NHS Dental Advice re: Bridge

welshdent

Daniel_Kelsoe wrote: »

It has also been said on this forum that if a dentist loses money on NHS treatments he cannot be expected to provide them. It is unacceptable for a medical practitioner to allow financial considerations to prevail over medical judgements,

Just to raise this point. I completely agree when it comes to health. Absolutely finances should not come in to it. However we have a situation which does not occur with medicine. ALL lab work provided to you the patient is paid for by US. The practitioner. If multiple units are to be provided I would honestly be better off giving you a tenner for a taxi and saying try down the road. Not saying thats right just stating how it is.

In the case of missing teeth we have the following options to replace them. 1 denture, 2 a bridge, 3 implant retained restorations.

What is appropriate is down to the abilities of the dentist, the anatomy of the patient and their hygiene/risk levels. That is before we consider the funding scenarios.

when we DO consider them, as an NHS practitioner we have an obligation to secure oral health. That does NOT mean we have an obligation to give you a bridge. (implants are not available within NHS general practice settings). We are obliged to assess you and then advise on what we think you need. To say bridge work is not available on the NHS is absolutely incorrect. However to advise that to meet you need of oral health a denture is sufficient but I can provide you a bridge privately if you feel you want a fixed option IS allowed. It may not be liked but part of the reason we have the contract we do is because the DOH wanted to reduce the numbers of expensive lab based treatments. If you have multiple bridge units, when that fails it is FAR more complicated and expensive to manage than a simple acrylic denture filling the same spaces. Plus a denture does not generally alter existing teeth but a bridge requires at best, minimal often extensive prep aka damage of teeth.

If we gave no consideration to our costs we wouldnt be here long. Some may like that but I quite like my job

jugglebug

Quick response to a quick point.
It was asked what guidance is there from the NHS to what can be provided and what can't?
Easy answer.
None.
The regs put the onus squarely on the individual practitioner and their opinion.
That way a politician can claim it is a comprehensive service when it clearly isn't.
Any practice that worked in that way would be bust within a very short period.

coldstreamalways

Daniel_Kelsoe wrote: »

Be aware that some dentists may try to mislead you.

the opinion of another dentist. This raises several questions.

How does a dentist decide whether a treatment is medically necessary or not? What are the guidelines from the NHS and the Royal College of Surgeons? How does he communicate with the patient? In my case, there was no discussion and no explanation and I am left with the impression that my dentist's motivation was financial and not medical. Why otherwise would he offer me private treatment if it was not medically necessary?

Many many dentists are not members of any of the Royal Colleges or the BDA (which you have mentioned in another posting). I wonder if you are confusing medicine with dentistry; the provision of these services in general practice is totally different and cannot be compared.

You raise a number of valid points which would be better directed to your MP than on here as they are points of the NHS contract which were foisted upon dentists. Yes, dentists didn't have to sign up to the contract but alot of dentists (believe it or not) feel that the provision of NHS dentistry is important and signed up despite deep misgivings which were pointed out to the government at the time.