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

boozercruiser

welshdent wrote: »

Not have the equipment? Seriously?? I fully understand the sentiments!! I consider a scaler unit essential and I use it routinely, daily for everything from removing temporary fillings to locating root canal anatomy. Occasionally I clean teeth with it too ;-)

Seriously Welshdent. Since I moved to Machynlleth six years ago there have been no less than five Dentists run by Denticare. All EU you understand and a new Dentist started only a couple of months ago.

Around 3 years ago the latest Polish recruit started and I was seeing him for the first time. After check up he said "You need a filling and also you have some Gum Disease so you should see the Hygienist who will scale and polish". Me.... "Well I usually have a Scale and Polish after treatment" Dentist ...."No, I cannot do it here as I don't have the equipment."

Bull and something that rhymes with hit springs to mind!:D

The rest is history here in this Post!.:)

sweetcheeks33

jugglebug wrote: »

Sorry, that technique isn't new. It what was taught to me at dental school back in the 90's and certainly a damn sight earlier than that.
However there are Dentists unfortunately that wouldn't know how to find a BPE probe in their own surgeries with both hands and a compass which is why if you look at litigation towards dental professionals as whole it includes a healthy wedge of untreated gum disease cases.

Exuse me how rude..... I was been sacractic and throwing some light throw away comment in there that did not deserve nor warrent your patronising tone against my detisrt treatment!

I hope however this has left your feeling more superior!

jugglebug

sweetcheeks33 wrote: »

Exuse me how rude..... I was been sacractic and throwing some light throw away comment in there that did not deserve nor warrent your patronising tone against my detisrt treatment!

I hope however this has left your feeling more superior!

Which dentist do you think I was being patronising against?
your current one who is treating you correctly or the last one who didn't seem to be by never examining your gums properly?

edit:
just reread your post.
no mention of 2 dentists.
I made the assumption you had a new dentist who has only just started doing BPE examinations on you (The new technique) I was simply pointing out that your new technique is simply what had been considered good practice for as long as I can remember.
If indeed it is the same dentist who has just started doing the exam, well good for them. too many never change their spots and I can never criticise an improvement in patient care.

sweetcheeks33

They are one in the same person.....I dont know how many you have- I have one dentist. How do you know they arent treating me properly, as I said i made a throw away comment which you seem to have latched onto and felt the need to rant on about the tratment I wasnt receiving!

jugglebug

you said. (My italics and bold for clarity)

sweetcheeks33 wrote: »

My dentist does a scale and polish on me every visit or second visit on the NHS while checking my gums ( a new unpleasant technique odd poking them with a metal instrument not particulalry pleasant) However it only only takes two minutes almost and its done. I've never been referred to the hygenist for one.

I use an electric toothbrush so maybe its just a quick after check up or treatment to end it and have a good poke round??

They are one in the same person.....I dont know how many you have- I have one dentist. How do you know they arent treating me properly, as I said i made a throw away comment which you seem to have latched onto and felt the need to rant on about the tratment I wasnt receiving!

I was simply pointing out that this is not new.
I was also pointing out that it is a sad fact that many dentists do not carry this out routinely as they should. Indeed this thread is largely about it.
I started working with a new nurse yesterday. She tells me her last dentist only did a BPE exam when he felt it was "clinically necessary" I would bet that all of the dentists on here would say clinically necessary in this context is that the patient has teeth.
Over the years I have come across this story often. My wife is a hygienist and complains of the same. Ie people being referred to her for a simple scale and having gross undiagnosed periodontal disease.

You say your post is sarcastic and a throw away comment. Most of this thread however is not. It has often degenerated into personal attacks. I suspect you think it has again, but that was not my intention. Text is often misinterpreted so I rely on the use of smilies or emoticons to spot sarcastic humour. Without it I think the post is serious.

Oh and as for how many dentists I have. I have the choice of 11 depending on what day of the week it is and which of my 2 jobs I am working in. I would say 12 but my closest friend is a paediatric dentist and is uncomfortable treating people of my size

sweetcheeks33

my accept my apologies I was too quick to jump sometime it is all to easy to jump on text ... please accept my apologies.

I am horrific at the dentists and have such a fear after train track ( sorry no idea technical term) braces burst in my mouth as a child. My dentist is a newish one as my old dentist left a set up his own practice( quite a bit away). He was really great to an understood how terrified i am. I let a dentist in my mouth through force and only for limited time lol ....

Poking around is not preferred in any way shape or form. But i am horrified to hear that people are send to hygenist for a scale and polish as this is done as standard by my dentist if deemed appropriate. This may or may not be because i live in scotland I am unsure of different rules etc if indeed any?

Please accept my smily faces in abundance :):):):):):)

jugglebug

sweetcheeks33 wrote: »

my accept my apologies I was too quick to jump sometime it is all to easy to jump on text ... please accept my apologies.

I am horrific at the dentists and have such a fear after train track ( sorry no idea technical term) braces burst in my mouth as a child. My dentist is a newish one as my old dentist left a set up his own practice( quite a bit away). He was really great to an understood how terrified i am. I let a dentist in my mouth through force and only for limited time lol ....

Poking around is not preferred in any way shape or form. But i am horrified to hear that people are send to hygenist for a scale and polish as this is done as standard by my dentist if deemed appropriate. This may or may not be because i live in scotland I am unsure of different rules etc if indeed any?

Please accept my smily faces in abundance :):):):):):)

No problem :beer:
NHS funding rules are different in Scotland.
Personally I would prefer to be seen by a hygienist, but being married to one I would say that
In simple terms they treat gum disease for 90% of the time. So they are very very good at it. The rest of their time is dental health work, prevention, fissure sealants etc.
Myself as a general dentist I spend some time on gums, some time doing restorative work, some time on dentures.
I like to think I am reasonable at it all, even pretty good at some but I know my wife is better at the gum stuff. :T

sweetcheeks33

I have had two fissure sealants too , again both done by the dentist

Billieblob

Fork86 wrote: »

While I may have posted earlier on in the thread, I thought it would be pertinent to those involved to know that the goal posts in perio are slowly changing again.

New evidence based dentistry is actually starting to show that removing calculus/tartar does not benefit the patient, and therefore BPE's of 2's can also be deemed clinically unnecessary (just look up Phill Orr).

If tar tar is kept clean, there will be no gingivitis.

Our new practice policy incorporates this new evidence into our current treatment planning, and our focus is on prevention rather than 'cure'

Before anyone flies off the handle. Anyone who presents with a BPE 3/4/* will have their perio treatment done on the NHS by our hygienists (so dentist's who even do fillings on the same treatment course will not even get payed for band 2's should perio treatment be needed).

Only patients who can bring their plaque scores down to 20% or less will get full mouth ultrasonic debridement on the 4th visits (the 2nd and 3rd being focused on pcoket depths, indicies and OHI).


So anyone thinking this new policy is for the benefit of the dentist is sadly mistaken, as we end up actually earning less through this change in treatment offered.

Thank you Fork86, but again I think this is a case of arguing two sides of the same coin. Calculus (aka tartar for those not fortunate enough to follow Gods chosen profession) does NOT cause gingivitis. The evidence for this is well established. It is, however, a plaque retentive factor and therefore should be removed as a preventive measure. I'm guessing that the evidence for 'harmful' S&Ps that welshdent was alluding to earlier was based an Aubrey Sheriam's report in the late 90's that S&Ps do not benefit the patient at all.

This is quite true, however what the media immediately leapt upon was that S&Ps alone do not do any lasting benefit to the patient, and in order to be effective, prophylaxis (please note the different term) needs to be combined with OHI in order to produce benefit.

Chris Orr is a highly respected lecturer in the field of Aesthetic Dentistry, but I would request that you forward a specific reference for your evidence as I'm sure Chris would not be too happy trying to cement veneers to calculus!

I would like to remind all readers of this post that my evidence is based on the British Society of Periodontology guidelines

http://www.bsperio.org.uk/members/policy.pdf

and (in deference to 1977's (apologies for being so informal)) concerns would seek to reassure them that I have completed the Periodontology Diagnosis section of my MSc and so consider myself fully conversant with current concepts.

welshdent

There is a school of thought that bpe's of 4 and obviously the corresponding 6ppc's needs specialist attention yet there is very limited access available in the nhs system. Hell they can't find room for decent endo!! I personally am comfortable with the non surgical approaches I provide but I wouldnt be happy doing any surgery. I couldnt really afford to farm all my work out though. I get lots of practice instead ;-)