root canal treatment - NHS and private costs & pros and cons

poolio

Dear Toothsmith et all,

Thanks for all the excellent info on this thread - I've read most of the pages and learned a lot, but am still a little unclear on a few things and would really appreciate your help and advice.

I went to the dentist today (mixed NHS/private walk-in centre in London) with some pain, and was told I needed root canal treatment on one tooth (UL4 I think), and fillings on 6 more which I thought were healthy.

The dentist told me that I could have the root canal + crown done for £196 on the NHS, or that I could pay for private treatment, by the same dentist, for £500 (RCT) + £270 (crown). I was advised that if I went private the materials and equipment used would be more advanced, the treatment was more likely to be a sustained success, and that the lab making the crown would take more time. I think she also said that the crown would be white instead of gold, which reading other posts here seems to be correct.

But other than the colour of the crown, is there really likely to be much difference between the two options, given that they will be performed by the same dentist? I notice that Toothsmith you have said here that patients are unlikely to get a goot root canal on the NHS, but why exactly is this? If it's the same dentist in this case, in what ways might the treatment differ? Would they (and are they allowed to?) use different equipment etc depending on whether it's under the NHS or not?

Ultimately if it really came to it I would pay for a specialist endodontist if it would really make a difference. How much should I expect to pay for this? After reading this board I'm suspecting that £500 is a little high for a GDP.

On a separate point she said I could get white fillings for £90, or metal ones for £45. I've heard that on the front teeth you can get white fillings on the NHS, so does that mean they should be £45, or am I confusing this here? Is an NHS white filling also £90?

Huge thanks in advance.
Anthony

Toothsmith

If they're charging that much for a private root canal, then I would consider paying £1-200 more and getting it done by a specialist. Much better chance of long term success.

I'm always a bit dubious of 'mixed NHS/private' places as the BIG thing about paying privately is that the dentist sees less patients and so has much more time for each patient. That means so much more than just 'using better materials'.

It means being able to get appointments quickly, having problems sorted efficiently, generally getting a good level of old fashioned SERVICE.

Not just paying more for essentially the same thing, with the dentist just promising to be 'a bit more careful'! Some practices efficiently section their appointment book in order to acheive this, but others really don't get it, and just see 'private' as 'charging more money'. I'm sceptical that an NHS 'walk in' practice will really set aside proper private time, but I may be wrong.

AS to the NHS charges, If you're already paying the Band 3 charge of £198, then all necessary fillings are included in that, so there shouldn't be an 'extra' £45 for NHS fillings.

The NHS pays for white fillings on front teeth, but not on back teeth, where it is a cosmetic (private) option. So, white fillings in your front teeth (canine to canine) will be included, but only amalgam on back teeth will come under the NHS.

ymakesmile

Today I had a filling on a back tooth which was meant to be for a 'small' hole. But once the dentist got going she soon found it was much worse and the decay went very near to the nerve. She filled it with a white filling she said also contained fluride, but she said if i do get pain it will need root canal. I asked what price they charge when i was paying by bill at reception and was told £160 an appointment with 2 appointments needed. Is this not rather excessive? I went private only because i needed a front crown replaced, even tho private prices I can by no means afford. Now I am rather concerned this filling wont work out, although if thats the case I wont have any choice but to have it removed. I just wondered if other private patients have paid similar for a root canal on a back tooth?

Toothsmith

£320 is about right for a root filling in a private general practice.

If you are referred to a specialist, it can be double that. But I wouldn't worry about it until/unless it happens.

ymakesmile

Toothsmith wrote: »

£320 is about right for a root filling in a private general practice.

If you are referred to a specialist, it can be double that. But I wouldn't worry about it until/unless it happens.

Yes your right, I shouldn't worry until its needing to be done but i am unfortunately a worrier...huff. thanks for your reply

devseven

hello toothsmith and other altruistic dental saints

I've read through many hundred of the posts in here, but can't see anyone who's had the same problem. I had a 15 year old filling replaced last year, the replacement never settled and was uncomfortable, so I had it quickly replaced again by the same dentist, who said that she'd gone pretty deep and that maybe I'd need a root canal in the future. I didn't have a great feeling about this dentist, to be honest.

A few months later, the tooth got very sensitive to heat and cold, particularly cold, which is annoying (but bearable). Still, I went to another dentist, who seemed more credible, if time-pressed, he said it would probably need a root canal, and he was prepared to do it under NHS. However, the tooth was just too sensitive to the cold air of the suction, even after two anaesthetic shots; we finally gave up when I couldn't take the cold air of the suction halfway through the third injection (different type?) of anaesthetic. I've no problem with dentists, and am have a pretty high pain threshold (I've had multiple knee dislocations and reconstruction ops).

Diagnosis was no way he could do job, had to refer to specialist costing £600. I do not currently have £600, I'm on sickness benefits, though hoping to get back to work soon. Can I afford just to delay treatment until I'm back to work? Is there any acceptable way of getting this treatment without paying £600, eg in a dental hospital? How will a specialist be more able to anaesthetise the area? If it's cracked, is the tooth history anyway? And so on...

Would be very grateful indeed for any advice, seems to be a minefield

~Chameleon~

Is it common to have RCT on a molar but to NOT have a crown fitted, just an ordinary amalgam filling?

This is on the NHS, not private. I had RCT yesterday but no crown offered, just ordinary filling

coldstreamalways

I don't always fit crowns to teeth I have root filled. Some dentists would say this is akin to not washing your hands after using the loo but we're all different! Be wary though, if your dentist says after a couple of months that you now need a crown, he may be trying to split your treatment plan which is not allowed under the NHS contract. It's a difficult call though, sometimes I'll leave a tooth to see how we get on and check it settles down, then decide to crown it later on. No definite answer here!

~Chameleon~

coldstreamalways wrote: »

I don't always fit crowns to teeth I have root filled. Some dentists would say this is akin to not washing your hands after using the loo but we're all different! Be wary though, if your dentist says after a couple of months that you now need a crown, he may be trying to split your treatment plan which is not allowed under the NHS contract. It's a difficult call though, sometimes I'll leave a tooth to see how we get on and check it settles down, then decide to crown it later on. No definite answer here!

Thanks! You've just described exactly what he's trying to do. It's all suddenly become very clear!

I was told to come back in August for check-up with view to fitting a crown if everything had settled down by then

This was an extremely reluctant NHS RCT done after I'd been in contact with PCT when he earlier refused to do it on NHS.

coldstreamalways

But he might genuinely be waiting to see if it's settled so don't jump to conclusions! I know it's very frustrating for you but this is what the NHS contract has done to dentists. Under the old system, you would have paid for the RCT and the crown (up to a maximum that I can't remember), now your dentist is almost paying for your treatment out of his own pocket! Not your fault though, blame Tony Blair.