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

xadoc

Katgoddess wrote:

My NHS dentist said that I could either have it taken out on the NHS or be referred to a specialist for a roof canal.

Roof canal... is that like guttering? :rotfl:

Sorry, couldn't resist. I'll get me coat.

Katgoddess

I had a long day.

Toothsmith

Katgoddess wrote:

My tooth broke a couple of days ago, on a tooth with a deep filling.

My NHS dentist said that I could either have it taken out on the NHS or be referred to a specialist for a root canal. An endodontist (?) in central London. My dentist said that it will probably cost £500 to save the tooth.

Does this sound right? Do you think I could get it cheaper elsewhere?

What he is saying is that he can't be bothered to do it on the NHS, as it will take him far too much time for the 3 funding points that it will earn him. So, as he realises he will be on very dodgey ground if he offers to only do it privately himself, he has told you that you would have to be referred to get this treatment done.

Despite the fact he has signed a contract saying he will do on the NHS all the work he has previously done.

If you need a root-filling, he is contractually bound to offer you one.

There have been a couple of cases so far of PCTs forcing NHS dentists to pay for their patients to have private referrals if their dentist has been doing this sort of thing too often, and 'cherry picking' simple NHS treatments to get their points target.

I would have a word with your local PCT and see what their opinion of this dentist's approach is.

Katgoddess

Toothsmith wrote:

What he is saying is that he can't be bothered to do it on the NHS, as it will take him far too much time for the 3 funding points that it will earn him. So, as he realises he will be on very dodgey ground if he offers to only do it privately himself, he has told you that you would have to be referred to get this treatment done.

Despite the fact he has signed a contract saying he will do on the NHS all the work he has previously done.

If you need a root-filling, he is contractually bound to offer you one.

There have been a couple of cases so far of PCTs forcing NHS dentists to pay for their patients to have private referrals if their dentist has been doing this sort of thing too often, and 'cherry picking' simple NHS treatments to get their points target.

I would have a word with your local PCT and see what their opinion of this dentist's approach is.

Thanks Toothsmith. I suspected as much.

I have booked an appointment to see a private dentist that has been recommended to get a second opinion. Hopefully he will be able to do the root canal for a lot less.

Toothsmith

It would be worth a word with the PCT as well.

If people just quietly go elsewhere, nothing will be done. You may be one of many, and you may be the 'one more' they are waiting for before they take action.

happygal_3

I had a root canal on Tuesday and i think my dentist has made a total mess of it. I am in heaps of pain, have ear ache, my face is swollen and can't even touch said tooth. I went back on Fri and have been given clindamycin hydrochloride 150mg 3x daily. How long thill they kick in? I want the tooth out now can't cope with the pain any more. My dentist refused, told me it's a perfectly usefull tooth - not very usefull if I can't use it.

Anyone know of a dentist - or anyone with a pair of pilers in Great Yarmouth area who can pull tooth out and roughly how much it would cost?

Thanks

xadoc

Oh no! Poor not-so-happygal

I've made an appt to see mine again about getting a root canal... I'm starting to have second thoughts.

Toothsmith

happygal wrote:

I had a root canal on Tuesday and i think my dentist has made a total mess of it. I am in heaps of pain, have ear ache, my face is swollen and can't even touch said tooth. I went back on Fri and have been given clindamycin hydrochloride 150mg 3x daily. How long thill they kick in? I want the tooth out now can't cope with the pain any more. My dentist refused, told me it's a perfectly usefull tooth - not very usefull if I can't use it.

Anyone know of a dentist - or anyone with a pair of pilers in Great Yarmouth area who can pull tooth out and roughly how much it would cost?

Thanks

You can get quite severe reactions after root fillings sometimes. (Not often)

If everything else looks OK about the root filling, then it will settle down and be a perfectly good tooth for a good long time.

When it's so painful, there is a very good chance that the anaesthetic would not work properly, so trying to take it out would make your eyes water somewhat!

So - in order to have it out, you need to wait for it to settle anyway, and once it's settled, you'll feel a lot better about it.

Take the antibiotics, use pain-killers, and whatever you do - DON'T hold anything warm against it. This will only make things 10x worse.

leni

I've just been to my dentist and think I've annoyed him. Basically I've been having pain in my back lower molar since mid December, finally booked an appointment last week for this morning. Basically the dentist wants to do root canal, BUT my tooth sits on my nerve and theirs a very high chance that he might go too far and severe the nerve, leaving me with permanant numbness in my lower lip, chin, gum and teeth. Obviously at 25 I don't want that and said so and asked about extraction (which can be done but he'd prefer to keep the tooth). I discussed the options with him and he gave me 3 options, told me to go away and make up my mind instead of sitting in his chair trying to decide (he didn't say this but said as much).He basically said I was over reacting to the numbness and no one but myself would know, numbness doesn't mean droopiness but thats not the point, I'm 25 and would like to be able to feel the kisses from my partner on BOTH lips.

My options are...

NHS root canal - high chance of hitting the nerve - cost including a corwn in 6 months time - £220

Private Root Canal - would take measurements from x-rays and the chance of hitting the nerve would be significantly less - cost £300 - £350

NHS Extraction - would leave me with only one molar at the bottom at that side as I had the wisdom tooth removed last year - £42.40

Now money IS an issue as my job contract runs end in March 07. Any advice?

Toothsmith

Anything the dentist does to you should be done with all the care and attention he can muster.

The method or amount of payment are immaterial. If he cannot do the job properly on the NHS than he should not have an NHS contract.

The fact that he has an NHS contract means that if he does a root filling on the NHS (And as he has accepted you as an NHS patient then he is obliged to, unless you choose differently) then he must do it properly.

Not to do so is negligent.

As for severing the nerve, has he told you this?

It is not a warning that I ever give any of my patients, as I cannot think of any situation where it might happen.

Prodding a file into the nerve bundle wouldn't even hurt if everything was numbed up properly, and you'd really have to be trying to do some damage to cut that nerve bundle with a tiny root filling file.

I suppose it is a theoretical possibility, but I would imagine that the risk is up there with the surgery ceiling falling on you, or the dentist fainting mid-treatment and head-butting you!

All pretty unlikely stuff.

I would have it root filled, and if he isn't prepared to do it 'properly' on the NHS, then it's time to change dentists, and put in a complaint to the local PCT about him giving misleading information.


P.s. Done properly, a root filling should be done with the tooth isolated with a device called rubber dam in order to stop bacteria from the saliva getting into the root canal system.

Apex locators are devices that locate the end of a root by a tiny (i.e.you won't feel it!) electrical signal. This is generally accepted to be more accurate than measuring x-rays.

If you find a private dentist to do it, then £3-500 is about the going rate, but make sure it's a practice that has the right proceedures, and not one that just charges more for a bodge job.

Asking if they use rubber dam & apex locators is a good way of filtering them out.