NHS dentist charges

Coulrophobia

I have never posted on the site before, but have read the site for many years (hence my apology if this is in the wrong thread), the site has been very helpful to my family and so whilst I cannot name the dentist - to do so might be thought of as unfair since he is unlikely to read the site and therefore could not respond, it may serve as advice to anyone in a similar situation. Find a dentist you can trust and keep going, if the trust breaks down do not give in to fear and become phobic (if any one knows how to achieve that... then please tell)

The saga begins when my wife (who is the person most affected by this) was expecting our second child 20 years back, the dentists during a check up advised that her body was reabsorbing calcium from her bones and teeth and as a result her teeth needed a lot of work, crowns etc. due to the scale of the work he had proposed, she had to go for a medical with the DHSS who refused to fund the work - but did not give an opinion about the requirement (or other wise) for the work. at that stage he said the he would do what he could in the scope of NHS costs.

She continued to see the same dentist for many years with no further mention of calcium problems and no further major dental work carried out.

the first warning sign should, with hindsight have been when he filled a milk tooth of our daughters (no excuses from us re the need for the filling - for many years she had been on various childrens medicines from the GP, due to deep seated ear infections, possibly the sugars in the medicines didn't help her teeth though), with in days an abscess erupted and he decided to remove the tooth - in doing so he dislocated her jaw! he said "that is only the second time I have done that!

About 10 years ago, still after regular check ups and little further work (possibly due to my wife having been present when he dislocated our daughters jaw ) my wife developed a bad abscess. I went with her to the dentist (still the same dentist) and he attempted to drain the abscess by sticking a hypodermic needle into it - causing great pain and no change to the abscess. He then produced a scalpel and slit her gum, causing great pain but did drain the abscess. His defence at that time was that to inject local anesthetic would have been pointless due to the abscess blocking access to the nerve!

My wife never went back to him and couldn't find another NHS dentist - in effect though she had become phobic of dentists anyway.

Last week one of the original crowns came off, and so I persuaded her to go back to the same dentist. The receptionist made an appointment and confirmed that it was with the named dentist after I had explained my wifes fears.

When we arrived for the appointment (the next day) the receptionist spent 5 minutes ignoring us, instead she continued chatting to the other receptionist about a tv programme shown the previous night. When she eventually decided to look up we said we had come for the appointment with the dentist Mr

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the response that he refuses to see you but our new lady dentist "who is very nice" will see you, my wife again explained her fears and past experiences and received the reply "and you still want to see him? I wouldn't" ~chuckle chuckle" "but the new lady dentist is very nice"

the examination was to say the least shambolic, no instruments at all were used, no x rays taken.the dental nurse was advising the dentist on what to do! the 'nice lady dentist' coldly said "you have to have all your teeth taken out, I can't do it here, I will send you to the dental hospital instead" when we asked why, the reply was "decay" when we asked "what even on "the front teeth which are crowns?" the dental nurse said " they all have to be removed" My wifes reaction was traumatised to say the least!" my wife did ask if she could go back there for NHS dentures (probably due to being in shock) and was told initially by 'the nice lady dentist' "no, but I might be able to do you some dentures" the nurse then added, quickley "but not on the NHS"

We have since visited a private dentist (this week), had a 40 minute examination, carried out with care and understanding, the dentist used instruments in the examination and took x rays. The result is that 3 implants are planned,some crowns are being renewed and some old fillings are being replaced.

The financial cost is high, but no alternatives had been suggested, mentioned or offered by the 'nice lady dentist' - who also charged £20 for the shambolic check up.

Sorry to ramble, but the abilty and motives of the local NHS dentists involved here are seriously questionable.

welshdent

I haven't got much time as on my mob but just a comment on draining the abscess - that's actually correct. The ph of the pus can neutralise the ph of the anaesthetic thus stopping it working. If there is a fluctuant pus filled swelling you do indeed need to drain it off and incising it I.e cutting the gum or draining via syringe are correct pratice. Also having a filling doesn't cause an infection. The disease process that made a filling necessary caused it. That is to say the decay did. If they said calcium was being drained from your wifes teeth then that's not correct. Once the tooth has formed then they do not behave like none. The calcium can only get out via decay. That's not really the same thing as many describe. Not siding with anyone just clarifying a few points I noticed.

Coulrophobia

welshdent wrote: »

I haven't got much time as on my mob but just a comment on draining the abscess - that's actually correct. The ph of the pus can neutralise the ph of the anaesthetic thus stopping it working. If there is a fluctuant pus filled swelling you do indeed need to drain it off and incising it I.e cutting the gum or draining via syringe are correct pratice. Also having a filling doesn't cause an infection. The disease process that made a filling necessary caused it. That is to say the decay did. If they said calcium was being drained from your wifes teeth then that's not correct. Once the tooth has formed then they do not behave like none. The calcium can only get out via decay. That's not really the same thing as many describe. Not siding with anyone just clarifying a few points I noticed.

Thanks for replying. I have noticed a few points made in your reply (should an infected milk tooth have been filled, indeed should a milk tooth be filled at all? the drainage attempt was made with just the needle - no syringe attached, there is his comment about calcium was made directly in relation to the pregnancy and the possible effect on the body of pregnancy, hence it was reabsorbing calcium), but our main problem at the moment is the fiasco last week.

We were not even given the name of the 'nice lady dentist' and the sound track of the examination, made whilst holding my wifes mouth open (with ungloved fingers) was (i can't remember the names dentists use for each tooth) A1 (for example) Extract. A2 Extract. A3 extract. A4 extract - going through each tooth one by one without using a single instrument or taking a single x ray. The entire time in the dentists room was less than 10 minutes, it took nearly as long to pay for the examination, due to the receptionist reciting in the waiting room that "when you let us know when is good for you we will make the appointment at the dental hospital for the extractions"

brook2jack

Milk teeth should indeed be filled, it is important to try and keep them as long as possible as back ones don't drop out until 10 or 12 and losing them earlier may mean the space for adult teeth may be lost.

A deep filling in a baby tooth where there is alot of decay often means the nerve dies off and becomes abcessed but every attempt should be made to save the tooth.

To relieve an abcess all you need to do is make a hole in the swelling and press normally does the rest. A needle on its own normally does the trick but sometimes you need to make a small nick with a scapel to relieve the pressure.

As to the rest the important thing is now your wife is going to someone you both trust is that she takes preventative advice to change her diet and habits to stop her needing more treatment in the future. Im sure the dentist will have discussed the implications of having three implants, they are not fit and forget they need careful maintenance for life and she will need to keep regular check ups and hygiene appointments for life.

Calcium is not taken from teeth ever. During childhood whilst teeth are forming if a child is so calcium deficient they develop rickets they may get problems in developing teeth but pregnancy has no effect on teeth at all. The teeth will have decayed because of diet and cleaning habits. Something which your wife and child need to get proper preventative advice about so they don't need further work.

Toothsmith

So after all that, and 10 years of not going to the dentist through fear, you actualy thought it woud be a good idea to persuade your wife to go back to the same person???

Why???

Coulrophobia

Toothsmith wrote: »

So after all that, and 10 years of not going to the dentist through fear, you actualy thought it woud be a good idea to persuade your wife to go back to the same person???

Why???

I thought it a better idea than going to no one. that is how bad the fear was. rock and a hard place. you ever see anyone ghostly white and perspiring heavily with terror? good spot though.

on a brighter note, the good thing was the private dentist, amazing the difference in attitude and equipment?

they actually used dental equipment and wore gloves.

Coulrophobia

brook2jack wrote: »

As to the rest the important thing is now your wife is going to someone you both trust is that she takes preventative advice to change her diet and habits to stop her needing more treatment in the future.

Diet and habbits? care to expand? or is that a general response?

brook2jack

Its not how often you visit a dentist that defines your oral health but what you do in-between times that determines how much treatment you need.

People can get to their nineties with no fillings and eighteen month old babies can need teeth extracting.

There are some factors that can make it difficult to maintain a healthy mouth eg dry mouth due to medications, arthritis making cleaning difficult, certain medical problems which impact on dental health but in general if you eat right and clean right you will never need treatment. 95% of dental disease is preventable.

Most people lose teeth because of gum disease and number factor in that is smoking, it decreases blood supply to gums and surpresses the immune system. The second big factor is cleaning many people do not floss every day or use tepe brushes.

Crowns and fillings are necessary because of decay. Eat or drink anything with sugar in it more than three times a day you get decay, so cut out sugar in tea coffee etc. Fluoride in toothpaste helps but only if you spit don't rinse at end of cleaning so fluoride stays in mouth for longer.

Your own dentist and hygienist will give more detailed advice particularly if your wife is thinking of implants.

Coulrophobia

for clarity, just before i go away from this topic I would just like to mention a few things.

To see the 'original' dentist would have been bad enough, possibly. The appointment was with the original dentists when made though.

However it was a completely different dentist within the same group practice who we saw. The 'nice lady dentist' whose name we were never given, who carried out an exam without gloves (so no cross infection worries either way about that is there then, not even to the dentist or any future patients, lucky for someone NO gum disease was involved or maybe it could have been passed on?) with no dental tools (probes etc), who did no x rays, who was constantly advised on procedure by her dental nurse, who offered no alternatives at all (such as you could consider x, y, or z, but you may need x rays or to see a specialist?). just extract.

maybe, or maybe not, if we had seen the original dentist (who is a senior partner in the practice anyway, in the very next room) he 'may' have suggested alternatives, then again he may not have done.

As I mentioned earlier, the difference between private and NHS dentistry is vast, obscenely so in my opinion (and not just in attitude to patients).

Previously I have never supported private health treatments, certainly not by people trained by the NHS, in practices funded by the NHS i.e you can see me on the NHS in 6 months, or privately tomorrow afternoon. Time is one thing (quicker appointments), but options not even being suggested or 'put out there for consideration' by a supposed trained professional on the NHS are worrying.

Funding issues aside (PCT etc), as someone mentioned earlier, before extraction is carried out options should be given or suggested where possible (if there are any - which in this case there obviously are) - the patient can than make an informed decision, even if that decision is made by the patient on the basis that they maybe can't afford to 'go private' - leaving extraction as the only 'viable' (at that time) option.

NHS dentistry, imho, is still in the dark ages. As are some of its practitioners. not everything that goes wrong with teeth is the fault of the working class 'oikes' these medical professionals are forced to endure in order to fund their holidays, nice cars etc. 'some' dentists are still at best 'slack' in their business ethos - carrying out unnecessary work and viewing patients as a renewable resource to be milked like a herd of cash cows.

Maybe the BDA could set up some form of mystery shopper system (which would be impossible for many reasons), or other inspection scheme to check on its members.... or would that be too radical?

Toothsmith

Private dentistry will never be carried out in clinics funded by the NHS.

The only clinics funded 'By the NHS' are community clinics set up in hospitals or some larger health centres to treat 'special needs' groups, and a few 'Dental Access Centres' (Which are generally being closed down now as they are too expensive to run!).

All other dental practices are funded by the owning dentist (Or private corporations in the case of places like IDH, Whitecross or Oasis to name the biggest). So they are in effect 'private' businesses with the owner taking the financial risk.

These places then subcontract some services to the NHS, in the same way that solicitors do 'Legal Aid' work or actors sometimes work for the BBC. So long as they fulfill their NHS contract, they can do what they like with the rest of their time.

Neither are dentists trained 'By the NHS'. They are trained at university from the education budget, just like anybody else doing a degree. When we qualify, we get a job and pay back into the 'pot' by paying taxes. (As well as huge student loans and the tuition fees nowadays too!) There is no compulsion on any other 'graduate' to be forced to work for the public sector, and neither should there be any requirement for a dental graduate to work for the NHS.

If the NHS wants dentists to work for it, then they should get the terms and conditions right.

As for the BDA - they are a sort of 'Trade Union' for dentists. They are there to look out for dentists, not patients. Regulating dentists is the job of the General Dental Council, and dental practices are now regulated by the Care Quality Commission.