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

welshdent

Do you know, to be honest if all you are having is a hygieneist scaling every 3 months and not much else with the dentist then that surprises me .... because it would be in their interests to treat you themselves as an exempt patient with periodontal disease. One of the bigger problems I have is getting patients to accept and understand that their condition can not be addressed with "a scrape and polish" and that they need a band 2 equivalent deeper clean (more expensive). Its not a problem with exempt patient for obvious reasons and managing someones deeper clean is a lot less difficult that for example a root filling or doing a difficult extraction, both of which are band 2 items. You should be ... as long as your BPE scores can justify ... an "easy" 3 UDAs hence my surprise that the dentist does not do it themself. We are constantlt told that this new contract is a swings and roundabouts set up and this would be one of those instances where you can claim easy UDAs rather than the rather frustrating moments where you have to all but rebuild someones dentition over multiple visits all for a few quid. toothsmith is correct, you are entitled to it on the NHS if they say it is needed. you should also see about getting that crown sorted ... once your gums are healthy.

stuchop

I have recently moved to a local dentist who has just started accepting NHS patients again.

My previous dentist carried out a scale and polish as necessary as part of my check up visit.

I was quite surprised haveing only recently seen my old dentist to be told by the new dentist that my gums looked diseased and I must see the hygienist.

I then went to see the hygienist who charged £45 for a half hour visit and I received a scale and polish with check and advice on how to floss. The hygienist actually told me that my gums were in general helathy and I was brushing well.....quite contrary to what the dentist told me.

It was only on departure I noticed the treatment bands for nhs charges and saw that scale and polish was included amonst the band a treatment - hence I have looked to see if anyone else has had the same experience.

I asked the receptionist on departure about scale and polish under a routine check up and she told me that this would be for just a basic scale and polish and the hygienist in effect does a more thorough job.

She advised that I book my next appointment in conjunction with a visit to the hygienist to save me time so I could get both done at the same time.

From what I have read and understand from this thread then the scale and polish should only be done under the nhs if required and shouldn't require me to pay unless I choose to do so. It seems this practise is routinely 'pushing' patients towards a hygienist when this treatment should be covered under the nhs.

I am considering changing dentist immediately and intend to write to them for their comments.

I spoke with my wife and they have booked her in for an appointment for a check up and visit to the hygienist for her next 6 monthly check.

It appears to be sharp practice to me and should be covered under the routine dental check up - am I right?

I wonder how many other of their patients are not aware what should be covered under nhs treatment?

If we have a visit to the hygienist every check up then thats £180 extra a year we are paying...

brook2jack

If a scale and polish is clinically necessary because eg you have gum problems then it is included in band one charges.

If a more intensive treatment is necessary then it is a band two charge £46 ish pounds.

If it is not clinically necessary ie you want staining removed then the dentist can offer this privately.

If you are having a band two treatment or a mixture of nhs and private treatment then you should have received a fp17dc estimate form stating clearly what charges you are paying for what.

I personally withdrew from the nhs for adults because I knew I could not afford to send patients to a hygienist on nhs fees (amongst many other things).

welshdent

Did you ONLY pay £45 for both or was it £15 ish AND £45?

alison999

This again... when will it end?!

stuchop

I paid for my check up and was told I should see the hygienist as I had 'bad gums' - first I was aware of any gum problem having only recently seen the dentist I was moving from (less than 3 months) but thought nothing more as if I had a problem tyhen it needed resolving, so on the day I paid my £16.50 for check up and booked hygienist appointment was given quote for hygienist of £45 - seemed that if it was required then it would be worth paying.

At the appointment the Hygieniest told me I was good on the whole at brushing and gums were in fine condition - £45 for 20 minutes consultation (scale and polish and a reminder to floss regularly plus a leaflet and a free sample of colgate total) - it was only whilst I was waiting to pay I noted that a scale and polish is listed as covered under band A treatment.

Having now read up further it appears that a necessary scale and polish should be covered under band a treatment.

The practice however now suggests we book a visit to hygienist along with every appointment and does not appear to offer scale and polish under normal check up conditions, based on comparing what my wife was told by same dentist with my experience. She also has to see the hygienist and has been told to book appointments with dentist and hygienist in tandem.

Surely they should be clear that some of the hygienist visit would be covered under normal treatment - perhaps the visit to the hygienist is recommended every six months but not a necessity and in fact if required the scale and polish should be covered under a band a check up?

brook2jack

You are right ,Read my previous posting for what should have happened.

Your choices are
1 complain to practice that they didn't follow above proceedure and s and p if necessary is available on nhs.

2 return to your old dentist

3 at £120 a year each this will be the same as many private practices offering denplan essentials or similar schemes which include 2 lots of check ups , two hygienist xray visits and normally some insurance covering accidents etc. Then you would be getting proper private treatment for the same as it's costing you "nhs".

George_Bray

boozercruiser wrote: »

had a look on the NHS website today, and it says that the scale and polish is included in the first £15.50 that I paid on the first occasion, and just because I had to go back again, which is down to them anyway, it is still included.

This is interesting. I'm sorry to hear about the difficulties you are experiencing under NHS dentistry.

I went for a check up earlier this week. The NHS dentist recommended a visit to the hygienist for £35. I asked if this was clinically necessary and was told I had some gum problems. I questioned why a 'scale & polish' couldn't be included under the NHS if it's clinically necessary. The dentist then agreed to make a further appointment to carry it out under the NHS. Back in reception, I was asked for £45 (approx) when I expected to pay only £16 (approx) for level 1. The Dentist implied the gum work was 'periodontal' which moved it into level 2. How can this be? Five minutes earlier he said the hygienist was suggested, so the work can't be all that 'advanced'. The description of level 1 charges (£16 approx) specifically mention scale, polish and more than one visit if required. Is this fair?

How can I ascertain whether a level 1 or 2 charge is justified when the work is just a quick scan round, X rays, and something akin to a 'scale & polish'. What can the dentist possibly do beyond that to justify 'periodonta'l treatment?

I just noticed stuchop's post yesterday. Is it the latest means of extracting more money? i.e. to charge for level 2 when it should be level 1?

Toothsmith

It's a very grey area when a 'simple' clean becomes a 'intensive' clean. It's not really defined by who does it or how many appointments (Although if it's done in less than 20 mins, it's hardly intensive).

A couple of misconceptions in your post though George,

1. Hygienists can and do tackle some very complex periodontal cases. I completely rely on mine to treat all sorts of severe perio problems. Frankly, they're better than me at it.

2. Just because you're paying more on the NHS, doesn't mean the dentist is getting more money.

The way the NHS contract works now, dentists get a monthly cheque of 1/12 their contract value. Any patient payments recorded are deducted from this cheque. So the dentist isn't getting paid more.

The difference from the dentist's point of view is that he'll get 3 points for a 'intensive' clean, but just one if it's just a check-up with a clean up. The dentist has to get a certain number of target points per year to maintain his contract value. If he gets more than 4% less, then he'll have his contract cut. If he does more, then he can apply for a bigger contract next year (But will only get more if ther is 'unused' capacity from other dentists in the area). The extra points earnt that year are essentially done for free!

George_Bray

Toothsmith - thank you for your helpful response. I've learned something in that hygienists can tackle quite serious gum problems. I question, though, whether my gum problems are very bad at all - i.e. bad enough to justify a level 2 charge.

Leaving aside, the dentist's dealings with the NHS and how they get paid, how can I ascertain whether the dentist is doing enough work to justify a level 2 charge when it specifically states that 'scale and polish' is included in level 1? Is it time-based, like anything over 20 minutes, or is there some named procedure which takes the gum work up to level 2?