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

brook2jack

Cat, I can sympathise as NHS dentistry is utterly demoralising , particularly as a recently qualified dentist.

Plan your move to private practice now by taking post grad courses that interest you and will give you marketable skills. It will involve a great amount of expenditure so continue working part time to fund training and equipment.

Revitalise your enthusiasm for dentistry by doing bridge2aid or any one of the many volunteer projects abroad . Providing lifesaving treatment puts your troubles into perspective ,and will give you a massive boost. Again you will need to save to fund this.

Become involved in peer groups such as LDC or clinical audit etc. Being around others who understand and are in the same boat and being able to talk helps.

Set yourself a five year goal ... Where do you want to be and doing what in five years. You can do the dentistry you want to , just not in the NHS. Doing a max fac job just as a way of getting yourself out of a rut will achieve nothing unless oral surgery interests you. Target your courses/jobs to what you really want to do.

catdentist

Thank you for your kind suggestions.

I have done Crisis over the Christmas periods providing treatment for homeless people in mobile surgery although the NHS provides very adequate emergency dental care for this cohort of patients already.

I would love to do Bridge2aid and I am saving at the moment. I understand it is £2000 for 2 weeks as I would obviously be self funding.

I wanted to get out of the situation by doing a year of maxfac while picking up on some more oral surgery skill. I am also investigating the oral surgery specialist training options. (3 yr course rather than the mbbs maxfac route).

I would love to move towards private practice hence I feel it is essential to go into one of the speciality. I don't know how competitive the private market is.

Thanks for all the kind comments regarding JoJo's remark over my English ability.

brook2jack

There are other organisations such as mercy ships which do longer placements (christian content as well) and cheaper ways to volunteer abroad (Honduras, Gaza, etc keep eye out in dental mags , professional websites).

There is competition for work in private practice because dentists stay put. Patients value continuity. Most of us have worked many years NHS and then converted to private when it became too much. There is simply not the turnover of dentists that there are in NhS polyclinics. There is more scope in mixed practice for jobs.

boozercruiser

catdentist wrote: »

Jojo- thanks for your comment. Sorry if my English is not up to your standard but it is my third language as I am a foreign student and went to boarding school and university here. When I am upset my English tends not to be at as high a standard as it should. Thank you so much for pointing it out. I will try to improve on that.

Dear WD, I am studying some other courses at the moment. May be I should take up JoJo's kind remark and do some extra English courses.

Jokes aside I am thinking of leaving GDP for a while and do a yesr of maxfac- I will be older than the average SHO but it would be a change from UDA!

Hi catdentist, and welcome to the Forum:beer:

Most on here are very nice people, but I must warn you now, be prepared for the odd sarcastic remark now and then though.
Some people will have a go at you.

I wish you well in hopefully a very long and fruit full career. Just be nice to people and try not to scoot them off to the Hygienist when you know that you could and should give them a Scale and Polish under your NHS contract.:D

Hello guys...i am back!..I had my last treatment of this session of treatment for a left in root taken out and a filling....so for my £39 NHS charge I have now had treatment....

3 Fillings
1 Tooth extraction
1 Root extraction
4 Tubes of Duraphat 2800 ppm Fluoride Toothpaste to help with my gum disease and sensitive teeth.

Oh! I nearly forgot to mention.......

A SCALE AND POLISH!:D

When I was sitting waiting for my treatment today two people came down from treatment and the receptionist said to one "O.K. pay £129.....and I will book you to see the Hygienist" (£28).....the other person £39.....and a booking for....

you guessed it....The Hygienist (£28):eek:

I just sat there quietly as usual and thought......."Mugs"!;)

Toothfairy4

Hi boozercruiser, I am a dental hygienist myself and I love my job. I agree with you that your NHS dentist has a duty to undertake your treatment themselves under NHS fees, I don't disagree with you on that one at all. I do however think that the way you speak about us Hygienists is a bit unfair.

We do undertake a lot of very complex treatment (often seeing people with severe periodontal problems who need treatment every 3 months and prefer to come and see me for a longer period of time than pay the fee to see the dentist every 3 months), there is a lot more to it than 'a quick scale and polish'.

I work in 2 practices, one NHS and one private, in my NHS practice the patients are told by the dentist if they have any gum problems and given the option of seeing me or having the dentist treat them, some choose to see me, some choose to see the dentist. Others come for cosmetic reasons. I think the crux of the issue you are trying to get across is that patients need to be given all the information and given the choice for themselves? Please dont give us hygienists such a hard time, we are doing our best to help our patients as most dentists do and unfortunately the current NHS contract makes it impossible for us to do this within their system.

boozercruiser

Toothfairy4 wrote: »

Hi boozercruiser, I am a dental hygienist myself and I love my job. I agree with you that your NHS dentist has a duty to undertake your treatment themselves under NHS fees, I don't disagree with you on that one at all. I do however think that the way you speak about us Hygienists is a bit unfair.

We do undertake a lot of very complex treatment (often seeing people with severe periodontal problems who need treatment every 3 months and prefer to come and see me for a longer period of time than pay the fee to see the dentist every 3 months), there is a lot more to it than 'a quick scale and polish'.

I work in 2 practices, one NHS and one private, in my NHS practice the patients are told by the dentist if they have any gum problems and given the option of seeing me or having the dentist treat them, some choose to see me, some choose to see the dentist. Others come for cosmetic reasons. I think the crux of the issue you are trying to get across is that patients need to be given all the information and given the choice for themselves? Please dont give us hygienists such a hard time, we are doing our best to help our patients as most dentists do and unfortunately the current NHS contract makes it impossible for us to do this within their system.

O.K. Toothfairy4...and thank you for adding to my original post.

Actually, I have to agree with every single thing that you say here and I also thank you for not just trying to kick me in the nuts but instead go for very constructive criticism and view.

Obviously Hygienists do a very valuable and honourable job both inside and outside the NHS and for the reasons you give, perhaps under some circumstances it's best to refer the Patient to a Hygienist.

At the start of my original posting, and the subsequent posts of others here, it just seems to me the there are lots of times, particularly in the Denticare group type of dental practice to just say "You have some gum disease" or "Your teeth could do with a clean up" or whatever and then push them off to the Hygienist.

This so another patient can be seen and both cost and time of a Scale and Polish is saved......when under a lot of circumstances that is what the Dentist should be doing as per NHS Contract.

It is certainly not may intention to give Hygienists a hard time......my 'Beef' is NOT with any Hygienist. Just with the Dentist practice that 'reneges' on the NHS Contract and Regulations.

Look.....no offence is meant to any of you Hygienist guys. Good luck to you, and I admire people like you who have done the training for a job not many people would fancy.

I don't go back to my Dentist for another 6 to 12 months now......and it may or may not be another Dentist.

I will only be back here for a rant if I come across the Dentist trying to shove me off to the..........instead of you know what!

So in the meantime......let us smoke the Pipe Of Peace and Kiss and Make up!:beer::rotfl:

welshdent

I think a major issue IS being highlighted BC but probably not the same thing you see .... A recurring theme I see is people not knowing WHY they have been told to see a hygienist or that they were told they had generically gum disease and they need to see one. to me I am ignoring the funding aspects. What grabs me is that as a profession we are clearly not communicating well enough. We are not clear enough with explaining a diagnosis and as a consequence we are not getting a good enough informed consent. I was told at an NHS inspection last week we shouldnt be doing treatment on patients with a BPE score of 4 and should be referring on to specialist care be it private or NHS. The reasoning being we are apparently not qualified enough to treat it! work that one out. However the inspector DID acknowledge that was largely impractical and as such we could do the best we could. Therein lies the crux. A scale and polish for periodontal disease is NOT sufficient and in some eyes could be taken as negligent if thats all we do ....personally I wont offer this if a patient refuses periodontal treatment. SO options are ... dentist do it or if you have a hygienist they do it ... but I should imagine that would have to be private. We have been put in a difficult situation ... in one corner the patient and their entitlements, on another the government and their rubbish contract that seems to think extractions are more valuable than advanced and preventive care, our morals and ethics and then the legal profession .... some of which represent the patient aggrieved that we made a different call to one they would have liked.

SO ....diagnosis and communication. Make sure you have a full diagnosis ... we must make sure we GIVE a full diagnosis. Explain options but practice safely and defensively .... or go private and eliminate the damn contract and government. Personally I like that idea but then if one was to do that we get painted as money grabbing and all the other derogatory descriptions.

boozercruiser

welshdent wrote: »

I think a major issue IS being highlighted BC but probably not the same thing you see .... A recurring theme I see is people not knowing WHY they have been told to see a hygienist or that they were told they had generically gum disease and they need to see one. to me I am ignoring the funding aspects. What grabs me is that as a profession we are clearly not communicating well enough. We are not clear enough with explaining a diagnosis and as a consequence we are not getting a good enough informed consent. I was told at an NHS inspection last week we shouldnt be doing treatment on patients with a BPE score of 4 and should be referring on to specialist care be it private or NHS. The reasoning being we are apparently not qualified enough to treat it! work that one out. However the inspector DID acknowledge that was largely impractical and as such we could do the best we could. Therein lies the crux. A scale and polish for periodontal disease is NOT sufficient and in some eyes could be taken as negligent if thats all we do ....personally I wont offer this if a patient refuses periodontal treatment. SO options are ... dentist do it or if you have a hygienist they do it ... but I should imagine that would have to be private. We have been put in a difficult situation ... in one corner the patient and their entitlements, on another the government and their rubbish contract that seems to think extractions are more valuable than advanced and preventive care, our morals and ethics and then the legal profession .... some of which represent the patient aggrieved that we made a different call to one they would have liked.

SO ....diagnosis and communication. Make sure you have a full diagnosis ... we must make sure we GIVE a full diagnosis. Explain options but practice safely and defensively .... or go private and eliminate the damn contract and government. Personally I like that idea but then if one was to do that we get painted as money grabbing and all the other derogatory descriptions.

Hi Welshdent (Lovely name that).....Everything that you say here, at least from this humble patients point of view seems pretty fair and even handed to me.

At today's very last visit for the present course of treatment by my Dentist lady, she did the root removal, went on to do a little bit of Scaling and a small filling which was not down for schedule.

When she finished she sat me down with her and showed me some X Rays she had taken of particular teeth. She showed me the extracted area and the teeth she was still having a problem with, a tooth didn't need to come out, but she couldn't really tackle (the scaling as it was on and in the gum line....and I could see that) including what she had done regarding Scale and Polish.

If she had approached me from the start like she did today, and in the way that you outline, perhaps a lot of misunderstanding may have been avoided.

I had of course started treatment after my check up with some adverse comments to the Practice Manager.

This was followed by a complimentary letter following my second visit for treatment, and now today I thought she was going to give me a Kiss and a Cuddle!:D I would not have resisted!:rotfl:

I have been known to beg to differ with some here......but I am a Pensioner Patient who will avoid dipping into my pocket if I can avoid it.:D

rozmister

My NHS dentist only gives me a scale if I have gum problems and I never get a free polish

Saying that I am very grateful as I narrowly escaped a con artist dentist who advertised themselves THROUGH MY UNIVERSITY as an NHS dentist but after seeing me with gingivitis tried to charge me £110 for treatment (which would have included a scale and polish!)!!!! I was devestated dentistry cost so much until I phoned NHS Direct and found out that actually it shouldn't cost that much. They also made me pay a deposit up front towards said treatment that they took 6 weeks to refund AND because I moved dentists I went to the bottom of the queue and ended up waiting 3 months for any treatment which meant my gums got worse!

My new dentist is lovely but I'm now a bit of cynic about it all! Not all dentists, but some, are out for every penny they can get!

boozercruiser

rosmister..."My new dentist is lovely but I'm now a bit of cynic about it all! Not all dentists, but some, are out for every penny they can get!"

Who am I to disagree!:D

I would add the proviso that in the main as far as I can see beyond the hills of Wales, it is the Dentist Practices who have been taken over by the bigger businesses who cannot be trusted to play fair.

The Contracted Dentists who work for them are under pressure to maximise profits, and because a lot of them are imported from the EU they just follow instructions.

When one has a Boss......what else can you do?

Profit is the name of the only game in town here I am afraid.:(