Anybody know much about NHS dentists?

lorark

Hello,

I had root canal treatment and a white filling carried out on my upper premolar. As I don't have any canine teeth (they were removed when I was young before my permanent teeth grew into place), I assumed this would be included on the NHS as the premolar is one of my anterior teeth. However, my dentist now says as I had a white filling on a premolar, none of the treatment is covered by the NHS and I have to pay £210. I was shocked by this as he hadn't warned me of it prior to the treatment so I have a few questions:
a) Is he correct in charging me this amount? My friend who is a dental student mentioned something about preapproval?
b) If I refuse to pay, can he force me in some way/blacklist me? Obviously I would be willing to pay the NHS charges but I can't help but feel he is ripping me off! Especially as I wasn't warned of the charges before he carried out the treatment. And it's nearly christmas!

All advice appreciated!
Thank you!

tirednewdad

I am assuming you are an NHS patient and haven't been told otherwise- did you sign a blue form?- if you did then you've had a NHS course of treatment.

Root cannal treatment (RCT) is included as an NHS treatment option so you have had to have been offered a NHS RCT with either an silver filling or crown as an option.
If you requested a white filling then the NHS dentist is within thier rights to charge you privately for the whole treatment-, although it is at the discresion of the dentist. The most important thing is that they must tell you that it is private treatment at the start and give you a quote about the costs. If they haven't, then they are at fault.

Ring them up and politely explain that you were under the impression that it was an NHS treatment.
If they say it was a private treatment then again politely say that that wasn't explained to you at the time- (remember to plead poverty it always helps).
If they still say it was private treatment then request a copy of the signed private treatment plan with assocaited costs (which they problably won't have)
Again politely state that you wouldn't have had a white filling if you'd have known the treatment was private- so can you just be charged the NHS fee.
If they still refuse the refund then request a copy of the practice complains proceedure and go on from there- this will usually not get this far though.

Toothsmith

All dentist should discuss and gain approval for (preferably in the form of a signed estimate) all fees - be it private or NHS

If they don't, then they only have themselves to blame if misunderstandings like this occur.

I would ring up the practice and explain that you thought the treatment was NHS and see what they say. Can they produce anything that shows you knew it was private and you knew how much it would cost? Are they a private-only practice who don't do NHS at all? Have you been an NHS patient there in the past?

If you are in Egland, the NHS charge for what you've had done would be £42.60 - make it clear to them that you are willing to pay that amount.

If you get no stisfaction, then go through the practice complaints proceedure first, as suggested above - but take it up to the local PCT if this gets nowhere, or they ask you not to come back as a result of this.

lorark

Thank you both for your replies, I will try ringing them tomorrow! And it's definitely an NHS practice, I have had NHS treatment from in the past!

mda99das

RCTs are tricky one.

I have given up doing them outside the NHS as there were too many problems.

I still do it as a course of treatment including the crown for £198.

However I give the pts the option of either an amalgam filling to restore the access cavity which fufills the NHS requirements or a white bonded filling which is more superior as it bonds to the tooth. The regulations permit me to charge a fee for this.

The crown of course is a FGC on ANYTHING beyond a 3, as these are posterior teeth, and a FGC is fully functional. If they want a white one they will have to pay for a private crown, so that the total course of treatment would be the band 2 charge with a private filling, pts choice or a private / nhs crown.

butler_helen

I'm confused mda99das... I am in the same position as the OP but I knew I was private before I began.

Should be fee at the end be £42ish for the RCT then the £50ish dentist cost for the white filling? I've been back 4 times since August as it was infected for a while, would this have an impact on the cost?

sorry to hijack a bit op.

just to add that I'm not getting a crown yet as I really can't afford one.

mda99das

Well it depends how much confidence a dentist has in his own work.
I do a fair few RCTs...yes 99% of them on the NHS with loupes and heated GP and using rotatory instruments.

I will put a crown on the tooth to protect it as part of the course of treatment as I have seen all too often what happens when a patient declines, the tooth splits in half and needs extracting

When you drill to where the nerve sits there is a big hole left after.
A white filling like Fuji seals the access to the root canal system preventing bugs from gaining entry. But it also bonds to the tooth as well thus providing additional protection.

An amalgam filling will do the same job but it does not bond to the tooth leaving it liable to fracture under a crown.

I give my patients the choice of which they would prefer and explain the risks and benefits. Most are happy to pay the little extra for the white filling.

In terms of the crown I normally go for the gold type on back teeth ie anything beyond tooth number 3. Most patients will pay a private fee for a white crown, or can stick to the NHS gold one.

Some dentists will do white crowns on back teeth, but thats there choice as the dentist is funding it. They are NOT obliged to place white crowns on posterior teeth when a gold one will do. Yes it may be a rigid enforcement of the regulations but at least there is nothing misleading

The way I look at it , there is no point in doing a sub standard root canal as all that will happen is that the problem will flare up later.

I give my patient the option of what type of crown they would like after.

I fufill my NHS contractual obligation, and the patient retains their tooth.
If they are not happy with these arrangements then they are welcome to find another practioner.