NHS Dentistry Charges - what is a scale and polish?

sa_06

welshdent wrote: »

a free check up would I imagine apply to the routine examinations. An emergency one probably not.

That seems totally fair and reasonable

welshdent wrote: »

Difficult to say without seeing you and your notes.

I wonder if I could get access to these. Do I have the right to request my own dentist notes?

welshdent wrote: »

In scotland it is fee per item son unfortunately for the patient they do need to be billed for each thing done.

I don't have a problem with this, as long as the itemised bill is fair and transparent

welshdent wrote: »

it may well be that they DID do sub gingival curettage .... but that is actually a higher fee so they may well have been trying to keep costs down for you.

They didn't remove any gum tissue to my knowledge. I certainly am not sore (and the lump isn't on the gumline, it's sort of up near where the skin meets the gum). Wouldn't it have hurt if they'd done this?

And if they did do something like that, I'd rather just pay for what was done and have my records 100% accurate. Even if that was a higher cost I'd rather the notes were just accurate / transparent...!

welshdent

We wouldnt take any gum tissue away (thats called a gingivectomy). What would happen is the side of the tooth that is exposed to the "pocket" would be cleaned to remove any plaque or calculus that is present and causing further inflammation.
You can request your notes if you want

sa_06

welshdent wrote: »

You can request your notes if you want

But they'd charge me a data protection fee to release them I'm guessing? Up to £50 fee?

Here are the last few charges from the dentist practice, bearing in mind I haven't had any significant work done besides checkups (and I suspect, those scales and polishes that I hate) - no fillings, just x-rays (twice that i recall, plus today's) and checkups in the last 6 years:
-14.64
-14.69
-13.59
-18.78
-20.16
-19.52
-12.84
-19.16
-28
... you can see that it's roughly looking between £10 - £20 on average per visit that I've paid.
I would love to get itemised bills for each of these visits actually, I'm strongly suspecting that the scale and polish part is what I've been charged for...

brook2jack

Yes that's right. A charge will be made for a copy of your notes, though there are variations in freedom of information in Scotland.
A scale and polish is only done if clinically necessary. As you now have a lump on the gum I would guess it was clinically necessary. That would give you a charge of £10.10 each time for check up scale and polish. No charge for check up but there is one for s and p.

brook2jack

You can refuse treatment but since you are now in pain from what appears to be a gum problem then forgoing a scale and polish doesn't seem sensible.

People are often very disappointed when they request dental notes since much of it is written in short hand technical script and is often not as enlightening to a lay person as you might think. If money is the issue here then trust has been lost so you need to seek a new dentist you trust .

What exactly does it say on your bill and what precisely are the amounts because there also appears to be some confusion on both sides as to what was said/done eg antibiotics/ charges for x rays etc? Or was this just what you remembered from the discussion with the receptionist and if so to clear confusion up you may be better getting it in writing.

brook2jack

Your last few bills look like ordinary nhs charges . Scale and polish is not a cosmetic treatment more people loose teeth due to gum disease than to decay. Your emergency looks as if it may be related to gum problems possibly around a wisdom tooth. You can refuse any treatment but refusing it because you don't like it or don't want to pay £10 odd for it may not be the most sensible idea for your health.

sa_06

No, I requested an itemised bill for the first time since it just suddenly occured to me at the desk, as we were walking out of the empty waiting room, (after paying) that I had no idea how much we'd been charged for what. I also wanted it (if I'm being honest) to put in a spreadsheet I've started keeping since October 2010 which breaks down household expenses - I wanted to see how much a checkup costs, and how much the emergency bit costs. because I didn't know off the top of my head, and in 6 months I will have an idea of the fee. I've never paid much attention before now.

When I asked for an itemised breakdown, there was some confusion at the desk. The lady didn't know how to get one; she asked a superior; they asked me about "my treatment plan"; I explained that I didn't have one, I just attended an emergency dental appointment for a gum lump; they printed something off which says:

£10.20 Scale and Polish (code 1001)
£29.32 Periochip (code 4604)

The dentist said I would get anti biotics under my gum (a little chip thing). I did have a full set of x-rays done (not just on the teeth, it was gums too) on the right side. I also had a "cold test" where he placed a chemical which apparently acted like an ice test on several teeth.

Also, this problem has also been going on for about 18 months (no lump, but pain in the area around (above) 1 particular tooth). I've purchased very strong sensitive toothpaste from the dentist practice to help, but it did nothing. I also attended a local dental hospital over a holiday period when a particular flare up of the pain got so bad I was in agony all weekend again (I attended the hospital dentist unit on a Sunday night).

Also Brook- I've never ever refused any treatment at any of my checkups, unless it was cosmetic, just to confirm that. I honestly want to avoid losing my teeth as much as I can. I've always done anything required, but cannot afford the luxury of optional stuff done. I honestly wouldn't refuse required (medically) treatment. We'd just have another lean food week! And anyway, despite doing everything my dentist has recommended, the pain is still here (now and then, although at the moment I can't remember what it feels like NOT to be in pain!)

sa_06

brook2jack wrote: »

Your last few bills look like ordinary nhs charges .

But in Scotland the NHS websites are saying that checkups are free. I understand now that I have probably been paying for Scale/Polish and that's what the fees are, but until this thread I had no idea it was the case.

brook2jack wrote: »

Scale and polish is not a cosmetic treatment more people loose teeth due to gum disease than to decay.

Again, learnt something new

brook2jack wrote: »

Your emergency looks as if it may be related to gum problems possibly around a wisdom tooth.

Nah - the lump is hard, not smelly, painful to touch but less so when not touched and left alone, and above my top right front molar (basically almost under my cheek), not a wisdom tooth, for reference - I've heard lots of horror stories from friends about those pesky things though.

brook2jack wrote: »

You can refuse any treatment but refusing it because you don't like it or don't want to pay £10 odd for it may not be the most sensible idea for your health.

True, but the helpful thing here for me is that I didn't realise it was optional. I thought my fees were FOR the checkup, which I obviously want to maintain. I didn't realise my bills were for the scaling/polish. This is the problem with non-itemised bills by default.

I think whatever I do, whichever dentist I use in future, I'm going to just request itemised bills every time - it keeps things more transparent all around. And in non-emergency cases, ask the fees every time they propose doing anything.

brook2jack

That's fine but the problem comes when deferring things ie not doing them when they need doing normally leads to either toothache or more expensive treatment. Why not just put a bit aside each week for dental treatment etc so it doesn't all have to come out of one weeks budget? It seems pointless going for a dental check up if you can't/ wonthave some of the treatment done ie a scale and polish.

A pound a week saved should easily cover your dental bills at your current rate.

As to your itemised bill periochip is not a nhs code or treatment. If the receptionists didn't know how to do a bill then there may well have been a mistake especially as the x rays don't appear.