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Advice needed - gum disease treatment

Towards the end of last week, I had a bad toothache in one of my molars, both upper and lower jaw. I thought I had a cavity having eaten some hard nuts recently and promptly booked a dentist appointment. They agreed to see me as an NHS patient. I went in this morning and she took an X-ray, said there were no cavities but bad gum disease. I told her the pain comes and goes (esp when I drink hot/cold water) and was uncomfortable and what could she do. She proceeded to apply some white substance, like those for a filling, to "coat" the base/root area as she said it's where the tooth is gradually getting exposed, resulting in the pain. She did this taking no more than 5-6 minutes, then presented me with a bill for £45.60. She told me I needed to get my gums treated, a colleague in the same clinic who comes in once a week would be the right person to do this. It would be around £60 per quadrant. I asked her whether it could be done on the NHS - she answered no and she could refer me to the hospital if I wanted it that way.

Now, having come back and feeling less than satisfied, my queries are:

1) Although I paid the bill (£45.60), her work seems to be more within the Band 1 charge since she did not actually put in any "real" fillings. All she did was apply this white coaty film to my tooth surface. Although I can feel it now when I thrust my tongue over the tooth surfaces, I am sceptical how long this coating will actually last as it seems mere brushing will wear it out in no time. Was her work pointless?

2) I have also researched previous posts in depth and it seems if they were agreeable to take me on as an NHS patient, the resulting gum treatment should also be on the NHS in which case, they were wrong to expect me to pay privately? Is this right? If so, what do I need to do? Report them to the PCT? I am not unwilling to make things difficult for them but won't this jeopardise my own dental treatment? I am a pain phobic and the last thing I want is to sour relations so if I complain against them, I think it would probably be better for me to get another dentist. What do I do about the £45.60 I have already paid if I can claim gum treatment as part of that charge but potentially from another clinic?

If Toothsmith or someone experienced can comment and suggest my next steps, I would be grateful.

Comments

  • Toothsmith
    Toothsmith Posts: 10,097 Forumite
    Part of the Furniture 10,000 Posts Name Dropper
    Basic work to improve gum problems is easily within the remit of an ordinary dentist, and doesn't need specialist referral.

    If the visiting person is a hygienist, or a specialist periodontist (gum dentist), then they are quite entitled to make these services private only, but some provision should be available in the practice to treat NHS patients on the NHS.

    If your condition doesn't respond to simple measures, then that is an excuse for referral.

    I can't say what the 'film' was - but multiple visits to clean your teeth could be legitamately put into Band 2 - so at least you are now fully 'paid up' for whatever treatment you get.

    Complain to the Primary Care Trust if the practice continue to insist there is no NHS treatment available for you there.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
  • tirednewdad
    tirednewdad Posts: 256 Forumite
    If they saw you as a new 'one off' patient- just to get you out of pain then the costs are correct.
    If however you are seen regularly at the practice then you should be seen for the rest of your gum treatment. As a regular patient, did they atleast give you a scale and polish?

    Unfortunately technically they have offered you an NHS option- in the form of a refferal. But i'm sure if you kicked up a bit of fuss to the right person in the practice, they would yield and clean you gums better.
    :money: Thankyou, thankyou, thankyou to everyone who has helped.
  • VfM4meplse
    VfM4meplse Posts: 34,269 Forumite
    10,000 Posts Combo Breaker I've been Money Tipped!
    Toothsmith wrote: »
    Complain to the Primary Care Trust if the practice continue to insist there is no NHS treatment available for you there.

    NHS dentistry - or a lack of it - is a nightmare for the majority of PCTs and also interestingly enough can be a neglected area of contracting. I would complain just for the hell of it to serve as a reminder that this is one area of care that should not be underserved.
    Value-for-money-for-me-puhleeze!

    "No man is worth, crawling on the earth"- adapted from Bob Crewe and Bob Gaudio

    Hope is not a strategy :D...A child is for life, not just 18 years....Don't get me started on the NHS, because you won't win...I love chaz-ing!
  • member161067
    member161067 Posts: 82 Forumite
    edited 13 July 2009 at 9:23PM
    If they saw you as a new 'one off' patient- just to get you out of pain then the costs are correct.
    If however you are seen regularly at the practice then you should be seen for the rest of your gum treatment. As a regular patient, did they atleast give you a scale and polish?

    Unfortunately technically they have offered you an NHS option- in the form of a refferal. But i'm sure if you kicked up a bit of fuss to the right person in the practice, they would yield and clean you gums better.

    Not new. Have used them once before. And no scale and polish. I was basically out of there in about 15 mins.

    The question now is what I want to do next. I do realise I need to do something about my gum problem, and fast. I was told I had this problem quite a while back but never took any action. I want to take this forward now. So I guess I need to decide do I continue with that clinic, or look elsewhere. The cost thing is not a deal breaker for me. Obviously, if I can have it on the NHS, I would prefer that but if I have to pay, I can and will. What I don't want is to be "cheated" in the sense of being told I am not allowed this on the NHS when in reality I am. Unfortunately, the line isn't so clear. I did trawl a couple of other websites and some seem to view periodontal treatment as being outside the NHS realm. Does the quoted cost (£60 per quadrant) sound about okay (for London)?
  • tirednewdad
    tirednewdad Posts: 256 Forumite
    Thats a decision you have to make your self- hygienists are much better at dealing with gums than dentists so the appointment might benifit you.

    You could always play dumb- ring up the receptionists and ask 'what a Perio 1 and perio 2 is?- say that you have read about it and that it is really good for gums- something you think you would really benifit from as a NHS option.'

    It goes without saying- you are the one who maintains the gums- the dentist should just help you with this and prevent any future problems. Smokers have poor outcomes when having gum treatment- so generally rteatment is postponed til smoking stops.

    Your gums might be too far gone where nothing can be done- difficult to say without seeing you.

    Cost in london could be about right- not sure. I'm in Wales and its £37 pound a visit
    :money: Thankyou, thankyou, thankyou to everyone who has helped.
  • jugglebug
    jugglebug Posts: 383 Forumite
    Part of the Furniture Combo Breaker
    Toothsmith wrote: »
    I can't say what the 'film' was - but multiple visits to clean your teeth could be legitamately put into Band 2 - so at least you are now fully 'paid up' for whatever treatment you get.

    .

    The guidance is so woolly now that the number of visits has nowt to do with it..
    This in italics is taken from the DOH website

    Q19. What band is 2 visit perio (old code 1011)?
    A. Code 1011 no longer exists and the number of visits is no longer a deciding factor. If the treatment provided is non surgical and for periodontal disease, (as Schedule 2 to the Dental Charges Regulations) it falls into band 2. If it is simple scaling for maintenance, it falls into band 1. It is for the clinician to determine which category of treatment is being provided.


    So basically it is up to the dentist as to charge band 1 or 2, even for a single visit!
    Where we draw the line is down to clinical belief, ethics, whatever you like.
    A regular scale as a maintenance is fairly clear band 1
    A patient with 6mm pockets scattered liberally is a fairly clear band 2

    However if I find a patient with a single site that hits CPITN 3 Then by the guidance given to me by the DOH I can legitimately charge the extra, claim the UDA's despite the fact that to instrument that single site will take hardly any extra time, the only extra cost to me is the ink that it takes to write the diagnosis.
    This is just another example of how the new contract is letting down patients and dentists alike. I have stacks of patients who I charge band 1 on where I could treat as band 2 but I would struggle to live with myself as the situation is so borderline, however I am confident there are many more out there who have come to terms with the system and it's many swings and roundabouts and accept this as a necessary "swing" :confused:
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