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

boozercruiser

jugglebug wrote: »

BC, there is a company called smilepod set up in covent garden doing drop in scale and polishes. Admittedly targetted at the cosmetic cleaning market.
Their cheapest 15 minute clean is 35 quid with some treatments going for well over £100
google em, they have been going for some time so there is the demand for this sort of treatment. I wouldnt be surprised if they had many customers who go far more often than 6 months.
They actually only use dentists as otherwise they would need referrals to operate, couldnt imagine working there myself though to be honest.

Hi Jugglebug. Look....there are goodness knows how many people who love to pay the extra to be seen by a Hygienist on a regular basis simply because they want teeth to look the best, feel good after treatment and will be happy in the knowledge that they are doing all that they can in Personnal Preventative Dental Care. I am sure that works well for them.

They are happy to pay extra for it, fair play and good on them, and I am not knocking that.

Me? I do my clean my teeth twice every day using Duraphat 2800ppm Fluoride Toothpase (no swill for half an hour), have a thing about a gentle toothpick as opposed to floss which I know is probably better.

I still have around 75% of my teeth...plus a few fillings.

Now then.....it's been flogged to death....but all I want is to be treated by my Dentist (not a Hygienist) for Gum Disease which should I think include at least a Scale and Polish.

Incidentaly...and please put me right if I am wrong....it seems to me that the growth of the hygienist has only happened in recent years, spurned on mainly by the Denticare organisations of this world who avoid Scale and Polish like the plague.

Up to six years ago I had never even heard of an Hygienist.

I just went every year up to age 62 .....see my Dentist...had my treatment which always ended with a Scale and Polish.

I still had 85% of my teeth, allbeit with a few fillings, so I don't think Dental Care was any worse then than it is now.

brook2jack

See previous posts from ?Welshdent whose mother was a hygienist, and from previous posters who have told you hygienists have been trained in the uk since at least the sixties. Every dental school trains hygienists alongside dentists.

In the practice I'm in we've had hygienists since we opened in 1976 as have all the surgeries around us.

The armed services have also trained hygienists for decades.

All of this has been said many times before in this thread.

Savvy_Sue

I'm sure DH was sent to see one years ago because he was brushing his teeth too hard, or something!

he won't go now, even though I tell him he should!

boozercruiser

brook2jack wrote: »

See previous posts from ?Welshdent whose mother was a hygienist, and from previous posters who have told you hygienists have been trained in the uk since at least the sixties. Every dental school trains hygienists alongside dentists.

In the practice I'm in we've had hygienists since we opened in 1976 as have all the surgeries around us.

The armed services have also trained hygienists for decades.

All of this has been said many times before in this thread.

O.K. fair enough...I take that as a given.

I can only harp on about that Dentist I had in Northampton up to around eight years ago. He didn't have a hygienist.....he never mentioned or advised me to see one either.

He just did whatever was required to teeth and always followed up with a rubber rotator etc. etc. to remove tarter and clean my teeth.

Lovely...worked for me without being pushed to see anyone else in respect of my dental care.

He did it all wonderfully himself. End of.

Look...I am under no illusions here. I feel that I am surrounded by Dentists and Hygienists who I have great respect for but are representing self interest, and who resent the fact that this *hole renegade is rocking the boat and exposing the cosy status quo.

Thats O.K. because although I live in Wales I am not a sheep and I just know that I am right...right...right to fight the practice of Dentists hiving the patient off to other people to deal with instead of carrying out work they SHOULD be doing under their NHS contract. Particularly when the patient has gum disease.

I would go so far as to say that some, including the Denticare organisation should be being done for breach of contract.
.
I am not the one in the wrong here because I just know that I am in the right:D

Toothsmith

boozercruiser wrote: »

Thats O.K. because although I live in Wales I am not a sheep and I just know that I am right...right...right to fight the practice of Dentists hiving the patient off to other people to deal with instead of carrying out work they SHOULD be doing under their NHS contract. Particularly when the patient has gum disease.

What they SHOULD be doing is sending you to the hygienist under the NHS contract!

The raison d'etre of the hygienist is to deal with exactly this sort of problem freeing the dentist up to do more complex technical stuff rather than cleaning people's teeth and teaching them how to use a toothbrush.

This all worked really well under the old NHS contract, where bigger practices used hygienists very effectively.

It also works really well in my small private practice, where hygienists do most of the routine maintenance work for my patients.

The reason it doesn't work in NHS practices in England and Wales anymore is purely because of the way the NHS contract is set up.

As I think I said in about post #4 of this huge thread. You are right that gum problems should be sorted out on the NHS for an NHS patient.

Hygienists, though, are a very important part of the dental team and the problem is not their existance, or any 'conspiracy' surrounding their use in PROPER practices.

But neither they, nor dentists, should have their services offered privately for necessary work on an NHS patient.

boozercruiser

Toothsmith wrote: »

What they SHOULD be doing is sending you to the hygienist under the NHS contract!

The raison d'etre of the hygienist is to deal with exactly this sort of problem freeing the dentist up to do more complex technical stuff rather than cleaning people's teeth and teaching them how to use a toothbrush.

This all worked really well under the old NHS contract, where bigger practices used hygienists very effectively.

It also works really well in my small private practice, where hygienists do most of the routine maintenance work for my patients.

The reason it doesn't work in NHS practices in England and Wales anymore is purely because of the way the NHS contract is set up.

As I think I said in about post #4 of this huge thread. You are right that gum problems should be sorted out on the NHS for an NHS patient.

Hygienists, though, are a very important part of the dental team and the problem is not their existance, or any 'conspiracy' surrounding their use in PROPER practices.

But neither they, nor dentists, should have their services offered privately for necessary work on an NHS patient.

I am really really really pleased:T that you have come back and said every word that you just have Toothsmith. For what it is worth I agree with every little bit of it.

(I wondered where you where!)

Every now and again someone (like Welshdent and some others) says something which gets to the root:D of what my 'beef' is.:j

Also, without smirking and trying to put me down!;)

Thank you. Thank you. Thank you.:D

brook2jack

Indeed BC you should prepare for more shocks, the doh wants more professions complementary to dentistry involved in practice . The model they would like is that you have a check up with a dentist and treatment with a dental therapist( someone who is qualified to do both hygiene work and simple fillings etc).

Dental therapists have also been around for years.

There are many subdivisions of people who work in dentistry from orthodontic technicians who place braces to clinical dental technicians who make dentures. If you are serious about maintaining your health the title of who treats you is not what you should be bothered about but listening to them and following advice. E.g. All the scaling and polishing in the world is an utter waste of time if all you are using to cleaning between your teeth is wooden tooth picks. They do not clean well and moreover cause damage by traumatising the gum or actively pushing food into it. They might remove the odd bit of meat but no hygienist or dentist would recommend them.

Many of us on here are in mostly private practice. We have no vested interest in nhs practice. Personally my patients can choose to go to one of the brand new nhs practices that opened up or even to one of my other private colleagues. They choose what level of service they want. With a few exceptions most of them choose to come twice a year and see the hygienist twice a year. Some see the hygienist much more often and a small percentage come once a year and dont see the hygienist.

Why do people do this , because I hope we have educated them. We use intraoral cameras so they can see what we see , they can see the difference when they start to floss or use tepe brushes. They see early decay ,change diet and brushing and have fewer fillings. They are not sheep either but active partners in their health.

The start of this thread might have been very useful to many and the message ,if you have gum disease then you should be treated on the nhs, if you just want your teeth cleaned to get rid of stain then you will not, deserves wider attention. However it's a message subsumed in reams of the same argument over and over again.

boozercruiser

brook2jack wrote: »

Indeed BC you should prepare for more shocks, the doh wants more professions complementary to dentistry involved in practice . The model they would like is that you have a check up with a dentist and treatment with a dental therapist( someone who is qualified to do both hygiene work and simple fillings etc).

Dental therapists have also been around for years.

There are many subdivisions of people who work in dentistry from orthodontic technicians who place braces to clinical dental technicians who make dentures. If you are serious about maintaining your health the title of who treats you is not what you should be bothered about but listening to them and following advice. E.g. All the scaling and polishing in the world is an utter waste of time if all you are using to cleaning between your teeth is wooden tooth picks. They do not clean well and moreover cause damage by traumatising the gum or actively pushing food into it. They might remove the odd bit of meat but no hygienist or dentist would recommend them.

Many of us on here are in mostly private practice. We have no vested interest in nhs practice. Personally my patients can choose to go to one of the brand new nhs practices that opened up or even to one of my other private colleagues. They choose what level of service they want. With a few exceptions most of them choose to come twice a year and see the hygienist twice a year. Some see the hygienist much more often and a small percentage come once a year and dont see the hygienist.

Why do people do this , because I hope we have educated them. We use intraoral cameras so they can see what we see , they can see the difference when they start to floss or use tepe brushes. They see early decay ,change diet and brushing and have fewer fillings. They are not sheep either but active partners in their health.

The start of this thread might have been very useful to many and the message ,if you have gum disease then you should be treated on the nhs, if you just want your teeth cleaned to get rid of stain then you will not, deserves wider attention. However it's a message subsumed in reams of the same argument over and over again.

O.K. Brook2jack...everything you say here is fair comment and I thank you for further adding to a post that you and others are probably getting a bit weary of now.

However, someone will Google Hygienist, look at this post, have food for thought and make an addition which I welcome because my main point is an ongoing problem as I see it.:beer:

boozercruiser

At the time of writing this post has had 31,514 views and 648 replies. Something must be right here!

It's been a good debate if worked to death...but is still and will continue to be relevent while NHS Dentists, particularly the Denticare organisations of this world are not treating Gum Disease as they should as per NHS 2006 regulations and contract.

If this post has helped some people save some money or obtained a better service...then I am happy. No matter how long this post goes on for and further worked to death. Carry on with the resuscitation (spelling?) as far as I am concerned.

I can take the flak!

boozercruiser

As sent to Denticare by E. Mail and normal post on 20th April 2011.

The spacings have not transferred with 'copy and past' exactly how I wrote it...but never mind.

Dear Sir or Madam,
Before moving to Machynlleth around seven years ago my Wife and I had one very good dentist in Northampton for 25 years. That particular
dentist always finished off treatment with a really thorough scale and
polish and I left England with around 85% of my teeth intact and
aso in relatively good condition.

However since moving to Machynlleth I have been a patient of your
Denticare Dentists, Dr. Botha...Dr. Gala....Dr. Ispas...Dr.
Tudor...Dr. Tsoumanis (Dolgellau) and am at present a patient of Dr.
Alina Jehac in Newtown because yet another dentist left Machynlleth.
Your customer policy statement says that denticare will "listen to
your dental needs, concerns and expectations"...........please allow
me to express mine.

With the exception of Dr. Tsoumanis all of your dentists (including
recently Dr. Alina) have said to me "You have some gum disease and you need to see see the hygienist".
(My teeth were then and are now quite sensitive and can be sore).
This though at an extra cost now of £28. However, my understanding of Wales 2006 NHS Dental regulations are that gum disease, needs and possibly warrants further treatment as per.........

SCHEDULE 1
Regulation 4(1) Charges – Diagnosis, treatment planning and
maintenance (i) scaling, polishing and marginal correction of
fillings.
SCHE DULE 2 Regulation 4(2) Band 2 Charges - Treatment (a)
non-surgical periodontal treatment including root-planing, deep
scaling, irrigation of periodontal pockets and subgingival curettage
and all necessary scaling and polishing. (Further regulations apply of
course.)

My very recent and most visits to your dentists over the years have
nearly always been treated under Band 2 mainly because of fillings
needed and I have never been offered without asking a scale and
polish or other treatment for gingivitis/gum disease. I have only ever
been advised to see your hygienist.

In fact when I first saw Machynlleth Dentist Dr. Ispas he said "You
need to see the hygienist because you have gum disease". I asked him if he could do a scale and polish? and he replied (I remember it
well) "I do not have the equipment here to do that, you will have to go to Aberystwyth and see the hygienist".

After always requesting and insisting on a scale and polish from your
denticare dentist(s) my teeth do get a sort of half hearted far from
thorough bit of a go over. Sometimes this may just involve a
scrape/clean of either lower or upper teeth but not both.

However, I do not want the continued embarrassment of having to ask
the dentist to please carry out a scale and polish (and possibly
further treatment as required in the regulations) in respect of my gum
problems.
Also, I would hope to be able to note that the procedure had been
carried out fully and correctly. To my mind at the present time,
unfortunately I cannot say that.

Perhaps what your dentists SHOULD be doing is sending me to the
hygienist under the NHS if they either do not have the time or
possibly the equipment to do it ?
Surely gum problems should be sorted out on the NHS for an NHS patient?

Either way, I just want my gum disease to be treated properly by
either the dentist or the hygienist if that is how the dentist sees
it, but at no extra cost of course.

This situation has been bothering me to the extent that now I wish to
know exactly what your companies exact policy is on this subject?
Is it to follow obligations under the Wales 2006 NHS regulations and
contract..........
http://www.gov.im/lib/docs/dhss/health/sd10006doc.pdf ? I would
hope and expect so.
I do of course appreciate that a scale and polish and/or further
treatment is only carried out if necessary.

Please understand that this correspondence is not meant as a complaint against your dentists, including Dr. Alina (who I praised in a recent E. Mail to your Newtown office) as I feel that they are only carrying out your companies policy.

I am thinking about taking my concerns to the relevant authority's,
but I wish to know denticares thoughts on the matter before I decide
that.

Best Regards