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

boozercruiser

I particularly interested in the pilot scheme for future NHS Dentistry mentioned in this article:- Daily Mail 10th May 2011

Are NHS dentists yanking out teeth just to save cash?



By Rachel Ellis

Last updated at 1:54 PM on 10th May 2011

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When Kate Reeve went to her NHS dentist with a problem tooth two years ago, she was told the only option was to have it removed.
The molar in the top left of her mouth was crumbling after a filling had partly fallen out and become infected.
‘I had left it a bit too long before going to the dentist,’ says Kate, 36, a designer from Oxford. ‘I could see the filling was crumbling, but it hadn’t fallen out.
‘My tooth was hurting and I couldn’t eat on that side, but I wasn’t able to get to the dentist for a month.’

Leading dentists argue that keeping your own teeth is better for your oral health and often cheaper

After he’d cleaned it out, the dentist told Kate the only treatment available on the NHS was to have the tooth removed, at a cost of £40 plus £200 for a bridge.
However, if she spent £400 she could save the tooth by having root canal treatment privately.
‘I am only in my 30s and the thought of having a gap in my teeth was unthinkable,’ she says.
She thought paying for a bridge seemed pointless if by spending a bit more she could save the tooth. ‘So I decided to have the treatment privately.’
Kate’s experience is far from unique. Two million people have a tooth removed on the NHS every year, but leading dentists are concerned that some teeth are being taken out unnecessarily.

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They argue that keeping your own teeth is better for your oral health and often cheaper.

The problem is partly that many people are unaware that infected teeth can be saved.
‘When a tooth is compromised, root canal treatment can be a really good way of saving it,’ says Dr Susie Sanderson of the British Dental Association.
However, there is anecdotal evidence that some dentists are not offering it on the NHS because of the cost and time it takes.
The treatment involves a two-hour procedure (in one or two sessions) under local anaesthetic. The pulp section of the tooth (a hollow section where the nerve is) is cleared out, disinfected and filled with a material based on latex.
The good news is that the NHS dental system is set for change

The procedure removes the nerves and blood supply from inside the tooth, so it is effectively dead and more brittle afterwards — that’s why a crown or cap is often advised to strengthen it.
A million of these procedures are performed every year on the NHS, costing £47 each, plus £204 if you go on to have a crown or denture to strengthen the tooth. Privately, it costs between £650 and £1,800.
If the tooth has to be removed, the gap is often filled by a bridge, denture or implant.
But the Saving Teeth Awareness Campaign argues that anything artificial in the mouth can cause problems. A denture, which is taken in and out of the mouth, can become dirty and infected, and to have a bridge put in, the teeth on either side have to be drilled to fasten it into place and this can damage them.
The problem is that an NHS dentist in England receives the same payment — between £45 and £75 — if they remove a tooth or carry out root canal treatment.
However, an extraction takes between ten and 15 minutes while root canal treatment may involve several visits, requiring X-rays, consultations and treatment using expensive equipment.

This disparity in the amount of time and expertise it takes to carry out the treatments has led some dentists to offer only tooth removal on the NHS.
‘There is not a financial incentive to sit the patient down and say let’s save the tooth,’ says Dr Malcolm Harbour, a dentist from Ipswich with 30 years’ experience in the NHS and privately.
‘However, most dentists will try to do the best for the patient irrespective of financial pressures.’
Indeed, experts accept that some patients will opt for removal because they see it as a quick and easy way of getting rid of pain.
‘People who are anxious will often avoid dental treatment and want to have teeth extracted rather than attend the extra appointments needed for root canal,’ says Tim Newton, Professor of Psychology as applied to Dentistry at Kings College London.

Evidence also suggests that if the only option is private dental treatment to save a tooth, many patients will opt for an extraction because it is cheaper.
The good news is that the NHS dental system is set for change.
A new approach is being piloted in 62 practices across England that assesses the time spent with patients and the quality of the care they receive, instead of only counting the number of treatments, which some say has led to a ‘drill and fill’ approach.
The new system will pay dentists according to the quality of care they provide rather than the number of treatments carried out.
Dentists will have to monitor patients’ dental health and show it is improving. And up to 10 per cent of their pay will be determined by the quality of the work they carry out.
This approach should mean dentists have greater freedom to use their clinical judgment to decide what’s in their patients’ best interests, rather than being driven by targets.
However, until any changes are introduced (in 2014, if the pilot scheme is successful), experts hope that by giving patients more information about the choices available will mean more people should keep their teeth.
For Kate, root canal treatment meant two visits to the dentist. While she is delighted she opted for it, she believes it’s unfair that in some cases only people who can pay can save their teeth.
‘For many people, it’s a lot of money that they can ill afford. Everyone should have the option of being able to keep their own teeth.’
For more information, go to www.savingteeth.co.uk


Read more: http://www.dailymail.co.uk/health/article-1385407/Are-NHS-dentists-yanking-teeth-just-save-cash.html#ixzz1LxaO7prH

Toothsmith

I wouldn't get too excited - If governments had any interest in improving NHS dental care, they wouldn't have been running it into the ground for the last 25 years!

Things like this are just exercises in being seen to be doing something.

boozercruiser

Toothsmith wrote: »

I wouldn't get too excited - If governments had any interest in improving NHS dental care, they wouldn't have been running it into the ground for the last 25 years!

Things like this are just exercises in being seen to be doing something.

Agreed! I am too old in the Tooth to believe anything any government tell me of future plans or trials. Particularly regarding the NHS.....as with this new way with Doctors contracts battle that is going on now.

Here in Wales that particular one doesn't matter as we arn't adopting it as I understand.

Still...hope springs eternal regarding improvement changes in NHS dentistry care.

In the meantime....I suppose I will just have to keep whinging about the current system!:rotfl:

welshdent

I would gladly root fill most teeth that were suitable! I usually do but its crippling in the long run. Its not just the number of visits it takes. Its the sheer costs to DO the treatment. The files alone that prepare the tooth can often cost more than they pay us to do the work. Thats not counting additional equipment that I feel personally is essential to do the job properly. Microscope - 10 - 30 grand or loupes ... a grand or 2.

specialist ultrasonic scaler tips ... £65 each
possibly an additional scaler unit .... £500.

Maybe a heated obturation system if you feel you need this - £3000 for just the unit and then the blanks to fill with are expensive especially when compared to non heated systems.

A filling on top to seal which is needed if you crown the tooth or not.

The government sit there smugly saying ... well its in the contract so they have to do it. The problem is they wont buy a bathroom plug without putting it through expenses but expect us to foot the bill for this and moan to the press when dentists can not do it. Its prohibitively expensive and long term I cant continue with it. I can only do it now because my principal is very understanding. This is why in many cases I would usually recommend someone goes to the specialist if they have been advised to do so by a dentist. You at least will be getting it done right with no corners cut to save a few quid on operating costs.

boozercruiser

welshdent wrote: »

I would gladly root fill most teeth that were suitable! I usually do but its crippling in the long run. Its not just the number of visits it takes. Its the sheer costs to DO the treatment. The files alone that prepare the tooth can often cost more than they pay us to do the work. Thats not counting additional equipment that I feel personally is essential to do the job properly. Microscope - 10 - 30 grand or loupes ... a grand or 2.

specialist ultrasonic scaler tips ... £65 each
possibly an additional scaler unit .... £500.

Maybe a heated obturation system if you feel you need this - £3000 for just the unit and then the blanks to fill with are expensive especially when compared to non heated systems.

A filling on top to seal which is needed if you crown the tooth or not.

The government sit there smugly saying ... well its in the contract so they have to do it. The problem is they wont buy a bathroom plug without putting it through expenses but expect us to foot the bill for this and moan to the press when dentists can not do it. Its prohibitively expensive and long term I cant continue with it. I can only do it now because my principal is very understanding. This is why in many cases I would usually recommend someone goes to the specialist if they have been advised to do so by a dentist. You at least will be getting it done right with no corners cut to save a few quid on operating costs.

I can see that the last government put you between a rock and a hard place regarding the cost to you to 100% carry out what it says in that contract. And we all know that the contract was poorly thought (like so many things the last lot did, and this lot seem to be following in the footsteps) out and thrust on dentists who did not really want it....BUT...it was either sign or go private I suppose?

I guess there just has to be a happy compromise somewhere. Arguably right now though my feeling is that the compromise is compromising the patients too many times with too many Dentists.:)

As per my thoughts in one, possibly two of my past posts!:rotfl:

welshdent

Sign or !!!!!! off was indeed the option and many dentists signed in dispute. For some private wasn't an option for where they work. Others believe in an nhs system. I have no loyalty to it myself. My loyalties are to the people
I treat to do my best for them. When it becomes feasible for me to become private I will

boozercruiser

welshdent wrote: »

Sign or !!!!!! off was indeed the option and many dentists signed in dispute. For some private wasn't an option for where they work. Others believe in an nhs system. I have no loyalty to it myself. My loyalties are to the people
I treat to do my best for them. When it becomes feasible for me to become private I will

What you say is sad also Welshdent.:sad:

Perhaps if and when a new contract is offered in the light of the trials mentioned above, it may lead to a rethink if there are improvements in it?

I do hope so, as in the two years this post has been going all that you have said in the past, I feel that you represent :A standards I feel are slipping now in NHS Dentistry.

brook2jack

Not a chance . The new contract will still expect the same number of treatments on the same number of people plus additional work all for the same money. Dentists are universally pessimistic about it. Think rearranging deckchairs on the titanic.

boozercruiser

brook2jack "Dentists are universally pessimistic about it. Think rearranging deckchairs on the titanic".

I do not believe it! I found something as a patient that I 100% with agree on with brook2jack! lol I am pleased!

And of course the Titanic did sink BUT some of the passengers got saved!

welshdent

The new contract sounds worse than the current and thats saying something! Just splashing fluoride all over the place. BC the dentistry I enjoy and am passionate about is simply not funded by the nhs and I am not going to be content with doing patch jobs to make up the financial slack. A MAJOR change in attitude from above is needed before they address my issues and I refuse to become a box ticker. The standards I try and maintain would apply wherever I was working TBH ... private or NHS