Asked for Dental NHS Scale and Polish.Told "Go to Hygienist at £25 extra"

boozercruiser

Hello. For my first post I would like to ask this:-
I went to my NHS Dentist today because a filling had come out and I had to have it re-done. I paid £39 for the privilege.
I had asked for a scale and polish and the dentist said that I will have to see the Hygienist to have this done at a cost of £25. (Total £64)
I am aged 66 now (No, I am not entitled to help with charges) and in my memory this was always included in the check up/treatment and I feel that this is just a new trend to fleece people.:mad:
Any advice or thoughts out there would be greatly appreciated.:T
Best regards
Boozercruiser.

Using information that other kind posters have inputted below, I have dug out this info which I hope will help you also.

Although the regulations below refer to Wales, looking at the England Regulations I cannot see any difference. If you wish to check this for yourself then go to http://www.gov.im/lib/docs/dhss/health/sd10006doc.pdf
NATIONAL ASSEMBLY FOR WALES
STATUTORY INSTRUMENTS
2006 No. (W. )
NATIONAL HEALTH SERVICE, WALES
The National Health Service (Dental Charges) (Wales) Regulations 2006

SCHEDULE 1 Regulation 4(1)
Band 1 Charges – Diagnosis, treatment planning and maintenance
(a) clinical examination, case assessment and report
(b) orthodontic case assessment and report
(c) advice, dental charting, diagnosis and treatment planning
(d) radiographic examination, including panoral and lateral headplates, and radiological report
(e) study casts including in association with occlusal analysis
(f) colour photographs
(g) instruction in the prevention of dental and oral disease including dietary advice and dental hygiene instruction
(h) surface application as primary preventive measures of sealants and topical fluoride preparations
(i) scaling, polishing and marginal correction of fillings
(j) taking material for pathological examination
(k) adjustments to and easing of dentures or orthodontic appliances
(l) treatment of sensitive cementum
　
SCHEDULE 2
Regulation 4(2)
Band 2 Charges - Treatment
(a) non-surgical periodontal treatment including root-planing, deep scaling, irrigation of periodontal pockets and subgingival curettage and all necessary scaling and polishing
(b) surgical periodontal treatment, including gingivectomy, gingivoplasty or removal of an operculum
(c) surgical periodontal treatment, including raising and replacement of a mucoperiostal flap, curettage, root planning and bone resection
(d) free gingival grafts
(e) permanent fillings in amalgam, composite resin, synthetic resin, glass ionomer, compomers, silicate or silico-phosphate, including acid etch retention
(f) sealant restorations
(g) endodontic treatment of permanent or retained deciduous teeth
(h) pulpotomy
(i) apicectomy
(j) extraction of teeth
(k) transplantation of teeth
(l) oral surgery including surgical removal of cyst, buried root, unerupted tooth, impacted tooth or exostosed tooth and alveolectomy
(m) soft tissue surgery in relation to the buccal cavity and lips
(n) frenectomy, frenoplasty and frenotomy
(o) relining and rebasing dentures including soft linings
13
　
(p) addition of tooth, clasp, labial or buccal flange to dentures
(q) splints (other than laboratory fabricated splints) in relation to periodontally compromised teeth and in connection with external trauma
(r) bite raising appliances (other than laboratory fabricated appliances)
　
SCHEDULE 3
Regulation 4(3) and (4)
Band 3 Charges- Provision of Appliances
(a) porcelain, composite or acrylic mastique veneers, including acid etch retention
(b) inlays, pinlays, onlays and palatal veneers, in alloys containing 60% or more fine gold, porcelain, composite resin and ceramics
　
Crowns including any pin or post aids to retention
(c) full or three quarter crown cast in alloys containing not less than 33
1/3% fine gold or platinum or palladium
(d) full or jacket crown cast in alloys containing stainless steel or cobalt chromium or nickel chromium
(e) crown in porcelain or synthetic resin and other non-metallic crowns
(f) full or jacket crowns in alloys containing not less than 33
1/3% fine gold or platinum or palladium, or alloys containing stainless steel or cobalt chromium or nickel chromium, with thermally bonded porcelain
(g) jacket crown thermally bonded to wrought platinum coping
(h) prefabricated full or jacket crown, including any pin or post retention
(i) crowns in other materials
　
Bridges including any pin or post aids to retention
(j) bridges in alloys containing 60% or more fine gold with or without thermally bonded facings
(k) bridges cast in alloys containing stainless steel, cobalt chromium or nickel chromium, with or without thermally bonded facings
(l) acid etch retained bridges
(m) bridges in other materials
(n) provision of full (complete) or partial dentures, overdentures and obturators in synthetic resin or metal or both synthetic resin and metal, including any cast or wrought metal components or aids to retention
(o) orthodontic treatment and appliances
(p) other custom made appliances excluding sports guards
14
SCHEDULE 4
Regulation 4(5)
Urgent Treatment under Band 1 Charge
(a) examination, assessment and advice
(b) radiographic examination and radiological report
(c) dressing of teeth and palliative treatment
(d) pulpectomy or vital pulpotomy
(e) re-implantation of a luxated or subluxated permanent tooth following trauma including any necessary endodontic treatment
(f) repair and refixing of inlays and crowns
(g) refixing a bridge
(h) temporary bridges
(i) extraction of not more than 2 teeth
(j) provision of post-operative care including treatment of infected sockets
(k) adjustment and alteration of dentures or orthodontic appliances
(l) urgent treatment for acute conditions of the gingivae or oral mucosa, including treatment for pericoronitis or for ulcers and herpetic lesions, and any necessary oral hygiene instruction in connection with such treatment
(m) treatment of sensitive cementum or dentine
(n) incising an abscess
(o) other treatment immediately necessary as a result of trauma
(p) not more than 1 permanent filling in amalgam, composite resin, synthetic resin, glass ionomer, compomers, silicate or silico-phosphate including acid etch retention



Simple...isn't it?

NHS dental charges from 1 April 2010
[FONT=Times New Roman,Times][FONT=Times New Roman,Times]�[/FONT]
[/FONT][FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]The charge you pay depends on the treatment you need to keep your mouth, teeth and gums healthy. You will only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it – either Band 1, Band 2 or Band 3. If you have to be referred to another dentist for another course of treatment, you can expect a second charge. Some minor treatments are free, including having stitches removed and repair to dentures (if they can be mended). [/FONT]
[/FONT]If you are not exempt from charges, you should pay one of the following charges for each course of treatment you receive:[FONT=Times New Roman,Times][FONT=Times New Roman,Times]�[/FONT]
[/FONT]Band 1 course of treatment – £16.50
[FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]This covers an examination, diagnosis (e.g. X-rays), advice on how to prevent future problems, A SCALE AND POLISH, IF NEEDED!!!!!!, and application of fluoride varnish or fissure sealants. If you require urgent care, even if your urgent treatment needs more than one appointment to complete, you will only need to pay one Band 1 charge. [/FONT]
[/FONT]Band 2 course of treatment – £45.60
[FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]This covers everything listed in Band 1 above, plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth. [/FONT]
[/FONT]Band 3 course of treatment – £198.00
[FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]This covers everything listed in Bands 1 and 2 above, plus crowns, dentures or bridges. [/FONT]
[/FONT]Free NHS dental treatment or help with health costs
[FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]You may be eligible for help with all or part of the costs of your NHS dental treatment. To see if this applies to you, see the leaflet [/FONT][/FONT][FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]NHS dental services in England[/FONT][/FONT][FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light], which is available from any NHS dental practice or at [/FONT][/FONT]www.dh.gov.uk/dentistry
[FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]For advice on how to get help with health costs [/FONT][/FONT]call 0845 850 1166 [FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]or see [/FONT][/FONT][FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]Help with health costs [/FONT][/FONT][FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light](HC11), which is available from Jobcentre Plus offices and NHS dentists, or at [/FONT]
[/FONT]www.nhsbsa.nhs.uk
For further information on NHS dental services and dental charges, see the leaflet [FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]NHS dental services in England[/FONT][/FONT], which is available from NHS dental practices, or the more detailed [FONT=Frutiger 45 Light,Frutiger 45 Light][FONT=Frutiger 45 Light,Frutiger 45 Light]Guide to NHS dental services in England[/FONT][/FONT], which are available at www.dh.gov.uk/dentistry, or ask your primary care trust (PCT) for help.

Wales is the same....but a bit cheaper.

Toothsmith

Are you in England/Wales, or Scotland/Nthrn Ireland?

The fees you quote don't look like English NHS fees to me. The different countries have different systems in our glorious 'National' Health dental service.

boozercruiser

Toothsmith wrote: »

Are you in England/Wales, or Scotland/Nthrn Ireland?

The fees you quote don't look like English NHS fees to me. The different countries have different systems in our glorious 'National' Health dental service.

Hello Toothsmith. I see you do lots of Posts here helping people. People like :A
My Wife and I live in Machynlleth west wales.
All I can say is that when this Dentist last (12 months ago) did a Scale and Polish he just scraped around the bottom lower teeth and that was it. No scrape all around the teeth as with my previous Dentists, or the use of a rotating Rubber Probe to take plaque off the teeth.
(Are you able to advise me what a Scale and Polish should involve?)
Now it is even worse than that. "Off to the Hygienist with you for a further £25.
The Dentist seems to go under an orginisation called Denticare which is NHS but will I think do private also.
Many Thanks for any advice given.:beer:

alison999

I really cant offer any help as I know nothing about charges in Wales, but why not ring the practice and ask them about their charging system?

Toothsmith

boozercruiser wrote: »

Hello Toothsmith. I see you do lots of Posts here helping people. People like :A
My Wife and I live in Machynlleth west wales.
All I can say is that when this Dentist last (12 months ago) did a Scale and Polish he just scraped around the bottom lower teeth and that was it. No scrape all around the teeth as with my previous Dentists, or the use of a rotating Rubber Probe to take plaque off the teeth.
(Are you able to advise me what a Scale and Polish should involve?)
Now it is even worse than that. "Off to the Hygienist with you for a further £25.
The Dentist seems to go under an orginisation called Denticare which is NHS but will I think do private also.
Many Thanks for any advice given.:beer:

Right - the Welsh NHS charges are different from the English ones, but the system of banded treatments is the same. So I can't be 100% sure of the exact charges, but the £39 you've been charged sounds like a Band 2 charge (It's £44.60 in England). This is the charge that includes all examination, X-rays, clean and polishes, and any necessary fillings.

This means that if you NEED a clean and polish, then you are entitled to it under that one Band 2 charge.

It depends how the dentist phrased his suggestion that you see the hygienist. If you were told you NEEDED to see the hygienist, then he really should have some NHS alternative to suit your need. He can't charge an NHS patient a private fee to sort out necessary treatment.

If he said your teeth were fine, but you might like to make an appointment with the hygienist, then that's OK. (A bit on the 'grey' side, but not actually breaking the terms of his contract) The clean up he doesn't consider to be 'necessary' but is offering it as a service you might like to choose.

Should you decline his nice offer, and your gums get a bit inflamed and you 'need' a clean next time - then he would be obliged to offer that on the NHS.

In short, this is a common 'dodge' on the NHS, with dentists in NHS contracts trying to get private 'extras' from as many NHS patients as they can.

If you feel the clean was sold to you as a 'necessary' treatment, then a complaint to the dental department of your local PCT may well be in order. They would then have a word with the dentist and 'remind' him of his obligations on the NHS contract he signed, and is being paid for.

MarkyMarkD

Good answer, Toothsmith.

Whilst I am generally pretty happy with my NHS dentist, there is a mysterious reduction in the "need" for scale & polish now that it's included in the (far higher) minimum standard NHS charge.

When a check-up was just £4 or so, I "needed" a scale and polish on every visit. Now, I hardly "need" them at all.

Strange, eh?

domdent

as part of your dental examination your gums should be examined and a BPE chart done. This grades the sextants of the mouth from 1 to 4 which then indicates what level of treatment you need to get your gums healthy.

THe BPE should be done every 12 months.

tirednewdad

For NHS cleans, you do not need to give the polish if the teeth don't require it. The scale part of it is usually essentail for most patients. Doing the BPE gum measurement will highlight the areas which require the clean.

If however you look after them very well and are also very lucky, a clean might not be required every examination appointment.

If your mouth requires a clean according to the dentist, then he has to give you an NHS option (unless he is a Private only dentist)!

boozercruiser

Thank you for your reply's people. BPE Chart? I wouldnt know what one was if I fell over it!
This morning I sent this E. Mail to the Dental Practice. I await a reply.

The Practice Manager
Machynlleth Medical Practice
Dinticare Limited

Good Morning,
It would appear that you cut me off during our telephone conversation yesterday which if this was the case is very rude. What I was trying to say is this.
The Dentist has said he wants to refer me on to the Hygienist. Following my £39 for a re-done filling yesterday this will involve a further payment of £25. I am on a Government Pension, not made of money and cannot afford these further costs.
All I am requesting for my booking on 10th November is a check up to include a Scale and Polish which I understand is included in NHS charges. In the past this has involved the scraping of the sides of the teeth and then using a rotating rubber probe to remove plaque.
This I feel is good enough for me.
It appears to me that the now trend is to scoot people off to the Hygienist at further profit to Denticare instead of carrying out the traditional Scale and Polish.
This E. Mail is not yet meant to be a complaint yet as I am just trying to find out if my 10th November appointment is still O.K. and if so will it meet my expectations?
I trust you will acknowledge that you have received this E. Mail.

Yours Sincerely

P.S. No reply yet.

alison999

MarkyMarkD wrote: »

Good answer, Toothsmith.

Whilst I am generally pretty happy with my NHS dentist, there is a mysterious reduction in the "need" for scale & polish now that it's included in the (far higher) minimum standard NHS charge.

When a check-up was just £4 or so, I "needed" a scale and polish on every visit. Now, I hardly "need" them at all.

Strange, eh?

Its tricky. I wouldn't want to do 'extra' work that I wouldnt get paid for.... but then maybe those dentists thinking that should've gone private? Maybe they are just trying to work within the new contract as best they can.

alison999

boozercruiser wrote: »

Thank you for your reply's people. BPE Chart? I wouldnt know what one was if I fell over it!
This morning I sent this E. Mail to the Dental Practice. I await a reply.

The Practice Manager
Machynlleth Medical Practice
Dinticare Limited

Good Morning,
It would appear that you cut me off during our telephone conversation yesterday which if this was the case is very rude. What I was trying to say is this.
The Dentist has said he wants to refer me on to the Hygienist. Following my £39 for a re-done filling yesterday this will involve a further payment of £25. I am on a Government Pension, not made of money and cannot afford these further costs.
All I am requesting for my booking on 10th November is a check up to include a Scale and Polish which I understand is included in NHS charges. In the past this has involved the scraping of the sides of the teeth and then using a rotating rubber probe to remove plaque.
This I feel is good enough for me.
It appears to me that the now trend is to scoot people off to the Hygienist at further profit to Denticare instead of carrying out the traditional Scale and Polish.
This E. Mail is not yet meant to be a complaint yet as I am just trying to find out if my 10th November appointment is still O.K. and if so will it meet my expectations?
I trust you will acknowledge that you have received this E. Mail.

Yours Sincerely

P.S. No reply yet.

It will be interesting to see what they say, though I would have done it through a phone call rather than a email, if your email has gone into their spam folder then you'll never get a reply.