Dentists - how can you spot a con?

andygb

My OH went to the dentist yesterday, because one of her teeth has not been right since she had it filled there a year ago. She wanted to go to another dentist, but they kept cancelling appointments. This is her third visit to this dentist in a year, and she stressed that she needed something doing about the tooth immediately, so they booked her in for a longer than normal appointment. She can normally stand up for herself, and not be pushed around.
Anyway, she came out after 50 minutes, and when we got outside, I asked her how it went.
They only took X Rays (Which she had done around a year ago and prodded around a bit, she had no treatment. It cost £130, which I think is outrageous.
The dentist has also told her that, her previous dentist left six months ago, and so could not comment on the work he had done (as a practice shouldn't they be responsible?). This dentist has also told her, that she needs root canal work, another filling, a cap, and advised her to have her teeth whitened, because they are yellow (they aren't, she has very clean teeth). The whitening will cost around £500, and the rest of the essential work will be around £2000.
I am out of work, and I was taken aback by this, because this place just seems to be "printing money" with the help of its patients (it is situated in a very affluent village).
I have asked her to talk to friends, and see if they can recommend an NHS dentist, but she has this thing about paying more to get better treatment (Load of old codswallop if you ask me).
I feel a bit sick at the moment, because we cannot afford this, and it has come at the wrong time, yet I do not want to seem mean about her health.
The problem is, that my OH tends to make a meal of things, and I never know how serious things are/how much pain she is in, because she is a drama queen.
I have already told her of an NHS dentist where I had a filling done three years ago (no problems, no pain, and it cost around £40 I think), but she doesn't want to go there, because the building is a bit run down, and the patients are a bit "chavvy" (her words, not mine).
The bottom line is, that I am not in the best of health at the moment (high blood pressure, and a couple more related issues), we cannot afford it, and she cannot see the effect it is having on me.

brook2jack

There are two issues here one is the relationship with your OH where it would seem there is a fair amount of communication issues you both need to work at.

The second is dental. Each dentist in a practice works independently so dentist x is not liable for work done by dentist y a year ago.

That being said £2000 for a root filling, filling and crown is expensive and will reflect the practice being in a ritzy place.

Perhaps you and your oh could discuss this and compromise by finding a private dentist (follow toothsmiths signature) who may be much more reasonably priced , and do the essentials rather than dental bling like bleaching.

It can be very difficult to go back to NHS treatment after private and root treatment on difficult teeth is often not available on the nhs. However if your finances are tight you and your oh need to discuss together and work out a way forward. I would guess if you had a treatment 3 years ago nhs and your oh goes regularly private you have different priorities but in the end this is more a question of the two of you agreeing what your finances can stand.

andygb

brook2jack wrote: »

I would guess if you had a treatment 3 years ago nhs and your oh goes regularly private you have different priorities but in the end this is more a question of the two of you agreeing what your finances can stand.

The priorities are exactly the same - to get the teeth fixed. She had hers done at this place a year ago, paid through the nose, and has had constant pain since. The current dentist has sidestepped that point quite neatly by saying that the previous dentist does not work there any more. I believe that the practice should be responsible.
I am a pretty down to earth person, and in this case, I think they may be trying it on a bit.
They are sending through a written quotation, so I will be able to be more accurate then.

welshdent

Just trying to dissect the post a little ... This is clearly a private practice going on the costs ... tooth whitening is not essential for health. What may have been said is that if your OH was thinking of having whitening done then it would be wise to do this before any crowns or tooth coloured restorations are provided. The reason for this is that whitening will not change the colour of these and as such they may look out of place should whitening be done after. We can not predict the shade that teeth will assume following whitening.

No the PRACTICE is not responsible. The dentist is. Some practices may have an arrangement to cover guaranteed replacements for a year i.e. crown breaks ... replace it. Filling falls out - replace it. What that doesnt apply to in normal circumstances is a tooth not settling after work. Thats because when dealing with the human body it does not always react as one would like. Its not the fault of a dentist if your tooth hurts after having work done. Sometimes the nerve just can not recover from the previous pathology (decay/fracture/both). The treatment to fix this is needed because if left the nerve would still do the same thing but its pretty much guaranteed to happen.

re £130 - that may well be the standard cost of the examination. The dentist would have to examine your OH to be able to be in a position to make a diagnosis .... they have done this by virtue of the fact they have suggested treatment. They wouldnt just take an X ray off the cuff. Also a new x ray may well show something that was not present before. It may show something that was not VISIBLE before due to angulations when taking the image or film/sensor placement showing a slightly different area.

The proposal of a root filling would be consistent with a tooth that has not settled. When a nerve dies off there are 2 options - root filling or extraction. Keep the tooth or dont. Crowns are regularly recommended for root filled teeth particularly back teeth as they are 6 times weaker following root fillings than when no root filling has been done. Even if no CROWN is suggested then a normal filling would at least be needed as a root filling does not address this.

We can not possibly say on here if the proposed treatment is appropriate because we are not in a position to examine your OH. If you have an issue the estimated costs then you could seek a second opinion elsewhere. Costs do vary. Personally I wouldnt have an NHS root filling because I know the time pressures that NHS practitioners are under. Personally I think a tooth needs a minimum of 30 minutes in direct contact with bleach soaking inside it to maximise tissue breakdown and killing off of micro organisms such as bacteria. Thats not counting how long it takes to find all the bits you are looking for, instrumenting the tooth and sealing the top off.

If you did go elsewhere however your OH would need to pay again for another examination and would probably need more X rays taken as they are the property of the practitioner. You could probably ask for copies though - you would need to pay for these though

welshdent

andygb wrote: »

] I believe that the practice should be responsible.
I am a pretty down to earth person, and in this case, I think they may be trying it on a bit.
They are sending through a written quotation, so I will be able to be more accurate then.

They aren't responsible. It is all down to the individual practitioner. You may not like it but thats how it is. The provision of a written quote does not sound like they are trying it on. It just sounds like they are an expensive practice.

Imagine you provide a service to the public. You happened to rent a room in a building. The service you provide is the same as the previous tenant. A client of the previous tenant returns and is unhappy with it. You never met the previous person. Have no idea what they did other than a quick look around. That person expects you to accept responsibility for the work and rectify the situation for free. You have never recieved any remuneration for any of it prior to this and just happen to occupy the same commercial space. How you you feel in that situation.

Thats what dentistry is like. All dentists are self employed independent practitioners be they private or NHS. the only recourse you may have is with the practice owner but it doesnt sound as if this dentist is that person

brook2jack

A dentist who works in a practice, unless they are the practice owner, is completely independent. They make their own clinical descisions and are solely responsible for their work. They normally pay a percentage of their earnings 50 to 60% to the practice owner to cover the cost of running costs, staff ,equipment ,materials etc. If anyone has leeway to take into account previous treatment it is the practice owner not the dentist who has taken over treatment.

However any treatment on a tooth be it filling, crown etc can cause problems and cause the nerve to die off and this is not necessarily the fault of the previous dentist. It is much more likely if the filling was deep or large. Quite often a tooth is touchy after filling and normally a dentist will wait for it to settle rather than launching into root filling.

The prices are consistent with high end private practice. There will be cheaper places to have it done in less ritzy surroundings with lower overheads etc. You and your OH should discuss this.

andygb

Sorry, I assumed that dentists, working from a practice, were like solicitors or chartered accountants working from a practice.
I think I will try to convince her to go down the NHS route.

jlh80

good luck finding an NHS one now days, over populated or have gone private. try the website and see if ur local ones have space rather then calling around

coldstreamalways

jlh80 wrote: »

good luck finding an NHS one now days, over populated or have gone private. try the website and see if ur local ones have space rather then calling around

Just got back from my out of hours session, depending on where you are in the country there are lots and lots of NHS dentists taking on patients. Seriously, at least three NHS practices have opened in the last 6 months in my PCT area.

I would contact NHS direct or your PCT, we have a central agency who have a list of dentists taking on patients.

Whether I would have NHS treatment is a different matter, in my opinion, the less you pay, the less you value the treatment. Paying £16.50 for a check up is an insult to the profession, paying £45 odd for a root canal is laughable. You get what you pay for.

However, that is the system dentists are in, fortunately I don't have to deal with that on a day to day basis and all of my emergency patients pay the same.

Hope you get it sorted.

Toothsmith

The treatment plan arrived at will be as a result of discussions between your partner and her dentist at the check-up. I'm assuming you weren't present at that meeting, but I'm betting that the dentists will have discussed various possibilities and their cost and the resulting treatment plan will be the thing they jointly agreed on.

How she has then presented this to you (The doubting Thomas who just wants her made pain free so she stops bothering him with her moaning, as quickly and cheaply as possible) will almost certainly bear no relation to how it was discussed and agreed in the surgery.

Is your partner happy with this dentist? If she isn't, then maybe she does need to look around for a new one. But she needs to find a GOOD one. Not necessarily a top-end prvate one. What you pay doesn't always reflect the quality of the treatment you get.

I've posted on here so you can see my signature line - but I can't stress enough how important it is to VISIT a potential practice before actually booking yourself in.

There are some good NHS dentists, and there are also some very good private dentists at a cheaper price bracket to the one she's seen already.

It's a bit like resturants.

Just because you can't justify the expense of a top Michelin starred meal, doesn't mean your doomed to a life of only going to MacDonalds or the local chippy. (Despite the fact there are some good local chippies!). There are nice resturants at every price bracket.

It's the same with dentists - you just have to know what you're looking for, and spend a bit of time finding it.

justjohn

Sorry you do not get what you pay for there is nothing wrong with nhs.
I am a petrified at the dentist. My last load of treatment cost over 350 pound. i had 4 teeth needing root treatment. And various fillings.
I had not been to the dentist in a very long time due to my phobia.

There will be dentist out there that are in the game to make as much money as possible.