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

boozercruiser

I thought that some Forum Members who are following this Saga may be interested in this post on the NHS Choices Web Site. I was.

(Now perhaps I have the Politicaly Correct crew putting me right?!)....................P.S. The links to the NHS Choices Web Site work..........

And eh! You can even rate your Dentist......but not the Hygienist!...............................

...................Gum disease............

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• Overview
• Medicines info
• Reuters news
• Clinical trials

• Gum disease
• Symptoms
• Causes
• Diagnosis
• Treatment
• Complications
• Prevention

Introduction

Video: gum disease





An expert explains how gum disease develops and how good oral hygiene can prevent it.




Rate your dentist

You can now comment on your NHS dentist and share your experience with others. Rate your dentist here



Gum disease (also known as gingivitis) and periodontitis, which can follow a case of gum disease, are two conditions that affect the teeth and gums.






Gum disease causes:

• red and inflamed (swollen) gums
• bleeding gums when brushing teeth

Gum disease is usually caused by a build-up of plaque on the teeth. Plaque is a sticky substance made up of bacteria. It is usually removed by brushing the teeth but, if it builds up, the bacteria can irritate the gums and cause inflammation (swelling).
Periodontitis







Periodontitis is a more severe form of gum disease. In periodontitis, the inflammation that affects the gums also affects:

• the tissue that connects the tooth to the tooth socket, called the periodontal ligament
• the bone in the jaw that contains the sockets of the teeth, called the alveolar bone

Periodontitis can cause a gap to develop between the tooth and the gum, making the tooth feel loose and, in some cases, fall out.
Acute necrotising ulcerative gingivitis (ANUG)

Acute necrotising ulcerative gingivitis (ANUG) is another form of severe gum disease. It used to be called Vincent's gingivitis or trench mouth. ANUG is a painful bacterial infection of the gums that can cause swelling and ulcers (open sores) to develop.
How common is gum disease?

Most people have at least one case of mild gum disease during their lifetime. In the UK, it is estimated that 50-90% of the adult population has some degree of gum disease.
Each year in the UK, there are six cases of severe periodontitis for every 100,000 people. Aggressive or early-onset periodontitis, where severe periodontitis is present before 35 years of age, affects 1-2% of the population.

ANUG is rare and usually only affects people with a weakened immune system (the body’s natural defence system) or people who are malnourished (do not eat enough nutrients to maintain good health).
Outlook

A mild case of gum disease can usually be successfully treated with good oral hygiene. This should include brushing the teeth twice a day (in the morning and last thing at night) and flossing at least three times a week.
If gum disease is not treated, it can develop into periodontitis or, in severe cases, ANUG. These conditions can cause more serious complications, such as painful sores, which can destroy parts of the gums, and loose and unstable teeth.

• show glossary terms

Glossary
Gum disease (gingivitis)
Inflammation of the gums, normally due to a build-up of dental plaque.
Periodontitis
This is when the inflammation of the gums also affects the bone surrounding the tooth and can cause your teeth to become loose and fall out.
Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.

Plaque
Plaque is a sticky substance that is made up of bacteria. It can build up on your teeth if you do not brush them.
Bacteria
Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some are good for you.
Ulcers
An ulcer is a sore break in the skin or on the inside lining of the body.
Immune system
The immune system is the body's defence system, which helps protect it from disease, bacteria and viruses.



Last reviewed: 09/03/2010
Next review due: 09/03/2012

jsinc

Hi. I also came across this issue recently - I've read a number of posts but not all so apologies if everything I write is just repetition.

I have in the past used nhs and private dentists. Am now registered nhs and previous couple of times at this new nhs place had a quick check (literally about a minute) and later paid for the hygienist. This time however, I spotted and read the notice posted in the waiting room that stated I'm entitled to a scale and polish for my £16.50. So as I got on the chair I mentioned to the dentist that I would like this. He said he would see... So after the usual one minute effort of counting my teeth and saying well done for looking after them he stated a scale and polish wasn't necessary, and to see the hygienist for cleaning.

Again I explained that I was entitled to what I paid for and after incredulously having to repeat myself several times he relented (not happy) saying he wouldn't be doing it again, and reluctantly polished the inside of my lower teeth - that was it. I would have restated my rights, but the atmosphere had become very uncomfortable and there seemed not upside to continuing.

To cut a longish story short we then had a politish 'argument' which amounted to me stating what I'm entitled to, asking how £16.50 was justifiable for about 60 seconds counting of teeth, questioning why it is only recently (since the advent of hygienists) that they don't scale and polish; and him explaining how the 'system' doesn't work because they are not recompensed for extra fillings/work, that it's not the job of the nhs to clean the results of too much coffee etc, that the scale and polish 'if necessary' was equivalent to a filling 'if necessary' - so sarcastically would I like a filling too?

I feel he was offended by my assertion that I was overcharged and he even tried to compare with how much a plumber call out would be etc, but didn't have much to say when I used that hourly plumber call out rate adjusted for the time it took to just count my teeth - not a lot obviously.

So it seems that those who actually brush and look after their teeth may be penalised to cover those who don't, yet I fail to believe that dentists can't and don't bill for their nhs services, or they'd all be private? I appreciate a dentist's training and skills yet don't understand the requirement to be belittled, when I am paying. It's not free to me. I don't think dentists quite understand that for some (like me) nhs is actually more expensive if it doesn't fit in with a day off. I can use a notionally more expensive private dentist (actually not that much more expensive when hygienist is taken into account - £80 private vs £16.50 + £47) closer to work without taking any time off, which is what I'll be doing from now on once I've had a chat with the surgery.

It would be great if a dentist/dental nurse could explain to me what I may be missing, or if I'm not within my rights to have a normal clean?

dmg24

jsinc wrote: »

Hi. I also came across this issue recently - I've read a number of posts but not all so apologies if everything I write is just repetition.

I have in the past used nhs and private dentists. Am now registered nhs and previous couple of times at this new nhs place had a quick check (literally about a minute) and later paid for the hygienist. This time however, I spotted and read the notice posted in the waiting room that stated I'm entitled to a scale and polish for my £16.50. So as I got on the chair I mentioned to the dentist that I would like this. He said he would see... So after the usual one minute effort of counting my teeth and saying well done for looking after them he stated a scale and polish wasn't necessary, and to see the hygienist for cleaning.

Again I explained that I was entitled to what I paid for and after incredulously having to repeat myself several times he relented (not happy) saying he wouldn't be doing it again, and reluctantly polished the inside of my lower teeth - that was it. I would have restated my rights, but the atmosphere had become very uncomfortable and there seemed not upside to continuing.

To cut a longish story short we then had a politish 'argument' which amounted to me stating what I'm entitled to, asking how £16.50 was justifiable for about 60 seconds counting of teeth, questioning why it is only recently (since the advent of hygienists) that they don't scale and polish; and him explaining how the 'system' doesn't work because they are not recompensed for extra fillings/work, that it's not the job of the nhs to clean the results of too much coffee etc, that the scale and polish 'if necessary' was equivalent to a filling 'if necessary' - so sarcastically would I like a filling too?

I feel he was offended by my assertion that I was overcharged and he even tried to compare with how much a plumber call out would be etc, but didn't have much to say when I used that hourly plumber call out rate adjusted for the time it took to just count my teeth - not a lot obviously.

So it seems that those who actually brush and look after their teeth may be penalised to cover those who don't, yet I fail to believe that dentists can't and don't bill for their nhs services, or they'd all be private? I appreciate a dentist's training and skills yet don't understand the requirement to be belittled, when I am paying. It's not free to me. I don't think dentists quite understand that for some (like me) nhs is actually more expensive. I can use a notionally more expensive private dentist (actually not that much more expensive when hygienist is taken into account - £80 private vs £16.50 + £47) closer to work without taking any time off, which is what I'll be doing once I've had a chat with the surgery.

It would be great if a dentist/dental nurse could explain to me what I may be missing, or if I'm not within my rights to have a normal clean?

The dentist was correct - you are entitled to NHS treatment within the relevant price bands where there is clinical need.

welshdent

16.50 does not entitle you to a clean and polish. It entitles you to contribute towards a band 1 course of treatment. A scale and polish counts as band 1 but you are only entitled to it if you need one as per the BPE scores stated elsewhere. If your dentist determines there is no need they do not have to provide it on the NHS but you can see the hygienist or have one with them privately. The price you pay bears no relationship to anything other than what the government tell us must be paid for an NHS course of treatment. If you do not like it then I would suggest you raise the matter with your local MP. Its a stealth tax ... end of.

One thing to note, hygienists are not new (you said since the advent of them). My mother is approaching (sorry mum) 60 and she has been a hygienist since her early 20s. All that is new is that the NHS no longer pays you a fee for their treatment and as such they cost a lot to employ which is why many only work privately.

WADR the last bit about costs ... its not the dentists fault. They do not set the fees and they do not set the terms of the contract and system. You are in the same boat as many people. I actually think the NHS charges are very reasonable when you consider the costs involved in running a dental practice.

Apollonia

jsinc wrote: »

This time however, I spotted and read the notice posted in the waiting room that stated I'm entitled to a scale and polish for my £16.50.

(You must have missed seeing the vital phrase,
"IF NECESSARY" . It is above, in the post by boozercruiser - you can't miss it, he likes to copy & paste in giant font!)

So after the usual one minute effort of counting my teeth and saying well done for looking after them he stated a scale and polish wasn't necessary, and to see the hygienist for cleaning.


It would be great if a dentist/dental nurse could explain to me what I may be missing, or if I'm not within my rights to have a normal clean?

What a pity your dentist didn't stick to the rules and continue to refuse to provide unnecessary treatment - this sort of thing only adds to patients' confusion.

Instead of being the clear-cut issue it should be, some people are still under the impression that a scale and polish is 'included in the price of a check-up' while others are being told the correct information, (and this thread explains over & over again) that cosmetic issues are not covered.

boozercruiser

Apollonia wrote: »

What a pity your dentist didn't stick to the rules and continue to refuse to provide unnecessary treatment - this sort of thing only adds to patients' confusion.

Instead of being the clear-cut issue it should be, some people are still under the impression that a scale and polish is 'included in the price of a check-up' while others are being told the correct information, (and this thread explains over & over again) that cosmetic issues are not covered.

Yes, once more, over and over and over again......

If the Dentist says the magic words "You have Gingivits (Gum Disease)" or possible other oral problems then various levels of Scale and Polish should be done on the NHS under his/her contract and NHS regulations as described above.

However, if the Dentist just says words to the effect that "your teeth could do with a clean, (you might be a smoker for instance) your teeth will look like pearls afterwards and your overall Dental health would be better served by a visit to the Hygienist" then this becomes your choice at extra cost of course.

If my opinion above is not strictly correct my Dentist friends will put me right!:D

In my case the Dentist advised me that I had Gum Disease which is why I insisted, and got a full Scale and Polish.

And by the way Apollonia, for your information most times I have NO INTENTION to print in large letters.

When this happens It just came that way from my 'Cut and Paste'. I understand that there is a way to make the words smaller but I havent got a handle on it yet.

In any case....if wording is meant to be that large on the NHS Direct Web Site....then it is good enough for me also!

Cheers.:beer:

PS jsinc. When the Dentist said you should see the Hygeinist....what grounds did he give for directing you there?

Apollonia

boozercruiser wrote: »

And by the way Apollonia, for your information most times I have NO INTENTION to print in large letters.

When this happens It just came that way from my 'Cut and Paste'. I understand that there is a way to make the words smaller but I havent got a handle on it yet.

In any case....if wording is meant to be that large on the NHS Direct Web Site....then it is good enough for me also!

Oh, really?! See below from page 26 of this thread.

Garetha wrote: »

before you 'submit reply' check what you have written/pasted
- if you find some big words, highlight them by dragging your mouse from one end to another.
Now click on 'sizes' and select 1 or 2 - maybe 3 and then you can 'submit reply'

and Gareth will be happy

boozercruiser wrote: »

Now then....you have taught me a lesson there Garetha:T

I really did not know that trick....I only know how

to get a free Copy and Paste and a Scale and Polish.....that's it!:D

Two other things lead me to believe that you are deliberately obnoxious:

1. You managed to produce large font in your post 'please don't let me be misunderstood'.

2. The phrase 'Simple, isn't it?' does not appear on the NHS website, therefore you added that to your post, in extra large font.

boozercruiser

I could answer Apollonias rather frivalous pap.
But WHY BOTHER?:p

Apollonia wrote: »

Oh, really?! See below from page 26 of this thread.







Two other things lead me to believe that you are deliberately obnoxious:

1. You managed to produce large font in your post 'please don't let me be misunderstood'.

2. The phrase 'Simple, isn't it?' does not appear on the NHS website, therefore you added that to your post, in extra large font.

coldstreamalways

Not that you have posted pap boozer but you could always just post a link to the relevant website instead of the reams of incomprehensible muddled cut and paste that seems to be your usual style.

jsinc

Thanks to all that replied. Boozercruiser - to be fair to the dentist he didn't direct me to see the hygienist, but that any polishing/cleaning would be done by them.

As general points, I think there's some confusion (certainly with me) about the difference between scale and polish vs cleaning. I thought they were the same thing, but re. your answers above abviously not. This may stem from the fact that - Welshdent - as to my earlier point about hygienists, until this dentist (joined about 3 years ago) I had never visited a separate hygienist to the dentist. For a period I was a prvate patient so may not have noticed changes.

I tried to word my post to describe my genuine confusion, so appreciate your replies. I don't think this system works for those like me, as I look after myself and I'm not paying £16.50 for someone to count my teeth, whatever their overheads. The net result is that I will be going less frequently and privately closer to work, leaving a (possibly) less orally hygienic person to take my place who will possibly need more work and be less able to afford to maintain a higher standard.