NHS dentistry and subtle ways they make you pay for private treatment

Inigo_Montoya

I have just moved house and been to see what I thought was an NHS dentist

My previous 2 NHS dentists used to do a basic scale and polish as part of the standard check up but this one said that their hygenist does all their teeth cleaning work

( BTW IMHO I have a clinical need for a scale & polish as there is one specific area of my gums that gets very sore due to the build up of plaque )

This means in order to get a scale and polish I now have to pay the hygenists private charge of £42 in addition to the standard NHS charge for a check up

I phoned NHS direct for advice and the person I spoke to said that the dentist is not under any obligation to do a scale and polish as part of the standard check up (apparently they can choose whether or not to do it)

Can anybody verify that this is correct ?

Also is £42 good value for a single hygenist appointment as I have seen alternate figures of around £25 mentioned ?

I will go through with this initial treatment but after that I will look for another dentist as I am not happy with the way they have added this private treatment

brook2jack

https://forums.moneysavingexpert.com/discussion/1211081

Has already discussed this point. Putting in scale and polish into search will also bring up answers .

welshdent

Bit of a leading and generalising title you have gone for there .....

on to topic. Yes a band 1 would cover a necessary scale and polish. We can not determine from here if it is necessary but your own dentist should have carried out a BPE (basic periodonal exam) which would have indicated if you needed a scale and polish or more. If determined that you need one then they should provide that for you on the NHS ... however they do not have to let you see the hygienist on the NHS. From my perspective what they should have done was offer you a scale and polish with the dentist as an NHS course or see the hygienist privately if the BPE indicates it is needed. If it is to remove cosmetic stain then they would be entitled to charge for a private scale and polish - but then you are entitled not to have it. As far as the cost is concerned, it varies incredibly so it is not really that easy to give a price guide. £45 does not sound like the higher prices however. I know of some places that would charge £80 ish.

coldstreamalways

More dentist bashing, what fun. The less charitable of us (are any of us charitable at all??) may suggest that if you cleaned your teeth properly, you wouldn't need any scaling or polishing at all thus saving you £42 or whatever.

Inigo_Montoya

Re : welshdent - I appreciate the advice

As I have already paid up front for the hygenist I will just go ahead with it this time but then try to find another dentist who is willing to do a basic scale & polish under NHS band 1

Just wondering how easy this will be ?

Not wanting to cast aspersions here but do most dentists tend to refer to hygentists nowadays even when there is a "clinical need" for a scale & polish ? (since it appears to somewhat of a subjective assessment from my laymans point of view ?)

Among other things discussed with this dentist I *specifically* mentioned my gum soreness due to plaque build up to them and I dont recall any "BPE" test being done - just a quick look at each tooth to check my "dental anatomy" & for decay

On the face of it I think I have a right to be a little aggreived as I had the right to a scale & polish due to a clinical dental health need

vwelsh13

I am so lucky to have found an nhs dentist, she gave me a basic S+P, then the hygenist did a full one. I had paid over £500 for private work that lasted under a year (crown and filling) and had no guarentee! have paid £42.50 for 2 extractions, 2 X S+P and buccal fillings as preventative measure

coldstreamalways

Hygienists are the experts in scaling and polishing. You are likely to get a much more thorough SP from a hygienist than a dentist.

You wouldn't necessarily notice a BPE being done, I check my BPE scores and write them down myself as my nurse usually puts them in the wrong order. You may have heard them call out a number. I would go so far as to say only a BPE 3 "needs" treatment, 1 and 2 are just people who let plaque and tartar build up despite having it cleaned off previously.

brook2jack

If you read through the thread mentioned above BPE is explained in detail. However most patients will not realise that BPE has been done as the dentist "just" calls out 6 numbers.

The best way to find a new dentist is by recommendation.... see toothsmiths signature.

Treatment of gum problems is problematical on the NHS since it is very difficult to employ a hygienist on the NHS and a scale and polish with the dentist at the same time as a check up is unlikely to treat longterm problems. This is more likely to be a band two treatment (£39 to £45 ish).

More important is to address the reasons behind gum problems so you don't need the hygienist so often..... smoking, not flossing or using interdental brushes properly and not brushing correctly. Since you have already booked and paid for the hygienist take your own toothbrush along and ask them to advise you on cleaning and prevention. The money spent may then be a worthwhile investment.

theheathen

coldstreamalways wrote: »

More dentist bashing, what fun. The less charitable of us (are any of us charitable at all??) may suggest that if you cleaned your teeth properly, you wouldn't need any scaling or polishing at all thus saving you £42 or whatever.

Really, that's your opinion? I'm surprised as a qualified dentist you are unaware that the microbial and enzymatic environment of the mouth in some people can make calculus formation inevitable, regardless of how fastidiously the person cleans their teeth.

theheathen

coldstreamalways wrote: »

Hygienists are the experts in scaling and polishing. You are likely to get a much more thorough SP from a hygienist than a dentist.

You wouldn't necessarily notice a BPE being done, I check my BPE scores and write them down myself as my nurse usually puts them in the wrong order. You may have heard them call out a number. I would go so far as to say only a BPE 3 "needs" treatment, 1 and 2 are just people who let plaque and tartar build up despite having it cleaned off previously.

LOL, I somehow doubt you pour such warm words on hygienists in private conversation.

brook2jack

theheathen wrote: »

Really, that's your opinion? I'm surprised as a qualified dentist you are unaware that the microbial and enzymatic environment of the mouth in some people can make calculus formation inevitable, regardless of how fastidiously the person cleans their teeth.

There are some rare gum diseases such as juvenile periodontitis in which the level of gum disease is unrelated to oral hygiene and plaque build up.

There are some conditions which make gum disease more severe than the level of cleaning would warrant ie diabetes, taking certain medications, smoking etc.

There are some mouthwash manufacturers who would have you believe that a mouthwash will cure all gum problems.

However years and years of proper research bring gum health down to one overwhelming factor...... if you keep your teeth clean stop the plaque building up this is the most overwhelming step you can take to keep your gums healthy. Moreover in the Uk 80% of people do not clean effectively. Learning how to do so is the most moneysaving and health saving thing you can do.

All advanced "gum treatments" are aimed at one thing.... making it easier for a patient to clean effectively.