NHS fee-exempt but dentist insisting on charging?

edited 30 November -1 at 1:00AM in Health & Beauty MoneySaving
14 replies 1.9K views
robokoderrobokoder Forumite
34 Posts
edited 30 November -1 at 1:00AM in Health & Beauty MoneySaving
Hi all

I am currently fee-exempt as I am in my 18th year and in full-time education (though I only have a few weeks left!).

In late June my NHS dentist said I should have a wisdom tooth extracted (not urgently, but as a future precaution), but wanted me to pay nearly £50 for a scan beforehand. I said I wanted to use my NHS coverage, so he referred me to the local hospital. In the meantime, that wisdom tooth has caused me signficant discomfort, but I left it - I was expecting a date from the hospital. Finally I chased it up (2 months later!) and it turns out the hospital said I wasn't eligible (note that they were unaware of any pain), and the dentist didn't bother to tell me :mad:

Anyway, I then asked to make an appointment with the dentist about the pain, and they said I would have to have a scan done privately to assess it and there was no way to have it done on the NHS

This really confuses me - if I am experiencing pain and they need a scan to treat the pain (and see if I am now eligible for an NHS extraction) how can they make me pay for a scan? Surely all necessary work is free?

Any ideas?

Thanks
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Replies

  • brook2jackbrook2jack Forumite
    4.6K Posts
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    The only scan you need for assessing wisdom teeth is xrays and these are available on the NHS. The dentist may want you to have an xray called an OPG this is also available on the NHS but for a derisory fee. Contact your PCT if they won't do on the NHS.

    NICE guidelines are that wisdom teeth will NOT be extracted unless you have repeated episodes of infection requiring antibiotics.(normally 2 to 3 in a year). Simple oral hygiene measures should keep the pain/ infection away. The hospital will not extract your wisdom tooth unless the above applies and if it does your dentist will need to rerefer you. The hospital normally sends you a letter to say if it will not see you and just sends a copy to the dentist.
  • reallreall Forumite
    44 Posts
    i would change dentist .find one that a friend/family recommends.i changed dentist after my dentist got 191.00 and did not complete the job but later closed down .i was more annoyed with this and found another dentist who made me an appointment and referred me onto a hospital for treatment (3 extractions) right there and then.I receieved a letter a few weeks from the hospital for an appointment.seen by the hospital and they referred me onto a dentist who does work for them otherwise i would be waiting from 3-6 months for them to do the job.i had the job done about a month later and have not needed or experienced pain since.No anaesthetic just paracetamol for a day. you should find one who helps nervous people and listens to you if you express pain on usual examination. take identification with you to the dentist and ask for nhs treatment only.The fee is clearly marked on the back of the presciption eg.there are three bands for both nhs and private from 40 something for check up to about 200.00 for treatments etc as a total.
    hope this encourages you to find help
  • brook2jack wrote: »
    The only scan you need for assessing wisdom teeth is xrays and these are available on the NHS. The dentist may want you to have an xray called an OPG this is also available on the NHS but for a derisory fee. Contact your PCT if they won't do on the NHS.

    NICE guidelines are that wisdom teeth will NOT be extracted unless you have repeated episodes of infection requiring antibiotics.(normally 2 to 3 in a year). Simple oral hygiene measures should keep the pain/ infection away. The hospital will not extract your wisdom tooth unless the above applies and if it does your dentist will need to rerefer you. The hospital normally sends you a letter to say if it will not see you and just sends a copy to the dentist.

    Thanks. Am I right in thinking £45 would be too high for an OPG? Bear in mind I am not meant to pay any NHS fees anyway - should I still be paying for this?

    In any case, I did have a glance at the wisdom teeth guidelines, but it seemed to me that there could be cases where structural problems could necessitate removal. In my case I think it is pushing heavily on other teeth and also interfering with my orthodontic work (I wear retainers). I have a weird tightness now in that part of my mouth and it is painful to chew. It may of course not even be the wisdom tooth, but if it is antibiotics won't help, so do I have any chance of a free extraction?
  • brook2jackbrook2jack Forumite
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    You should not pay for the OPG if it is necessary for NHS treatment full stop.

    It is a common and old fashioned misconception that wisdom teeth put "pressure" on other teeth, push teeth forward or should be routinely removed because of braces. If the tooth is front is badly decayed and it is impossible to do a good job with the wisdom tooth in place, then it may be removed, otherwise it's repeated severe infections requiring antibiotics is the only indication.

    Most wisdom teeth problems respond to meticulous oral hygiene measures, and taking lower wisdom teeth out has multiple risks which is why we don't take them out so often any more.
  • edited 30 August 2010 at 5:32PM
    robokoderrobokoder Forumite
    34 Posts
    edited 30 August 2010 at 5:32PM
    brook2jack wrote: »
    You should not pay for the OPG if it is necessary for NHS treatment full stop.

    It is a common and old fashioned misconception that wisdom teeth put "pressure" on other teeth, push teeth forward or should be routinely removed because of braces. If the tooth is front is badly decayed and it is impossible to do a good job with the wisdom tooth in place, then it may be removed, otherwise it's repeated severe infections requiring antibiotics is the only indication.

    Most wisdom teeth problems respond to meticulous oral hygiene measures, and taking lower wisdom teeth out has multiple risks which is why we don't take them out so often any more.

    Okay thanks for clearing that up, hopefully my dentist will help me resolve the problem without extraction - which I'd prefer anyway. Incidentally, one reason he kept pressurising me to get it removed was that he said it would eventually cause other teeth to be moved out of place (it is coming out at an angle and has got stuck) - he even insisted on showing me photos of other patients with the same problem who didn't have them out. Is this irresponsible scaremongering?

    Re: the scan, basically I need to know what to do. My dentist was adamant that the scan was not covered by the NHS under any circumstances (that's why I originally asked for the referral). Is there something I can quote at them? And do I you recommend I discuss this with the receptionist on the phone before the appointment or just wait until he asks me for money there?

    Sorry this is going on a bit but they're being so awkward and I want to feel 100% equipped to fight my corner.
  • brook2jackbrook2jack Forumite
    4.6K Posts
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    Discuss now not after treatment.

    Ask them to put in writing ( a quote will do) and then contact your pct , you'll find the number in the book. If the tooth needs to be treated all stages are available on the NHS. Make sure you phone and speak to receptionist before you have the opg.
  • brook2jack wrote: »
    Discuss now not after treatment.

    Ask them to put in writing ( a quote will do) and then contact your pct , you'll find the number in the book. If the tooth needs to be treated all stages are available on the NHS. Make sure you phone and speak to receptionist before you have the opg.

    They refused to put any quotation in writing and suggested I look for another dentist or just go to the hospital.

    I've actually got an appointment elsewhere tomorrow but I really don't think my current dental practice should be allowed to have an NHS contract. Ah well.
  • brook2jackbrook2jack Forumite
    4.6K Posts
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    You are absolutely entitled to a written quote. Moreover if a dentist mixes NHS and private treatment (eg a check up and "private scan") they are in breach of their conditions if they do not give you a form fp17dc which details what your charges are and what are NHS and what private.

    You should complain to the PCT if you had a NHS check up and they refused to do a OPG on the NHS.
  • ToothsmithToothsmith Forumite
    9.8K Posts
    Part of the Furniture 1,000 Posts Name Dropper
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    I would agree with Brook - the refusal to put something in writing, especially when they are mixing private and NHS items is seriously in breach of conditions.

    Complain direct to the PCT if they persist in fobbing you off like that. I doubt you'e the only one they'll be trying it on with.
    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.
  • brook2jack wrote: »
    You are absolutely entitled to a written quote. Moreover if a dentist mixes NHS and private treatment (eg a check up and "private scan") they are in breach of their conditions if they do not give you a form fp17dc which details what your charges are and what are NHS and what private.

    You should complain to the PCT if you had a NHS check up and they refused to do a OPG on the NHS.
    Toothsmith wrote:
    I would agree with Brook - the refusal to put something in writing, especially when they are mixing private and NHS items is seriously in breach of conditions.

    Complain direct to the PCT if they persist in fobbing you off like that. I doubt you'e the only one they'll be trying it on with.

    Well, you're right that they are behaving appallingly badly, but it's not really obvious that there's much I can do. I had a conversation with the Quality Manager at my local PCT this afternoon and she basically said they did not have the resources to 'microinvestigate' (her words) each problem, instead advising that I could complain to the practice, and saying they'd be grateful to be copied in. I'm pretty sure that complaining to the practice is going to do no good, and I'm not sure I particularly want to pursue a more comprehensive line by forcing the PCT to look at it, and also complaining to national dentistry regulators. Given that I have now got alternative care it would look spiteful. This might sound silly, but these people know where I live and have my personal records.

    (Leaning the other way, of course, is that I'm pretty sure that I have been given advice motivated by money not medicine for a while now, in addition to other issues I haven't even mentioned here... they are really taking the mick and I do have a part of me that says others shouldn't be stung similarly.)
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