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

jugglebug

Xaccers wrote: »

Just got off the phone to the PEM, very nice lady who guessed what had happened when I started to explain.
Confirmed that as it was a single scale and polish with no follow up required it should have been included in the £16.50
Also confirmed that if I go ahead with the filling before and after the extraction, then I'll be charged at band 2 twice, thought it was strange and suggested I talk to the dentist about whether it does actually make sense to fill before the extraction.
Raised it as a formal complaint, she's going to type up and send me my statement to sign and then take it further with the practice.

Agree with everything above except the "no follow up" part.
The NHS contract, along with its patient charge regulations makes absolutely no mention of how periodontal (gum) disease should be managed with regard to timescales, numbers of visits etc etc.
This is one of the many faults with the system. However by making that statement she is incorrect.
In the old days a course of periodontal care was strictly defined (which in itself was daft because we are all different in how we respond to such things).
This isn't to take away from the fact that you were entitled to your treatment under the NHS, and your complaint has validity. Just not on that one point.

welshdent

Xaccers wrote: »

I've been reading this thread with great interest.


Today was the appointment, was charged £32.50, took 20 minutes, hygienist got to work grinding away and picking, while her assistant did a great job sucking any debris/water away, then she used the rotary toothbrush, talked about flossing, I said I've started using those picks with floss in the end as I've never got on with normal floss, she said great.
Out in the car, I checked my teeth, the stain is still there which is a shame, but I can feel the gaps between my teeth are now bigger.
Got home and told my gf, who asked why I was charged as scale and polish should be included in the £16.50
We looked it up and yes, it is indeed included, and I was definitely told I needed it, and definitely not told it would be private.
So I phoned the practice up and queried the cost, they said it was private, I said I'm an NHS patient and it should be included in the £16.50 I've already paid. They claimed it was a more intense scale and polish than an NHS one (despite it being identical to all the other scale and polishes I've had in the past on the NHS), I pointed out they didn't even get rid of the stain and was told they can't clean teeth and very blase said if I liked I could complain to the PCT, which I will do tomorrow.

They SHOULD have made you aware of what you were agreeing to however a few points ... lack of follow up is in no way indicitive of what is required or has been carried out. Indeed as soon as a dentist closes a course of treatment, thats it for follow up care. You are entitled to a 2 month continuation period for treatment the same band or lower ... and fillings and crowns/inlays are guaranteed for 1 year. Thats it. You are then the "property" of the LHB/PCT. The charge band is related as stated before .. to the diagnosis and recommended treatment to be done. The bands are also shown in a link in this thread. No mention of follow ups and recalls are to be recommended as per NICE guidelines. The gaps you found getting worse are probably the natural spaces between your teeth now that the calculus deposits have been removed (I feel the time spent on you alludes to there being SOMETHING to remove).
If you did indeed have sufficient debris to remove then you MAY (although your dentist would need to be able to demonstrat reasoning - again see before) ... have qualified for a band 2 charge which would have resulted in a charge of £39 in wales and £42 in england. You MAY have been treated privately as it may have been cheaper for you. I am just putting another slant on it as I Can not see you or your notes.

Before complaining directly PLEASE speak to the practice who may be able to explain things to you and sort things out in a more pleasant manner for both sides.
WADR and I do not mean to be disrespectful but you probably can not quantify on the basis of experience, the difference between a simple scale and polish or a deeper cleaning. See previous notes!

coldstreamalways

It is frustrating when patients complain to the PCT before the dentist has had a chance to explain their thoughts. Just another reason there are so few NHS dentists in the country and certainly one of the reasons I will never return to the Nash. Totally out of control of any aspect of your clinical decision making if a patient doesn't like what you've said.

Still, if dentists didn't take advantage of patients not knowing their rights, perhaps there would be fewer complaints to the PCT's "experience manager" who is almost certainly not qualified enough to put a plaster on someone let alone advise someone about wisdom teeth surgery.

Xaccers

coldstreamalways wrote: »

It is frustrating when patients complain to the PCT before the dentist has had a chance to explain their thoughts. Just another reason there are so few NHS dentists in the country and certainly one of the reasons I will never return to the Nash. Totally out of control of any aspect of your clinical decision making if a patient doesn't like what you've said.

Still, if dentists didn't take advantage of patients not knowing their rights, perhaps there would be fewer complaints to the PCT's "experience manager" who is almost certainly not qualified enough to put a plaster on someone let alone advise someone about wisdom teeth surgery.

Thankfully PEMs are qualified enough to comment on what a dentist should explain to a patient, and what is included in the fees.
Of course, if I were to just have a quiet word with the dentist, I'm sure I could get a refund, they'd be happy as no one else would be aware of what they're up to, and they'll be free to continue scamming their other patients.
Personally i have no pressing need for the incorrect charge to be refunded, I'm not in financial dire straits, however many people are finding it hard to make ends meet, so that money which they shouldn't be charged is needed for other things.
As I said to the PEM, I want two things to come out of this, first a refund, and second, and to me more important, an assurance that the practice will abide by the rules and not over charge their patients.

In saying the gaps between my teeth have increased, I wasn't saying that was a bad thing, I was saying it to show that they did indeed remove calculus, I'm not disputing that I needed a scale and polish, infact quite the opposite, I definitely needed a scale and polish hence why I should not have been charged extra.

brook2jack, she informed me that if it was found the molar needed to come out even though the x-rays didn't show much decay, then it would be done at the same time as the wisdom tooth.
My concern is that as she has said the filling will have to be re-done after the wisdom tooth is extracted as she'll have better access, then why try and fill it while there is such poor access? Especially when the wisdom tooth which actually does have a hole large enough for food to get in and cause discomfort isn't going to be filled in the mean time.
Why put a patient through the pain of a filling twice, and charge them twice?

boozercruiser

Xaccers wrote: »

Thankfully PEMs are qualified enough to comment on what a dentist should explain to a patient, and what is included in the fees.
Of course, if I were to just have a quiet word with the dentist, I'm sure I could get a refund, they'd be happy as no one else would be aware of what they're up to, and they'll be free to continue scamming their other patients.
Personally i have no pressing need for the incorrect charge to be refunded, I'm not in financial dire straits, however many people are finding it hard to make ends meet, so that money which they shouldn't be charged is needed for other things.
As I said to the PEM, I want two things to come out of this, first a refund, and second, and to me more important, an assurance that the practice will abide by the rules and not over charge their patients.

In saying the gaps between my teeth have increased, I wasn't saying that was a bad thing, I was saying it to show that they did indeed remove calculus, I'm not disputing that I needed a scale and polish, infact quite the opposite, I definitely needed a scale and polish hence why I should not have been charged extra.

brook2jack, she informed me that if it was found the molar needed to come out even though the x-rays didn't show much decay, then it would be done at the same time as the wisdom tooth.
My concern is that as she has said the filling will have to be re-done after the wisdom tooth is extracted as she'll have better access, then why try and fill it while there is such poor access? Especially when the wisdom tooth which actually does have a hole large enough for food to get in and cause discomfort isn't going to be filled in the mean time.
Why put a patient through the pain of a filling twice, and charge them twice?

I find almost all of the posts here very interesting and I do hope that most visitors are finding the topic(s) discussed of value to them.

If I may say so, you really sound like you know a thing or two:T

Very interesting addition to the debate, that!:D

Xaccers

boozercruiser wrote: »

I find almost all of the posts here very interesting and I do hope that most visitors are finding the topic(s) discussed of value to them.

If I may say so, you really sound like you know a thing or two:T

Very interesting addition to the debate, that!:D

Thanks BC.
I would think all of us, patients and practitioners alike, are against dentists overcharging patients.

brook2jack

X rays don't tell the whole story. The hole in the tooth in front of the wisdom tooth may be larger than anyone thinks it is. It may be so large that it causes problems eg the decay may be so close to the nerve that the tooth abcesses etc.

The dentist will not know until they drill the tooth the hospital will not drill the tooth under ga and will not know how extensive decay is.

As the tooth is decayed it is weak and will probably crumble when pressure is applied nearby to take the wisdom tooth out. The hospital once it takes xrays will always write to the dentist if it sees decay asking for it to be dealt with before the wisdom tooth comes out. So the dentist will have no choice but to fill tooth before you have ga.

I think you are also underestimating how long it may be before you have the wisdom tooth out. The first appointment will only be to examine you etc and then you will be on waiting list to have wisdom tooth out. I know there is a sixteen week target but wisdom teeth surgery often have longer waits. You will be looking at a few months with a hole in your tooth that is only going to get larger.

It makes alot of sense to fill tooth now and warn you that because of problems with access and because taking the wisdom tooth out might chip tooth in front then filling might need redoing.

boozercruiser

Xaccers wrote: »

Thanks BC.
I would think all of us, patients and practitioners alike, are against dentists overcharging patients.

Yes, and like you I am certain that this certainly applies to the fantastic practitioners who post here helping with free time and very knowledgeble advice.

With great respect to them, not always agreed with mind.:)

I do think though that many of the Dentists who have been brought over from the continent to work for the Denticare's of this world are under pressure to make undue charges.

After all, as has already been said here, I think the 'imports' don't REALLY know our NHS way of working...and the training perhaps is not quite up to what the training would be in the UK.

To be brutaly honest. When I am now sitting in that Dentists chair...I just do not feel as safe as I did with my past English trained folk.

(Oh! and there is no racism meant here in any of my comments at all!)

For instance, one little thing that happened last time. I had a tooth out. In the past I would have an injection of aneshetic, sent out of the room while the Dentist saw another patient. Then back in and I wouldn't feel any pain for the extraction or fillings.

Last time I was having a rear tooth out, I had an anethetic, kept in the chair for what seemed like no time at all, and I was feeling so much pain that he stopped half way through the 'pull' , gave more anesthetic, waited a couple of minutes and started again.

That paricular Dentist has gone back home to Poland now, (just before he TRIED to charge me for a Scale and Polish) but you get my grift?

Xaccers

brook2jack wrote: »

X rays don't tell the whole story. The hole in the tooth in front of the wisdom tooth may be larger than anyone thinks it is. It may be so large that it causes problems eg the decay may be so close to the nerve that the tooth abcesses etc.

The dentist will not know until they drill the tooth the hospital will not drill the tooth under ga and will not know how extensive decay is.

As the tooth is decayed it is weak and will probably crumble when pressure is applied nearby to take the wisdom tooth out. The hospital once it takes xrays will always write to the dentist if it sees decay asking for it to be dealt with before the wisdom tooth comes out. So the dentist will have no choice but to fill tooth before you have ga.

I think you are also underestimating how long it may be before you have the wisdom tooth out. The first appointment will only be to examine you etc and then you will be on waiting list to have wisdom tooth out. I know there is a sixteen week target but wisdom teeth surgery often have longer waits. You will be looking at a few months with a hole in your tooth that is only going to get larger.

It makes alot of sense to fill tooth now and warn you that because of problems with access and because taking the wisdom tooth out might chip tooth in front then filling might need redoing.

So what you're saying is, not only did the dentist scam me by charging for a scale and polish that should have been included in the band 1 payment, but she also hasn't a clue when it comes to hospital extraction procedures by telling me the wrong information regarding the molar if it needs to be extracted?
Not only that, but she'll also fill a tooth which is giving me no trouble twice, but the tooth which is giving me trouble she'll leave open for months until it's extracted?

welshdent

Xaccers wrote: »

So what you're saying is, not only did the dentist scam me by charging for a scale and polish that should have been included in the band 1 payment, but she also hasn't a clue when it comes to hospital extraction procedures by telling me the wrong information regarding the molar if it needs to be extracted?
Not only that, but she'll also fill a tooth which is giving me no trouble twice, but the tooth which is giving me trouble she'll leave open for months until it's extracted?

Brook isnt saying that at all. What brook is saying is that the hospital will only do what they are asked to do i.e extract the tooth that is deemed necessary for extraction. They will not do any exploration of the other tooth at all. What brook is saying is that if you have decay in a tooth then yes it is best to at least remove it before going to the hospital. This serves 2 purposes. 1 allows the dentist to see how extensive the decay is ... and also STOP the decay progressing to possibly avert the need for an extraction in that tooth. An x ray shows historic decay. A "carious lesion" actually has an advancing front which may be as much as 2 mm. THis will not show on an x ray because an x ray will only show what has already been demineralised and decayed. As a result I always know that whatever an x ray shows me, the reality will be bigger. Should the filling break during the extraction then its hardly your own dentists fault. Its a complication that MAY occur and you are rightly being warned about it.