What is better NHS or Private for Root canal?

tilly78_2

I have just tried having a filling replaced as my premolar had become really sensitive since i had a filling in March. Unfortaunately the tooth is still very sensitive therefore the dentist has advised i need to have root canal and has offered me two choices:

NHS - £48 (75 min appointment) or Private - £150 (90 Mins Apt)

I tried to ask what was better and she muttered something about better equipment.

Either which one i pick it will be done by my dentist in the same surgery therefore is the private root canal really worth the extra £100??

I had a root canal done 10 years ago from a fully private dentist for roughly £250 and haven't had any problems with it.

Any advise would be greatfully appreciated.

Thanks

londondent

Hi Tilly,

in general, the dentist (if charging privately rather than NHS) can spend more time doing the treatment and cleaning/disinfecting the inside of the tooth (the canal of the tooth), and should be able to use better equipment and materials - this theoretically should result in a success rate and your tooth lasting longer.

The £48 charge you pay for the NHS job Buys about 20 mins of surgery time, so your dentist is certainly going to be losing money on this. On the nhs, you can expect the cheapest available materials, and oudated techniques, but That's beside the point,they should still be able to provide a satisfactory root filling, just make sure they use a rubber dam!

Privately they should be using NiTi rotary equipment (which can cost more than the NHS £48 fee itself), which can't be justified on the NHS due to costs.

I would say its definitely worth paying extra to get a better job done, as long as you are convinced that the dentist is truly using better equipment/ materials and spending the extra time.

Bronnie

I had an NHS root canal in 1982, never had to touch the tooth again, still fine. Just had my second root canal filling and happy to opt for an NHS one.

I can't remember how long the first appointment was (quite lengthy though) as I didn't know he was going to start the root canal treatment, but the second was 45 minute appointment and I don't feel he rushed the treatment.

I will be paying for a white crown, privately for the tooth.

Toothsmith

1982 was a whole different world in NHS dentistry! The vast majority of the country's dentistry was done on the NHS, and relatively speaking it was quite well funded. You could be a good dentist on the NHS and survive then.

To answer the OP - being pragmatic, and here in the real world, yes - it probably would be better getting it done privately. I am assuming that generally you are quite happy with your dentist otherwiise?

Ethically speaking - this case is quite dubious.

It would be completely unethical for a dentist to offer any lesser degree of care and attention dependent on the payment system. If he can do a good root filling, then it would be unacceptable for him to do anything less on anybody.

He signed an NHS contract that said he would provide treatment where there was a clinical need for it. There was nothing in the contract about how much time he could spend on items, or what equipment he could use on items. Just that if a treatment was required, it would be done.

If you choose the NHS option, he has a duty of care to spend time enough on it to make it a satisfactory job, even if he decides not to use the swankiest equipment on it.

If he can't do this, he shouldn't have signed the NHS contract, and shouldn't be offering NHS treatment.

welshdent

pandoras box

Bronnie

Toothsmith wrote: »

1982 was a whole different world in NHS dentistry! The vast majority of the country's dentistry was done on the NHS, and relatively speaking it was quite well funded. You could be a good dentist on the NHS and survive then.


.

I'm sure............but presumably the NHS root canal filling that was done in 1982 and lasted 30 years was done without the 21st century "better equipment and materials" that OP said her dentist referred to to justify the fee.

Given the ethics of duty of care toothsmith mentioned, people shouldn't be worried into automatically feeling that the only way they will get a decent root canal job is by paying privately.

**Hopefully not speaking too soon lol**

welshdent

They shouldnt no but the opposing view is in 1982, dentists were paid to do root canal treatment on the health service whereas now they are not. They are effectively provided for free but it is a complex and demanding process. As a result rightly or wrongly many dentists are quite resentful of this fact. One thing you CAN say is that if a dentist is working with in the NHS and tells you that you need one, its a safe bet you do and not an immediate assumption they are trying to get more money for treating you.

Also in 1982 technically speaking the success rates are not drastically different compared to more modern techniques (but much of the data we have compares specialists who are inherently very skilled at whatever approach they take). However the cost of the instrumentation is VASTLY different. In some dentists hands yes modern approaches WILL yield a better result but they would argue that they simply can not provide it thay way on the health service. I know I only can because I have a very easy going boss. I know plenty of friends who have been told they are not allowed to use certain tools and are effectively hamstrung. When some of you guys see "the dentist" be aware that if they are an associate they probably do not get much say in what they have access to.

So yes in an ideal world there should be no difference in the care taken. But do we live in an ideal world?

Bronnie

Mmm! Think I must be very fortunate with my dentist then, as I feel very well looked after.

welshdent

Thats the most important thing bronnie. YOU are happy and I hope that continues. I hope my patients are happy too! I do my best to provide as high a quality treatment as I can. Most of us do try but have to compromise with the funding restrictions. Hate to admit it but i have to keep my costs down by cheaper lab fees where possibly on band 3 treatments. Keeps my principal happy and means I can spend as long as I need to treatments such as root fillings and use all the equipment I need.

brook2jack

Bronnie wrote: »

I'm sure............but presumably the NHS root canal filling that was done in 1982 and lasted 30 years was done without the 21st century "better equipment and materials" that OP said her dentist referred to to justify the fee.

Given the ethics of duty of care toothsmith mentioned, people shouldn't be worried into automatically feeling that the only way they will get a decent root canal job is by paying privately.

**Hopefully not speaking too soon lol**

There are many proceedures I used to do on the NHS in the eighties and nineties that were very successful on most people that I wouldn't do now NHS or private. I used to do apicectomies with amalgam, wisdom teeth removal etc.

These were successful then using materials and techniques of the time. If I used those same techniques now and they failed I would be sued and wouldn't have a leg to stand on because I didn't use the materials and technique that is expected in 2012.

I refer all my apicectomies to specialists and ditto wisdom teeth. I refer some root fillings now which I would have had a go with in the past because I will be sued if the root filling fails and I didn't offer a specialist who with their microscopes etc has a better success rate that I.

The problem is several fold
a British people are more likely to sue a dentist than any other nation including the US.

b techniques and expense has increased massively. MDA glue used in some endodontics costs £50 a use, NITI cleaners £35 to £50 a go, an endodontic microscope £15,000.

c techniques that were used twenty or more years ago might have worked for many people but if not successful today lay the dentist wideopen to litigation and disciplinary action

In disposables alone a private root treatment will cost a couple of times the total NHS fee. So the cheapest materials, equipment and amount of time will be used NHS.