An urgent(ish) dental question - dentist advice appreciated please

ClaireLR

I have a question about paying for NHS treatment, I’ve written down all that has happened and would be grateful if someone could advise. Sorry for the long winded post.

Date first seen 29.06.2008 – had scrape and polish, check up and was told I needed to have a filling. Paid £16.50 at this visit

Next seen 06.07.2009 – had the filling done (dentist for some reason did a white filling instead of a standard one). Paid £30 at this visit.

Following this I had some episodes of pain which got worse and worse. I rang on 3rd Sep thinking I had 3 months from last treatment to go back and not have to pay again – was informed it was 2 months (checked NHS website and 2 months is correct), so they got me seen on 5 September (tried to offer me a later appointment first and told me I would be charged since it was outside of the 2 month period). Had the same filling filed down slightly, which seemed to ease the pain slightly. Also had some fluoride gel applied. No charge for this treatment. Was told to come back if the pain didn’t get better/got worse.

Following that the pain got worse and so I was seen again yesterday (28.09.2009). X-rays were taken which showed the filling is close to the nerve and the dentist (a different one this time) told me that my options are root canal treatment or extraction. I’ve opted for extraction and am having this done on 06 October. She also stated that sometimes the white fillings can cause sensitivity of the tooth which is the kind of pain I’m getting, I’m wondering why dentist number one didn’t just do a silver filling, the rest of my fillings are silver?

So my question is, will I have to pay for this further treatment? The NHS website states the following:

• Band 2: £45.60. This charge includes all the necessary treatment covered by the £16.50 charge, plus additional treatment, such as fillings, root canal treatment or extractions.

(This is the charge I have already paid).

And:

If, within two months of completing a course of treatment, you require further treatment within the same charge band or a lower charge band, e.g. an additional filling, you don't have to pay anything extra.
However, if you need further dental treatment after two months of completing an earlier course of treatment, you will have to pay an additional charge.

Now when I spoke to the dentist last night she said I would have to pay another £45.60 as it’s a different treatment. But my argument is that it’s the same treatment, and the course of treatment was never finished, since it’s the same tooth and the problem has not been dealt with by the filling.

Can I have a dentist tell me what they think? I don’t want to go in and start world war three with my dentist about this but I feel strongly that I shouldn’t have to pay for this.

Thank you.

Toothsmith

I'm not an expert in the NHS contract as I have nothing to do with it - but my feeling is your dentist is right. If it's been more than 8 weeks it is a different course of treatment.

That's according to the NHS rules.

If the dentist was trying to keep your goodwill, then he'd probably act differently - but does the dentist in an NHS practice really have to care about patient goodwill? For every patient that leaves, there'll be 10 wanting to be seen 'on the NHS' (God knows why).

As for the choice of filling material, or how well it was done - I can't comment on that as I don't know the circumstances of why it was done.

ClaireLR

Thank you toothsmith, was hoping you would be around.

The 8 weeks thing though, is that 8 weeks from the start of treatment, or the end?

I have to be honest and say I use NHS dentists because I can't afford to pay privately, I had some private work done a few years ago, sedation, tooth out, filling and clean up - £220 it cost. Same things on the NHS would have been £45.60.

Thanks

Toothsmith

The thing is, you wouldn't have got the 'same thing' on the NHS. Not if it was a proper private practice.

It would have taken you longer to get an appointment, the appointment time would have been shorter - leading to a more rushed job, the dentist would probably have been someone you'd never seen before, or would again afterwards, you might even have had difficulty understanding him/her. The filling would probably have hurt afterwards and ended up needing taking out or root filling, and the clean up would probably have been a superficial little tickle that got the odd chunk of tartar off the back of your teeth.

A filling on the NHS, and one done privately are very rarely the same thing, even though the material might be the same.


Back to the problem - I'm not sure if the date is start date or end date. I would suspect it's end date.

If you ring up your local PCT and speak to somebody in the dental department,they should be able to help.

tirednewdad

Its 2months from the start date- the day you sign the blue form.

maria777_2

Toothsmith wrote: »

The thing is, you wouldn't have got the 'same thing' on the NHS. Not if it was a proper private practice.

It would have taken you longer to get an appointment, the appointment time would have been shorter - leading to a more rushed job, the dentist would probably have been someone you'd never seen before, or would again afterwards, you might even have had difficulty understanding him/her. The filling would probably have hurt afterwards and ended up needing taking out or root filling, and the clean up would probably have been a superficial little tickle that got the odd chunk of tartar off the back of your teeth.

A filling on the NHS, and one done privately are very rarely the same thing, even though the material might be the same.


Back to the problem - I'm not sure if the date is start date or end date. I would suspect it's end date.

If you ring up your local PCT and speak to somebody in the dental department,they should be able to help.

I have to agree from personal experience! I am a terribly nervous patient and broke a tooth a few weeks ago - went to the dentist (NHS) and was told it had to be capped. I knew that involved a lot of drilling and was in such a state about it - it doesn't help that at my NHS dentist it is literally like a cattle market and when I tried to discuss my fears with the dentist she just didn't want to know!
A private dentist was recommended to me and although I knew it would be much more expensive his reputation for dealing with nervous patients was worth it so I went to see him.
What a different experience, he was so patient, listened to all my fears and was so reassuring. However, when he xrayed the tooth found that it wasn't worth capping as root canal work I had done last year (with NHS dentist) had not been done properly! So I ended up saving money as I would have paid £200 for the cap on NHS only to find the tooth would have to come out eventually anyway!

Eliza1001

Toothsmith wrote: »

The thing is, you wouldn't have got the 'same thing' on the NHS. Not if it was a proper private practice.

It would have taken you longer to get an appointment, the appointment time would have been shorter - leading to a more rushed job, the dentist would probably have been someone you'd never seen before, or would again afterwards, you might even have had difficulty understanding him/her. The filling would probably have hurt afterwards and ended up needing taking out or root filling, and the clean up would probably have been a superficial little tickle that got the odd chunk of tartar off the back of your teeth.

A filling on the NHS, and one done privately are very rarely the same thing, even though the material might be the same.


Back to the problem - I'm not sure if the date is start date or end date. I would suspect it's end date.

If you ring up your local PCT and speak to somebody in the dental department,they should be able to help.

Whilst browsing the MSE forums, I have often come across some extremely well explained and very sound advice from Toothsmith. However I have just read this post, and you could almost see the steam coming out of my ears!

As an NHS dentist I take great exception to several of the statements you have made. I do not rush treatment, or provide fillings that are substandard when compared to those provided on a private basis. Why should NHS fillings hurt more than private ones?
I am of course restricted in some of the treatment options that I am able to provide on an NHS basis, and being a salaried NHS dentist, I cannot offer private treatment, and I do on occasion find this very frustrating. All my patients have additional medical/social/physical needs that make receiving treatment in a general dental practice difficult.

I can totally understand your frustrations Toothsmith, as I assume at one point you were providing NHS treatment, but were forced out by the various catastrophic contract changes over the years. Having said that, can I please request that you don't tar all NHS dentists and the dentistry they provide with the same brush. I am in the fairly lucky position of being able to provide extremely good quality NHS dentistry without the severe financial constraints that apply to those in general practice.

Back to the OP's question, it is 2 months from the end of treatment. As you did go back with pain within 2 months of having the filling placed, I would have thought your dentist should show goodwill and not charge you. Good luck!

Sorry to be negative, but I just had to say something to defend myself and my colleagues who work extremely hard under often very difficult circumstances.

All the best
Eliza

ClaireLR

Eliza1001 wrote: »

Whilst browsing the MSE forums, I have often come across some extremely well explained and very sound advice from Toothsmith. However I have just read this post, and you could almost see the steam coming out of my ears!

As an NHS dentist I take great exception to several of the statements you have made. I do not rush treatment, or provide fillings that are substandard when compared to those provided on a private basis. Why should NHS fillings hurt more than private ones?
I am of course restricted in some of the treatment options that I am able to provide on an NHS basis, and being a salaried NHS dentist, I cannot offer private treatment, and I do on occasion find this very frustrating. All my patients have additional medical/social/physical needs that make receiving treatment in a general dental practice difficult.

I can totally understand your frustrations Toothsmith, as I assume at one point you were providing NHS treatment, but were forced out by the various catestrophic contract changes over the years. Having said that, can I please request that you don't tar all NHS dentists and the dentistry they provide with the same brush. I am in the fairly lucky position of being able to provide extremely good quality NHS dentistry without the severe financial contraints that apply to those in general practice.

Back to the OP's question, it is 2 months from the end of treatment. As you did go back with pain within 2 months of having the filling placed, I would have thought your dentist should show goodwill and not charge you. Good luck!

Sorry to be negative, but I just had to say something to defend myself and my colleagues who work extremely hard under often very difficult circumstances.

All the best
Eliza

Thank you very much. I wish you were my dentist, you sound lovely You don't happen to be in the West Midlands area do you!!!

McKneff

Toothsmith, for shame

I have regular check ups, and as i have major osteoporosi so every now and again i have to have extractions. Last time i had to have both my two front teeth out and a denture put in. I have always had excellent, extremely sensitive care from my dentist and all the staff there. When i had my plate put in i was so upset emotionally at actually losing my front teeth the receptionist made me a cuppa and sat with with because she could see i was upset.
However, when i looked in the mirror, my two front teeth which had been ever so slightly crossed for all my 50 odd years where now a perfect straight down, i felt better instantly.
I have never suffered any pain afterwards from any of my extractions, always had excellent after care. Have i just been lucky. I think not. My husband visits another pratice in the same town and its just the same there, nothing wrong with NHS dentist up here.

For some, even NHS charges are too much and much of the population even nowadays are walking around with rotten teeth and cant afford care. I think this is shameful that our country does this, especially to older people

Eliza1001

ClaireLR wrote: »

Thank you very much. I wish you were my dentist, you sound lovely You don't happen to be in the West Midlands area do you!!!

No problem ClaireLR. I'm afraid I'm based in the West Country.
I think when you see the dentist again, if you calmly explain that you did initially return to the practice within 2 months, and that you would be very disappointed if you had to pay again, that should hopefully swing it in your favour. Definitely don't go in all guns blazing, but do calmly stand your ground if needs be.
Let us know how you get on.
Liz :rolleyes:

McKneff

Claire, could i hijack and ask you a question. As above i have Osteoporis and will have more extractions to come, mainly my top teeth.

Now, whether people are scaremongering I dont know but is there any difference between a lady dentist pulling teeth or male, is it quicker for a male
(and i dont want to be sexist here) ie strenght wise, but my normal male dentist has retired and i now have a young lady dentist am i worrying without cause that its going to take longer (and obviously in discomfort longer) because she is not as strong.