Should I insist on NHS treatment to my dentist?

londondent

welshdent wrote: »

I wouldnt have an NHS endo either!

I wouldn't either.... Unless welshdent was doing it for me....

Josepina

Thanks both for your help!
As you have both mentioned the time constraints within NHS mean that very little chat takes place and its mouth open wide before you sit down although I did say that I'd started antibiotics and did point out the swelling. He did x ray me initially but said he couldn't see anything.
I know self medication isn't great but I couldn't get an appointment for 2 days and as I'm also busy in work I didn't see the point in watching things deteriorate when I was 99% sure it was an abscess.
Anyway I'm going for a consultation with his collegue who's doing his MSc in RCT on Friday so I'll see what he has to say. I'll keep an open mind, I've been given the recommendation of another dentist today from a friend who's parents are both dentists at the dental hospital so you can't get better than that!

Toothsmith - you say its not great combining NHS and private - but I thought that was the best option because you get the best of all worlds? I'm not a die hard NHS fanatic but I like to feel its not over yet and if we can't support it who can? I don't treat my NHS patients any differently to my private patients although I do realise our contracts are very different. Do you think I should call it day and just go private?

Toothsmith

I think paying privately at a mainly NHS place is the worst of both worlds. For reasons given above.

brook2jack

There is a world of difference to a gp practice where practice expenses, wages , running costs, training costs are paid for and a NHS dental practice where there is no money other than what the dentist earns per treatment. That pays for everything buildings, equipment, wages, training, for everybody employed in the practice . The cleaning contract at my local gp centre costs more annually than the earnings of two of our dentists.

A dentist in nhs practice has to earn at least £130 an hour to break even so that means in one hour completing six band one treatments in total or two band treatments (all check ups, xrays,fillings, root treatments, gum treatments). If you do not have your hands in a patients mouth you earn nothing but the practice overheads still need paying. The upshot is a nhs dentist will see and treat forty to sixty patients a day. A private dentist will see 20 ish patients a day.

In private practice you pay for time. You have longer to talk and explain as well as treat because you bill partly on time used. You use better materials but mostly you take more time. You spend time on preventative treatment and advice which is not paid for in the nhs.

Toothsmith

Telegraph Article. http://www.telegraph.co.uk/health/healthnews/9297666/Good-dental-practice-will-lead-to-happier-smiles.html

welshdent

londondent wrote: »

I wouldn't either.... Unless welshdent was doing it for me....

Thank you

DentalNomad

Treating patients differently on NHS vs private is a very tricky area...

From the patients' perspective I think it would be horrifically unfair to charge £400+ for an RCT and provide the same £48 NHS service (time, materials).

It is also not fair to rush the NHS patients... the workmanship needs to be of a quality to ensure a healthy and pain-free mouth... but in root canal treatment there is very little room for error. There is no such thing as a "that'll do" RCT. Or at least there shouldn't be.

Oh well. At least RCTs aren't band 1

brook2jack

But when mda cement costs £50 a use, good quality rotary instruments £35 or more a patient, dental microscopes £15,000 and a specialist will spend three hours on a molar canal whereas on the NHS you get paid approx £66 for check up , x rays, unlimited fillings and root canals it is folly to suggest you get the same treatment on both systems.

Even if a general dentist does a root filling using endosonics, rotary instruments, a good root filling system and the correct amount of time loses a shed load of money on every endo done.

londondent

Good Point Brook.

As an associate I am limited by the materials available to me, especially under the NHS. For example, I can only use hand files for NHS root canal treatments, which is laborious, time consuming and quite difficult to create the correct shaping of the root canals.

Privately I can use the more expensive Rotary files (at least £40 per patient), which makes the whole treatment much more efficient and comfortable for both dentist and patient. Also means I can spend more time cleaning/diinfecting the tooth which should translate into better success rates.

The only way I could use these expensive materials/equipment on NHS treatments was if I paid for it out of my own pocket, and paying for someone else's treatment is where I draw the line.

The DOH insists that we as dentists cannot imply that NHS treatment is inferior to Private treatment - in other words they are telling us to lie to patients!

You cant get the perfomance of a Ferrari for the price of a Ford.