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

George_Bray

brook2jack and others - thank you for your suggestions. No, I've never smoked. It would be serious indeed, if the Dentist was making this up and I don't really have gum disease, so I guess he's noticed subtle signs, like you say. Trouble is, if I go to my GP and question the prescription, it could stir up a whole can of worms. If I go to another dentist for a second opinion, there could be a long wait and it will cost quite a bit. I trust it won't harm me if I take the 500g Amoxicillin tablets (but don't really need them). I don't floss because it seems like too much effort, if I'm honest.

brook2jack

The antibiotics dont worry me nearly as much as not flossing.

Theres a great phrase... only floss the teeth you want to keep.

welshdent

Your GP isnt qualified to assess a dental issue. You can question them as much as you like but they have zero idea when it comes to most dental matters let alone ones involving subtle signs. They are also completely incapable of examining you as they are highly unlikely to possess the necessary equipment

George_Bray

Following the mild surprise expressed here over the prescription, I double-checked with the pharmacist. She said 500g Amoxicillin was a normal adult dose and the prescription didn't seem out of the ordinary at all for my gum infection.

vvvvvvvvvvvvvvvv

Toothsmith wrote: »

I can't think of the last time I gave 500mg of amoxicillin for anything! I certainly wouldn't give it for gum problems!

Metronidazole is a more effective ab for gum problems, but even so it seems strange.

2nd opinion?

My OH was given both of those antibiotics to take at the same time only last week

George_Bray

The original thread title was: Asked for Dental NHS Scale and Polish.Told "Go to Hygienist at £25 extra"

My situation is now that I asked for a Dental NHS filling and was told "We'll refer you to a private dentist costing many £100s.

The dentist says the filling, and possible crown is beyond his capability. But is it beyond NHS capability? The dentist simply says he'll extract the tooth, which I'm very reluctant to accept. A visible quarter of the molar has gone and the X-Ray shows a shaft of decay going below the gum line. I thought this was a typical root canal job. How can I appeal? Is it reasonable to expect the NHS to fill this tooth? How can a private dentist do more?

Toothsmith

It's a bit misleading to just call it a 'filling' in your first line when it's really a root filling George.

Any time decay goes below gum level, the long term prognosis of the tooth is affected adversley. Even from your description of what you've seen, I would probably agree with your dentist that it's not worth saving.

There is no 'appeal' per se, but you could try a different dentist.

It might be that a private dentist can't 'do more'. You might get to see the specialist, and he decides it's not worth your while to try (Private specialists have nothing to gain by doing 'no hopers' even though you're paying.)

It might be that the private dentist will attempt it, but give you the warning that you might be paying a lot of money for something that will not last very long.

But the point is, it will be your choice. The NHS dentist has decided that it's not good value for the taxpayer for him to use his time to be heroic with a tooth with a very poor prognosis.

What you choose to spend your money on is up to you.

George_Bray

Toothsmith wrote: »

Any time decay goes below gum level, the long term prognosis of the tooth is affected adversley. Even from your description of what you've seen, I would probably agree with your dentist that it's not worth saving.

It's not what I wanted to hear but I guess you're probably right. The forum is so lucky having you as a member.

My filling might look like the photo shown here:

http://en.wikipedia.org/wiki/Root_canal

The filling in the middle of the photo towards the right of the tooth goes below gum level (on Wikipedia), so why is it such a problem for my tooth (from my amateur description)?

jugglebug

George_Bray wrote: »

It's not what I wanted to hear but I guess you're probably right. The forum is so lucky having you as a member.

My filling might look like the photo shown here:

http://en.wikipedia.org/wiki/Root_canal

The filling in the middle of the photo towards the right of the tooth goes below gum level (on Wikipedia), so why is it such a problem for my tooth (from my amateur description)?

a radiograph cant tell you the 3d situation, or show the gumline.
The central tooth in that radiograph is crowned, not filled. The core of that tooth is now a metal post (left hand root) with an amalgam filling placed right down into the right hand root. So this is within the tooth. There may very well be sound tooth above this fill line that is invisible on the picture as the metal blocks all the xrays.

When deciding if a tooth is restorable or not the amount of decay is one factor, but also where the decay is.
For example if it gets near to where the 2 roots divide (again using that tooth as an example) a small amount of decay could be terminal as you would be left with a very weak base to build any sort of restoration on. In that situation the root filling would be technically possible but getting any sort of long term filling / crown etc would be unlikely, therefore rendering the RCT pointless

George_Bray

The dentist said he lacked the necessary capability/skills/experience (I'm not sure which) to carry out a restoration but said/implied it could be done privately. It doesn't need hyper-expensive drugs or other expensive facilities, so why should I be turned away or fobbed off with an extraction? The cost to the NHS of a restoration would be trivial compared to major heart surgery or something, but it really does seem like NHS dentistry is being phased out. Another trap is that I had 4 X-rays at the first place so if I go for a second (NHS) opinion it will have to go through some kind of official X-ray transfer or referral, rather than me let the second dentist make up his own mind, without influence from the first dentist. It seems too risky to say nothing and let the second dentist take at least two further X-rays. Does anyone have any suggestions of what I might do to try and get a restoration under the NHS?