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

Debsidoo

Hello-
Can you help? I am a patient at a NHS dentist. Back in Dec I had a filling removed on an upper rear (5?)molar which was very sensitve.. The dentist recommended I have a white crown fitted (NHS would only allow metal crown - ans he felt it would be visible. I paid £285.
I have now had to go back to the dentist, as this weekend, I have had terrible pain and he has said I now have an absess.
He has recommeded root canal treatment, but states it is not worth it for me on the NHS as they dont allow him enough time to do a good job- therefore he said it would be £285(3 canals).
My concern is that he said he doesnt have to remove this crown, he can drill thru' it to do the root canal work!!!!!????
He cannot guarantee the work even if I pay privately. Should he be talking me out of having the root canal work done by him on the NHS?

Toothsmith

He can try, but he isn't allowed to say that he isn't allowed to do it well on the NHS.

If he has an NHS contract, then he has a duty to provide all the treatment you NEED, to the best of his ability, on the NHS.

There are no time limits whatsoever written into the NHS contract, only financial ones. If he didn't like the finances, he shouldn't have signed the contract. As he has, he shouldn't complain if he has to do the odd treatment that takes a bit of time.

If you have very recently had a private crown (He was right about the tooth coloured bit) on this tooth then clearly you NEED it saving, and so he should do it on the NHS for you.

Did he take an x-ray of the tooth prior to crowning it?

If he didn't, then he is on very dodgy ground, as he cannot prove that the infection wasn't already there before he crowned it.

It is always recommended that an x-ray is taken of a tooth prior to crowning.

Doing the root canal work through the crown won't damage the function of the crown, and if an x-ray of the tooth showed it to be OK before crowning, then that's just one of those unforseen things I'm afraid.

If no x-ray was taken, as I said, it's a very different story, and you'd have very real grounds for serious complaint.

Debsidoo

I'll check about the xray- i'm not too sure he did one prior to recommending the crown. I think he used one I'd had done some time ago. Thanks again!

shilpa_2

hiya, i am currently a student, applying 4 dentistry at universty. i was just doing some reserach 4 interview, and came across this thread...

Basically im am soooo confused on the new NHS contract, and what the disadvantages are to the dentist? - so far i have come up with these- please can u add any, if theres any more :
DISAVATAGES OF THE CONTRACT
DENTISTS = this could have a detrimental effect on health with patients waiting until they need multiple treatments to get value for money.

-The plans for increased PCT involvement in the running of practices is also facing fierce opposition with dentists objecting to becoming "employees" of the health trust rather than independent practitioners

- TO DO WITH MONEY = some dentists can get loads of patients with 1 root canal treatment and another get loads with 10, but they both get paid the same, it isn't exaclty going to be fair.
- the system is that the "dental practice" , not each individual dentist, get paid an average of their last 3 years earnings, so far a new graduate to come in and work for them would mean the the salary for the practice would have to get split one extra way

and also if someone knows about the whole point and target system for dentists on the NHS - please explain!!!

buddingdentist

shilpa there's loads of info on the contract in other threads on this board, so have a search and you'll find plenty about it. Good place to start is http://forums.moneysavingexpert.com/showthread.html?t=152290

Toothsmith

shilpa wrote:

-The plans for increased PCT involvement in the running of practices is also facing fierce opposition with dentists objecting to becoming "employees" of the health trust rather than independent practitioners

Especially as the PCTs don't have the decency to actually buy the business before imposing their rules on how it should be run.

In another time this would have only been done at sea and the vessel doing the taking over would have been flying a black flag with a skull & crossbones on it!

If one party is the Government, and the other is a dental practice, it's now perfectly legal though apparently.

Even in the old days of socialism, if something was nationalised, the business owner got some compensation.


The rest of your analysis is pretty accurate, but you've only scratched the surface.

Katgoddess

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?

I've just had my appointment with a private dentist for a second opinion.

The dental surgery waiting room was excellent with today's Mail and Express to read, a water cooler, nice chairs, and one other patient. The receptionist greeted me with "is it Kat?" as I walked through the door. They email or text you a reminder for your next appointment. I impress easily.

Anyway, this dentist seems to think that I *probably* won't need a root canal at all. :j

I don't think I can explain it very well, but basically the nerve ending has moved so where the tooth has eroded/broke it's still ok for the moment and I don't need a root canal. I also need a new filling, and 2 fillings repaired before they end up like the broken tooth.

He took x rays which were put up on his fancy computer and explained everything to me. (Which I've now forgotten. )

The four fillings and a visit to the hygienist are going to cost me £460 :eek: but this is much better than £500 for a root canal I don't need. :T

This is what I'm having done:

WPF LL6 DO
WPF LL7 O
WPF UR6 O
WPF LR7 MO

If that means anything to anyone.

Toothsmith, I am going to write and complain to my PCT as well.

shilpa_2

hiya, one more thing toothsmith -

if the qusetion why are so many dentists going private? was asked, and i said:
- becoz of the determental affects on the patients health
- the PCT having too much involvement = lack of concept of OWN BUSINESS
- if a dentist has 1 filling, and another has 10 fillings = same points = NOT FAIR, as the 10 fillinf one, spent more time, and money on technicians, but gets same amount towards the targets ... not fair

would that b it? surely does this outweigh the INVERSE CARE LAW... the fact that so many dentists are going private = costs soo much...therefor the patients who need care the most, cannot afford it, and the ones who can are wealthy......

i dnt get the right thing to do? or why sooo many dentists are going private?

Toothsmith

The ones who can afford it are not necessarily wealthy.

People put different values on different things.

I've had people who are on benefits, and would be entitled to free NHS treatment stay with me (Despite an NHS practice taking on patients within a couple of miles of my practice)

I have had people with lots of money tell me where to stuff my private dentistry and go down the road to this practice.

The bit about inverse care law - this is POLICY. Policy is the job of Government. If Government want a social dental care service in this country then they have to put a workable system in place, and define who is to receive it.

Dentists, at the end of the day, have a business to run, staff to pay, equipment to service and loans to repay.

If money coming in is less than money going out, then there won't be any dental practice there for long!
That won't serve anybody - rich, poor, those that value good dental care, or those that don't.

Costs can be cut by speeding up and seeing more people, buying cheaper equipment, getting it serviced less, hiring cheaper non-qualified staff (Although that is not an option since last July, when all dental nurses have to be registered).

There comes a point where a dentist is providing a much worse service to his patients than his conscience allows.

Different dentists have a different level for this.

When that level is reached, the dentist has no choice other than to escape the NHS.

girlsmum

I am lucky and have a NHS dentist and as i am on WFTC we are exempt anyhow
a year ago i had root canal done on one of my molars and a gold filling but in, i now have an abses on the same tooth,
the dentist told me i have 3 options

1. leave it as a am not in pain, but eventually the tooth will be eaten away (not a good option)

2. have root canal done again, but aparently as i have already had it done the NHS wont pay to have it done again in the same tooth, I need to go private and i have been quoted a figure of £600 :eek: and i doubt that its guaranteed to work

3. have the tooth extracted and leave a gaping hold in my mouth,


Does anyone know of another option,