Dental Advice

nnanno

I'm not currently registered with a dentist and got an emergancy appointment with the PCT 2 weeks ago now, after having severe tooth pain. I got put with a dentist who I really wish I didn't have to see again, but I have an appointment with later this week.

It turns out I have a root abscess on a 2nd premolar (though I had to find this out for myself by reading his notes, as he wouldn't give me a straight answer to anything). At the first appointment the anaesthetic wouldn't work - I was told by the nurse this was because I had taken painkillers that day and they had somehow interfered with the anaesthetic (which to me sounds like nonsense?), and by the dentist that it's because the infection is at an accute stage. He prescribed amoxcillin for 5 days and I made an appointment for the day of finishing the course, as instructed. The pain went off completely, but at the next appointment I was just sent off for an OPG x-ray, when I feel that treatment really should have been administered then, considering I was there on an emergancy basis. I attended the x-ray on the Friday and had a further appointment on Tuesday. Over the weekend, the infection flared up again - this time with lots of facial swelling as well as the pain. I had to call up yet another emergancy dentist who prescribed another course of amoxcillin and told me to keep my Tuesday appointment. However the antibiotics didn't work this time, and at the Tuesday appointment I got prescribed metodizanole and am back there on Friday where apparently, though I'm not holding out much hope, I'll get the abscess drained and either root canal or extraction will follow.

Now, my question is: what if the swelling hasn't gone down again by then? Does it mean more waiting, because I don't think I can stand more waiting/pain (so far, the swelling remains but the pain has lessened). What options do I have?

missm29

my advice is to pay more and find a private dentist, the treatment is so much better and faster. The nhs and their rules just do not make sense, i'm pregnant and was refused treatment last week, even though i was in agony, the next day i went to our old private dentist and £73 and 10mins later the tooth was out and the pain gone, i only signed up to the nhs dentist because treatment should be free when you are pregnant.

pjk_3

I'm not a dentist but I did have a problem with my wisdom tooth that needed antibiotics. My dentist prescribed metronidazole and it worked very well and really quite quickly (and permanently). He said he wouldn't do any work until the infection had cleared up so I imagine that's standard. He also recommended using salt water (yuk) as a mouth rinse which may help you as well. Good luck.

coldstreamalways

When a tooth is infected, the acidity of the infection can stop the anaesthetic from working. That is why, if there is swelling and infection, sometimes, we will prescribe antibiotics to get the infection down as much as possible before doing any treatment. Amoxicillin and metronidazole are two, very effective antibiotics for dental infection so hopefully, they will start working soon.

As said above, a private dentist will help you so much more, I don't work in practice so please don't think I'm plying for trade, I do however do some emergency sessions for the PCT and, if I don't think we will be able to get a patient numb enough to drain an abscess or extract a tooth, antibiotics are the route to follow.

With the NHS, you get what you pay for, unfortunately, you can't add your national insurance into that equation because Alistair Darling sure doesn't!

nnanno

Thanks, I'm glad to hear that it's standard to wait this long. I'm concerned about the abscess spreading and annoyed that when I was pain-free after the first treatment of antibiotics, he suddenly changed his mind and the infection ended up worse because I had to wait. I don't trust this dentist at all, therefore I find myself questioning his every move.

I have some other non-urgent work to be done following this and I'll definitely be changing to a better dentist.

brook2jack

Unfortunately if it is an emergency clinic you will only get an extraction or temporary filling they will not do a root filling or any other routine treatment as they are funded for emergency treatments only.

Some pcts will fund some clinics to do one course of treatment to bide you over until you can find a dentist ( however as there is no such thing as registration any more a nhs dentist is only obliged to see you during a course of treatment any emergencies eg inbetween check ups are not their responsibility).

nnanno

It was an emergancy slot within a normal NHS dentist, not a clinic.

Can you please explain more about your last comment? What do you mean there's no such thing as registration anymore?

brook2jack

In order to free up more space so nhs dentists could see even more patients the government got rid of registration. What that practically means is if you find a nhs dentist to treat you they will do a course of treatment but once that course of treatment is finished you are not automatically entitled to go back to that practice.

If ,for instance, you had toothache again after treatment finished the practice does not have to offer you an appointment (they may be busy or have run out of funding) it is the pcts responsibility to sort your toothache out.

To follow other government guidelines designed to get more people seen on the nhs you may very well wait up to 2 years for a check up from your last course of treatment if you are seen in the same practice.

To go to your other question access sessions provided by pcts in local nhs practices will only provide emergency treatment. You will not get root treatment or routine treatment.

nnanno

Thanks. I wasn't aware of those changes, and it certainly hasn't helped me find a dentist as when I was looking every one was "not taking on new patients".

I am actually getting root canal treatment from the emergency dentist as it's one of the things he has said explicitly, that he doesn't want to pull the tooth because first he'll try and fill and save it. I suspect technically this will be done under a registered basis with them though.

brook2jack

I am surprised as root treatment cannot be done as an emergency treatment. It can only be done as a band 2 course of treatment which should include all your other fillings, check up , etc.

As all of this will be a fair amount of treatment for little money on the nhs I am surprised the emergency dentist will take you on as a routine patient.

nnanno

I presume the root canal will be done at a charge of the band 2 treatment, I wasn't expecting to get it done for £16! tbh I don't think the dentist is entirely clued up on the matter though. He has to keep asking his nurses on what the procedures are, and I'm not sure they have much idea either.