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

alison999

civicwalker wrote: »

The exact words were "not worth". I hear what you say. However to say "not worth" without bothering to take a x-ray surely cannot be a clinical decision. As she brought the endodontist into the equation she must consider that the tooth has a viable chance . . so why can't she perform the same work under the NhS?

because the nhs dont pay them enough to spend the time on it, thats why.

Toothsmith

civicwalker wrote: »

The exact words were "not worth". I hear what you say. However to say "not worth" without bothering to take a x-ray surely cannot be a clinical decision. As she brought the endodontist into the equation she must consider that the tooth has a viable chance . . so why can't she perform the same work under the NhS?

I assume that she took x-rays before and after the root filling that she did.

If this was only in Sept '07, then there isn't really a lot to be gained by taking another one. Not an awful lot will have changed radiographically in that time.

You have to be able to justify every X-ray taken these days, and in this situation, the symptoms are telling you far more than any x-ray would.

The root filling hasn't worked.

Taking an x-ray wouldn't tell you anything different, and the options are still the same - extraction or specialist referral.


EDIT _ as for the last bit - you would trust your GP Dr to deal with something like mild angina. But if it turned out that you needed a cardiac bypass operation, would you want the GP to have a crack at it, or a specialist cardiologist?? It just happens with the way dentistry never really got intergrated with the NHS back in the 1940s that the 'specialist cardiologist' never came into the system, and has to be paid for by the patient.

alison999

^ preach toothsmith

civicwalker

Toothsmith wrote: »

I assume that she took x-rays before and after the root filling that she did.

If this was only in Sept '07, then there isn't really a lot to be gained by taking another one. Not an awful lot will have changed radiographically in that time.

You have to be able to justify every X-ray taken these days, and in this situation, the symptoms are telling you far more than any x-ray would.

The root filling hasn't worked.

Taking an x-ray wouldn't tell you anything different, and the options are still the same - extraction or specialist referral.


EDIT _ as for the last bit - you would trust your GP Dr to deal with something like mild angina. But if it turned out that you needed a cardiac bypass operation, would you want the GP to have a crack at it, or a specialist cardiologist?? It just happens with the way dentistry never really got intergrated with the NHS back in the 1940s that the 'specialist cardiologist' never came into the system, and has to be paid for by the patient.

bank_of_slate wrote: »

Why don't you try the NHS root canal? if it fails within 12 months it will have to be treated again free anyway....Linda xx

If NhS "rules" dictate that root fillings will not be redone under any circumstances then I'm more than happy to accept that my choice is either to go private for £700 or have the tooth removed - but is that stated anywhere? In my case it's simply that my dentist has not (other than "not worth") communicated the Regulations.

NHS GDS contracts Regulation 2006 part 5 Regulation 14….
“A contractor must provide all proper and necessary dental care which includes:- That which a dental practitioner usually undertakes and which the patient is willing to undergo, including advice & planning of treatment."
GDS Regulations Schedule 1 Section 5 para 10. Mixing of services provided under the contract with private services..
“a contractor shall not…advise a patient that services which are necessary in his case are not available from the contractor under the contract ..or seek to mislead the patient about the quality…”
Repair & replacement of restorations Schedule 1 Part 5 para 11 without charge within 12 months

Alegedley my choices are supposed to be outlined in a Dental Care Plan - never seen one! Linda in her post is suggesting that the NhS work has to be redone free of charge if it fails within 12 months however my dentist is strangely refusing to xray my 8 month old root filling to search for any possible cause of the failure!

Toothsmith

If you think she's pulling a fast one, then you need to either complain to the PCT or get a different dentist.

From what you've written so far, my opinion is that she's done nothing wrong, or given you any bad advice.

I have no access to your notes, and haven't seen you, so my opinion may be wrong.

The NHS dental service is deliberately ambiguous so that politicians can claim it is a full and comprehensive service whilst dentists on the ground have to make it work within the confines of the money paid.

There are many dentists out there who would have told you that a root filling on a molar needed specialist care right from the start. The fact your dentist had a go at it is what makes me think she's one of the good guys.

I will repeat that there is nothing strange about refusing to x-ray the tooth. The x-ray will show nothing that would change the treatment plan. It will show nothing different to the x-ray taken at completion of treatment therefore it is not justifiable. Guidelines on radiation safety fully support this. The root filling might have failed for any number of reasons, but if the dentist felt that she did it as well as she was capable of that first time, she's not suddenly going to be able to do it any better a second time. It's time to either take it out, or refer you to someone who is better at them.

My advice is to accept your choices.

What you do is up to you.

newname_3

How soon after root canal treatment should you get any necesarry crowns fitted?

thanks

Toothsmith

There are many opinions on this.

Some say straight away, some say wait a while.

I think in an ideal world, it should be done immediately, but root fillings don't always work - and if you've paid a lot of money for that, and then an extra wad for the crown, and it all ends up with the tooth being taken out anyway, then you may well feel you've been cheated (you haven't - just unlucky).

Many dentists tend to wait until an x-ray a few months later shows the infected area to be healing before going on with the crown.

Of course - those that do it straight away would argue that a main reason for failure is not having a well sealed final restoration (That is - a good well fitting crown) in place.

you pays yer money........

ems2

How come it is so expensive to have RC done? I have just been quoted £1200 for root canal and a crown which I find absolutley astonomical, and it made me wonder what is so costly about this? I have two one hour appointments for this, and I am not sure whther to 'shop around' (it is a new dentist as recenlty moved) or just somehow pay it. I do not enjoy going to the dentist at all but know I need to get it done and reading this thread makes it seem like if I go NHS, I will have to get it redone too soon for my liking?

signed very nervous patient

alison999

ems2 wrote: »

How come it is so expensive to have RC done? I have just been quoted £1200 for root canal and a crown which I find absolutley astonomical, and it made me wonder what is so costly about this? I have two one hour appointments for this, and I am not sure whther to 'shop around' (it is a new dentist as recenlty moved) or just somehow pay it. I do not enjoy going to the dentist at all but know I need to get it done and reading this thread makes it seem like if I go NHS, I will have to get it redone too soon for my liking?

signed very nervous patient

b/c youre paying for the dentists time, paying towards the cost of materials, the running of the surgery etc. im assuming your dentist uses electricity and sterilizes his instruments and has a nurse to run around after him?

Toothsmith

ems2 wrote: »

How come it is so expensive to have RC done? I have just been quoted £1200 for root canal and a crown which I find absolutley astonomical, and it made me wonder what is so costly about this? I have two one hour appointments for this, and I am not sure whther to 'shop around' (it is a new dentist as recenlty moved) or just somehow pay it. I do not enjoy going to the dentist at all but know I need to get it done and reading this thread makes it seem like if I go NHS, I will have to get it redone too soon for my liking?

signed very nervous patient

You've been quoted £1200 for 2 things, not 1.

A root filling is a complicated thing. As you say, you have two 1h appointments.

A dental practice operating to current regulations and guidelines, doing things carefully and well, will be operating at a rate of about £175 per hour on average.

So two hours in the chair of an average dental practice will cost £350. Plus materials.

A dentist with extra training in root fillings will be charging more, and dental practices in higher cost areas will be more expensive.

Then you have the same thing again for the crown, plus a technicians fee for making the crown for the dentist.

Yes - you could shop around. I'm sure you could find it cheaper.

If your relationship with your current dentist is not particularly good, then why not look around?

You might find an NHS dentist, but it would be very unlikely that an NHS dentist would spend the time and care really necessary for a successful long term fix.