And as he has pointed out, a number of assumptions based on healozone have been wrong. It is not a wonder treatment, and if it was, it would make our jobs a hell of a lot easier......

[Undisputedtruth]

I too have been following this post and would like to comment, if i may..
I do not understand why toothsmith's practices/policies are being questioned and attacked.

Sorry but on a discussion forum every point of view should be questioned and discussed from all angles. If toothsmith's feel vulnerable then this is not my fault. I'm simply asking questions and analysing the answers.


It seems crazy that this guy is giving up a fair bit of time on these boards to help people out, and is being ridiculed...
And as he has pointed out, a number of assumptions based on healozone have been wrong. It is not a wonder treatment, and if it was, it would make our jobs a hell of a lot easier......

I've seen enough Dentists to know that sometimes you can't rely on a single point of view. Otherwise you are asking for trouble.

Toothsmith's overreaction in his last post has made him look ridiculous. I simply asked him if he could provide evidence that Ozone doesn't work. So far he hasn't. Rather than providing evidence he simply directed a wave of attack by misrepresenting my words and copying stuff from the dental watch website about NICE comments about Ozone. I suspect Toothsmith will never find the evidence to
back up his initial comments that Ozone was an expensive gimmick.

I have every respect for the health professionals as long as they can conduct themselves in the appropriate manner by providing proper factual evidence and explanation.

Undisputedtruth

[Toothsmith]

Toothsmith's overreaction in his last post has made him look ridiculous.

I will leave the judgement of that to others.

[Undisputedtruth]

I will leave the judgement of that to others.

Absolutely, in this case I'll go back to your earlier comments bit by bit and scrutinise them even further especially where you have misrepresented my words.

Undisputedtruth

[sylwright]

Absolutely, in this case I'll go back to your earlier comments bit by bit and scrutinise them even further especially where you have misrepresented my words.

Undisputedtruth

For god's sake get a life!! and I can see why you chose your name, but maybe you should change it to SMARTARSE KNOWITALL!! It would be more accurate.

Sorry to bring the tone down but your attitude has really got my back up :mad: :mad: :mad:

[tomstickland]

I'm very interested to read the info on filling materials. I was talking to my dentist about amalgam and he also explained that the Mercury forms into a stable bond. It's a Nickel allergy that's more of a problem.

When I had a White filling I noticed that the resin absolutely stinks and it made the back of my mouth sore/tasted really bad for a few days. It seems to be some pretty extreme resin filler, but then again I suppose it has to be to survive for years in the mouth.

As to Ozone etc, there are loads of hyped procedures out there that might well have some sound basis, but it takes years for the true picture to emerge.

[tonytooth]

Hi Tom, just a thought, but it may have been the acid etchant (that is used to alter the tooth surface to help the filling bond better) which may have caused the bad taste/pain.... rather than the actual resin.

And well put re the ozone. It may well be beneficial in some circumstances but whether its outcomes are any better or more cost effective than the procedures we already have is another matter.......Only time (and good trials) will tell

[tomstickland]

It was defintely the resin, though the irritation might have been the acid etchant. Either way, it's preferable to tooth rot. I paid £128 for a 45 minute visit and I actually think it was good value. Take out practice overheads and materials etc and it's not mega money for the hassle of doing a filling.

[tonytooth]

fair enough, i've just never had any patients complain about pain/taste in the back of their mouths after white fillings....
anyway, 'twould be good if more people shared your feelings on the cost of treatment

[Undisputedtruth]

For god's sake get a life!! and I can see why you chose your name, but maybe you should change it to SMARTARSE KNOWITALL!! It would be more accurate.

Sorry to bring the tone down but your attitude has really got my back up :mad: :mad: :mad:

Thanks Sylwright, your post has truly spurred me on. As I already have a life I will tackle Toohtsmith's comments bit by bit. I have every right to challenge him for misrepresenting my words.

Undisputedtruth

[tomstickland]

It's because consumer goods are so cheap. I've looked at this from a number of angles:

- I paid £128 to cover: practice overheads (receptionists, cleaners, admin, dental assistant, machinery, building etc), materials, and then used up 45 minutes of chair time with a dentist.

-How much do people pay for basic car servicing?

-What value do I put on not being in pain and preserving a tooth?

-How much would I want to be paid to spend 45 minutes doing what's a fiddly and not really a very entertaining task?

I've found going fully private has actually provided me with a better service. The dentist is happy to talk about what he's going to do, I can ask questions and I believe that I receive better care. Maybe not fully MSE, but I believe that I get better value, even though I pay more.

Paying Denplan for 4 years, now that's something I do resent.

[Toothsmith]

Paying Denplan for 4 years, now that's something I do resent.


It would have been good value if you'd used it! :p

[owey]

Toothsmith,
Can you give me a bit of advise?, just been to the dentist and they tell me they are going private :mad: . It looks like they want me to go for a policy which cost £10 a month, which will give me 2 check-ups 2 polishers and x-rays if I need them per year, plus 15-20% off further treatment.Or I can register with them for £30, strange that, as I am already registered with them, "scam comes to mined there :rolleyes: .
They said they are going private becuse it would cost the same for a check-up or a check-up and fillings on the new NHS prices?. So it would not be fair on people that don't need any work doing.
I have just looked up the new chargers which are in three bands, £15.50, £42.40 and for major treatment £189.00, not sure if these are up to date?.
I don't see how it can be cheaper for me or most people to go private, is it worth going on the books of another dentist, or are they telling me the truth that it won't be much more expensive staying with them.
If only I could get all his customers together and refuse to pay, he surly would have to change his mind.

[Toothsmith]

Hi Owey,

You are registered with the practice until midnight on 31st March. That is when the 'old' NHS contract expires, and everybody who is currently registered with an NHS dentist is De-registered by the Government. This is because such an embarrassingly low number of people are registered with an NHS dentist, they are abandoning the concept of registration.

There will be dentists with NHS contracts on April 1st, and there will be patients looking for NHS treatment. All those looking for treatment will be entitled to contact any dentist with a contract!

There are many problems with the 'New contract' which is why dentists are abandoning it in droves. There are many good threads on these forum in which I go into the reasons. I would suggest you have a read through these. Most are in this Health board, but the discussion board and the vent board have a few as well.

Bear in mind, your dentist has to see many people in a day, and so he/she will have to give some explaination as well as doing the check up or treatment. There is no way they can go into it in precise detail with every patient, and answer all questions and have any philosophical arguments about the rights and wrongs of it all without running hopelessly behind schedule, and really putting everyones back up even more!

This is why some patients come out feeling they've not been told the whole story, and believing the tabloid version of the greedy dentist (although even the tabloids now are beginning to see the blame may well lie elsewhere) think some scam is afoot.

The long & short of it is that no - it's probably not cheaper to go private, but I can see what your dentist was trying to get across. It will be a lot more expensive than before to be an NHS patient, and for the extra money you're paying, the service will be vastly inferior, as you will have to jockey for your appoinment with every other person looking for an NHS dentist.

In theory, yes, if everybody refused to pay private rates, the dentist would have to do a rethink. When I went private 8 years ago my 'rethink' plan was to take over my fathers tyre & exhaust business (He was looking to retire (No pun intended) at the time) and give up dentistry completely. Other options would be to emigrate to a country like Australia or New Zeland, where life is generally better, and a dentist is still allowed to make a living!

In practice though, the dentist will be able to survive with a lot fewer patients. In fact to operate in a private environment, it is actually necessary to loose at least 1/3 and preferably 1/2 of your patients in order to be able to spend more time with the ones who have chosen to stay with you. It is a safe bet in this day and age that at least half of a patient group will be well informed enough to know what is really going on and see that a few quid a month really is good value for money to be on the books of a decent dentist.

Of course if it's a dentist who you aren't really happy with anyway, then now may be a good time to have a look at what else is available. I cannot recommend chasing down the last NHS dentist in the country though.

As I have been saying lately, now is the time to find a decent private dentist and to become an established patient there. in a couple of years time, the good private places will be stuffed full of patients discontented with the NHS service, leaving very little choice for those that have stuck with the nHS 'come what may'

[raymond]

I hope all those patients forced to "go private" will get a refund on their national insurance contributions which will no longer be needed to pay for NHS dentistry.

By the way, undisputed truth may recall the fantastic laser treatment that meant no more drilling ever again .... how many dentists are using that ?

I would prefer my dentist to make a professional decision about new techniques based on his years of training and many years of experience rather than some book jockey on a forum who knows all about dentistry by being a patient.

[Symbeaux1]

Toothsmith,
I would appreciate your advice, I do not neglect my teeth, but it sure looks as if I do!! I'm going to the dentist tomorrow because I've lost part of a back tooth filling. My question is, having had three extractions after unsucessful root canal work post-abcess several years ago (one gap in front bottom and other two visible) , I really need to be able to smile again, I have broached the subject several times with my dentist regarding the possibility of having some sort of bridge work and his attitude is that it will be considered at a later date, how do I pin him down in the prevailing climate of change to say if it is ever going to happen ?? Or should I just have the treatment necessary to secure a certificate of dental health and then sign up with denplan???

[Toothsmith]

I hope all those patients forced to "go private" will get a refund on their national insurance contributions which will no longer be needed to pay for NHS dentistry.


Can't argue with that, but dentistry comes out of general taxation, not N.I.

Also, if every taxpayer got his/her NHS Dentistry bit back, it would probably only pay for a round of drinks once a year. :o That's part of the problem!

[Toothsmith]

Toothsmith,
I would appreciate your advice, I do not neglect my teeth, but it sure looks as if I do!! I'm going to the dentist tomorrow because I've lost part of a back tooth filling. My question is, having had three extractions after unsucessful root canal work post-abcess several years ago (one gap in front bottom and other two visible) , I really need to be able to smile again, I have broached the subject several times with my dentist regarding the possibility of having some sort of bridge work and his attitude is that it will be considered at a later date, how do I pin him down in the prevailing climate of change to say if it is ever going to happen ?? Or should I just have the treatment necessary to secure a certificate of dental health and then sign up with denplan???


You are highly unlikely to get any bridgework on the NHS nowadays, and even less likely after April 1st. A simple removeable denture would be the most likely treatment, and that would cost you £189 after 1st.

You could become 'dentally fit' and sign onto Denplan, but Denplan is a maintenance contract, not an 'improvement' contract. You will not be able to get a bridge provided under Denplan where one didn't exist before.

To 'Improve' things, it will have to be a case of 'hand in pocket' I'm afraid, but take your time to find a decent dentist who you are happy to do the treatment before rushing in.

I'm sure you will find the result will be worth it.