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

brook2jack

Dentistry is not a "one off" purchase. All treatment needs careful planning and maintenance.

As said before even the best treatment done by the best people goes wrong. It's not so easy to rectify if the dentist who did it is hundreds or thousands of miles away.

Finally all dentists in the uk have to have indemnity insurance and if you have problems there are many mechanisms to enable you to get help. People who have problems arising from treatment abroad are left trying to negotiate through foreign courts , often in a different language and at potentially very high costs.

Toothsmith

scotsbob wrote: »

Interesting that the specailist dentists are from overseas.

Whenever people on this forum mention that they are going abroad to have their treatment, at 30-50% of the UK cost, the posters on this forum with a vested interest become very xenophobic and tell us UK dentists are the best. Strange that dental practices here are bringing the continental dentists here.

I would challenge you to find any such posting.

There are several that give very good reasons for having complex surgery close to home - but I can't think of any posts I have read from any dentist that say that UK dentists are 'best'.

Strange as well, isn't it scotsbob that when these lovely charitable, altruistic foreign dentists get here - and have to work under UK registration, and to UK regulation, that they're suddenly not 30-50% cheaper anymore.

Any reason you can think of for that?

usignuolo

Well it could be that they are coming here because they find they can make much bigger profits than they can back at home.

I don't think it is disputed that British dentistry is the most expensive in Europe and probably among the most expensive in the world. Dentists may claim that this is down to the high cost of equipment and standard of living here but surely the equipment does not cost more and the standard of living is no higher, indeed may be higher, in other parts of northern Europe. A Dutch university study, hotly contested, released in 2008 said the reason for high costs in the UK, after factoring in cost of equipment, premises etc, was the amount UK dentists charged for their time.

Agreed dentists have expensive equipment to buy and the younger ones have to pay for their training. But my dentist is of the generation whose training was paid for by the state and whose practice is in premises owned outright. No sign of any cash crisis. As they only offer NHS treatment for children and everything else is private, I imagine the senior members of the practice are among the one in 20 dentists earning over £200k annually.

Currently the amount of people regularly attending a dentist is at its lowest figure in 9 years.The reason is that they cannot afford it. If you want a root canal, privately, to judge by my OHs experience, it will end up costing around £1000. If you have an extraction and an implant it will cost over £2000.

Who has that sort of money to spare? My sister, whose work means she deals a lot of people on low incomes or unemployed, says that most of the older ones now either have no teeth or only a few rotten ones left and this is increasingly common among younger people on low incomes.

The Labour government issues platitudes about it - not surprising as the Health Minister is Mrs Expenses Ann Keen. But the Tories in their turn did little to sort things out. I assume politicians get their dental care on expenses, like everything else. Meanwhile there are millions of people without an NHS dentist who cannot afford private care and whose teeth are falling out.

Really it is a disgrace.

welshdent

How do you KNOW senior denists are on 200K plus? have you seen their accounts? How do you know their practice is owned outright? Have you see the documentation? A lot of assumptions being made there with little in the way of foundation for them. I dont know any dentists earning 200K plus purely from dentistry. I know many private dentists earning significantly less than that ... and less than they would earn on the NHS. I am a senior dentist in my practice who routinely takes on the complex endodontic treatments and I can assure you I am an on SIGNIFICANTLY less than that. Would you care to reference this dutch study? I have never seen it in any press I have read. I am sure myself and others on here would most intrigued by it. If you are unhappy with the system then I suggest you take that up with your MP because it is they not the dentists that give you the NHS and all its trappings. The dentists merely supply their services. Incidentally have you tried calling a plumber out recently? I think you will find that is rather more expensive that you would pay for most emergency access in the practices I know near me. Incidentally you say "no signs of a cash crisis" when commenting on the practice you attend .... do you REALLY think they would put up signs??? It is a professional establishment delivering medical care to patients not some shoddy run down nightclub in town. They no doubt pride themselves on at least looking like a place you would be well cared for.
Sometimes it makes you wonder why you bother given the apparent lack of appreciation for the time and effort we spend training to help people. We just get accused of being greedy money grabbers and are expected to happily take it

jugglebug

Dentists often have NHS contracts worth massive amounts of money. But this is the money that runs the practice, The nurses salaries, the receptionists and every other expense. For example I work in a practice where there are 4 dentists, and 6 nurses. However the contract is in the name of the practice owner alone.
Therefore when the daily mail quotes the money "Paid to NHS dentists" They can only quote the gross amount paid, before it is used to pay staff, electricity bill, rates etc etc.
They have absolutely no idea how much a given individual takes home, and it is a nonsense to think otherwise.

Toothsmith

usignuolo wrote: »

I don't think it is disputed that British dentistry is the most expensive in Europe and probably among the most expensive in the world.

Err - I would dispute that, unless you can back it up?

usignuolo wrote: »

A Dutch university study, hotly contested, released in 2008 said the reason for high costs in the UK, after factoring in cost of equipment, premises etc, was the amount UK dentists charged for their time.

So others were disputing it as well! Any chance of some sort of link to show that you haven't completely made that up anyway?

usignuolo wrote: »

Currently the amount of people regularly attending a dentist is at its lowest figure in 9 years.The reason is that they cannot afford it.

Any back-up for that??

The Government would have it that the NHS reforms of 2006 have been a roaring success. Whilst that probably isn't true, figures attending NHS practices certainly aren't at their lowest ever, and those attending private practices are at an all-time high, so add the two figures together, and dental attendance can't possibly be at an 'all time low'.

Maybe it is as a % of the population but numbers-wise, it's more than ever.

usignuolo wrote: »

If you want a root canal, privately, to judge by my OHs experience, it will end up costing around £1000. If you have an extraction and an implant it will cost over £2000.

But if you have the tooth out and a plastic denture, it will cost £198 on the Nash. That's all you need to restore aesthetics and function. Anything else is a lifestyle choice.

That's like saying you can't possibly afford to go to the shops because it will cost too much to buy and run a car - when there's a perfectly good bus service.

usignuolo wrote: »

Meanwhile there are millions of people without an NHS dentist who cannot afford private care and whose teeth are falling out.

Really it is a disgrace.

Indeed it is a disgrace - because all it takes is sensible eating and good toothbrushing, and you needn't have the expensive problems in the first place!

welshdent

Toothsmith wrote: »

Indeed it is a disgrace - because all it takes is sensible eating and good toothbrushing, and you needn't have the expensive problems in the first place!

I had a girl in the other day that hasnt been for 7 years. She attended with pericoronitis but aside from a tiny bit of lower anterior calculus she was spotless. You and I both know what that means ... she actually looks after herself ... a lesson others should pay attention to

usignuolo

Independent (and other)10 January 2008


Dental treatment in England is the most expensive in Europe, according to an unprecedented survey which is likely to fuel the exodus of patients seeking treatment abroad.The survey of nine European countries found the total cost of a standard filling ranged from €156 (£117) in England to €8 in Hungary. That total included the cost of x-rays, materials, drugs and overheads, as well as the dentist's time. Dentists with their own practices earned an average of £105,000 in 2004-05. More than half their total income (52.4 per cent) came from private work, up from 41.8 per cent in 1999-2000. In 1990 it was 6 per cent.


While England topped the table as the most expensive country for dentistry at €156 for a filling, it was closely followed by Italy (€135) and Spain (€125). Costs in the other western European countries were less than half as much, ranging from €67 in Germany to €46 in France.


It is the first time that the cost of carrying out a dental filling has been compared across Europe. Siok Swan Tan, of the Institute for Medical Technology Assessment, at Erasmus University Rotterdam, and lead author of the study, said differences in dentists' earnings were the most important reason for the variation in costs. "Without exception, labour costs were the most important cost driver in all countries and practices," she said. "They accounted for 70 per cent of total costs in England. They ranged from €0.09 per minute in Hungary to €2.88 a minute in England."


The survey is part of a wider study, commissioned by the European Commission, comparing the cost of a range of medical procedures among the nine countries and is published in the journal of Health Economics.


Telegraph (and others) August 2009


The NHS Information Centre released figures showing that 382 of the 20,000 dentists in England and Wales earned more than £300,000 in 2007/8 while 1,172 earned more than £200,000 that is one in every 20 dentists. Overall 5,200 – more than one in four – earned above £100,000.

The income is before tax but after expenses, which typically include the costs of renting surgeries and paying staff, have been taken into account. The figures, based on dentists' tax returns, include those who work solely for the health service as well as dentists who have a mix of NHS and private work.
________________

In the case of my dentist, there are five in the group and I know that they have paid off the premises and only do private work for adults in a relatively prosperous suburb.


No one above had addressed how the mass of the population are expected to find the sort of money now being charged to care for their teeth, in the absence of a local NHS service. No NHS dentists at all in my area.

brook2jack

The first study you quote with an average cost of£117 per filling in the UK is the cost of dental treatment in NHS dental clinics with similar European clinics. These are clinics which provide treatment to groups with special needs such as severe physical disabilities which require specialised equipment and skills. These are clinics owned and operated by the NHS where the dentists are paid a salary (typically £28000 to £45000) as well as the nurses,receptionists etc . It is not a comparison of cost of treatment in normal general dental service.

It is interesting as Community clinics are run by the NHS and not for profit so what the study shows is how much more expensive it is to PROVIDE dentistry here than elsewhere in Europe.

welshdent

I havent read the article yet but to comment on your last couple sentences ... how do you know they have paid off the premises? How do you know they do not have large loans taken out to cover capitol investment in equipment? I personally am an associate and I am paying a loan off of 20K to cover my own gear I have bought separate to the practice. So what if they only do private work on adults? What is the problem with that? No one is forcing you to go to them.

I believe I DID address how the mass of the population could find ways of seeking dental care - speak to your MP!
Incidentally I do not know many people that charge an average of £117 for a filling ... but that price does not specify (I said specify - I know it says the price is included) the following things - material, size of cavity, time taken to do, practice overheads, bases used beneath the filling. Now given that they say they have taken in to account x rays - not all fillings require an x ray, not all fillings require drugs. It is a wishy washy figure designed to sell newspapers and generate shock in people. It clearly has. You would need 5 years of training to come close to appreciate why that figure is not a fair representation because dentistry simply doesnt come down to a simple average cost of 1 filling.