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Dentist Query ... correct advice?

Anon
Anon Posts: 14,552 Forumite
Part of the Furniture 10,000 Posts Name Dropper
edited 16 August 2012 at 10:31AM in Consumer rights
Dear All

I hope that someone can advise. Basically, a filling fell out of my tooth and part of the tooth came away due to decay (not pretty, :o). I therefore bit the bullet and decided to visit a dentist as I have not been for quite a number of years (10+) as I had been put off when I had to have a wisdom tooth out years ago. Anyway, I digress, sorry for the long message.

I returned to my old surgery, explained the problem, booked an appointment and have been today. I assumed that this was NHS. The result is that the dentist says it needs to come out and that I need a course of treatment due to advanced gum disease (:o). At the start of the consultation he explained that the model of dentists had changed over the years and now there were options for NHS or private, he would assess me and then give me my options.

After the assessment, he has said that the tooth would need to come out but it is slightly complicated as it is falling to pieces and I will also need other repair work. The quote for all the work is £500+, including £300 for taking the initial consultation/xrays/takingtooth out/repair work. The initial consultation cost around £50. I asked whether this treatment would be available on NHS and he said that due to the nature of the extraction he wouldn't do it on NHS, a colleague may do (but unlikely) and would possibly refer to dental hospital, but they would not undertake the work if the only reason for going to them was the basis of cost. He said other dentists may also consider it on NHS but may also not due to the nature/amount of work required. I will also apparently need to see a hygienist for a number of appointments to sort the gum disease which will cost £400+.

My question is, are some forms of taking teeth out/repair work no longer allowed on NHS or have I been steered towards private treatment (effectively, have I fallen for sales patter)? The distinct impression I got was that NHS work was not the same/same standard and some of what I need doing (tooth out/resolve gum disease problem) would not be possible through NHS. I was given a written quote and the receptionist asked me to sign to say that the dentist had gone through the options - I now see I signed to apparently agree to the treatment proceeding :o (I was a little in shock by what I had been told and how much it would cost, but no excuse for not reading it).

I know that the tooth needs to come out (apparently un-repairable, based on what I have been told) but is it true that this work (tooth out) would not be covered by NHS? Is gum treatment also not available on NHS? And could I cancel treatment if I have signed the estimate?

I am normally very MSE but feeling slightly out of my depth having avoided going to the dentist for so many years and now "in my hour of need" I am worried that I have made the wrong choice and could get this work completed on NHS (indeed, £50 for the initial consultation, as I had booked specifically to resolve the filling falling out, on reflection seems steep!).

Many thanks

Anon
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Comments

  • neilmcl
    neilmcl Posts: 19,460 Forumite
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    I didn't see anywhere in your conversation with your dentist that he said that any of the treatment isn't available on the NHS, he simply advised that he himself wouldn't but others might, his choice at the end of the day.

    If you want the treatment done on the NHS then go to a dentist accepting NHS patients or go to a local NHS walk-in dentist centre. Chect the NHS Choices website for any avaliable near you.
  • Anon
    Anon Posts: 14,552 Forumite
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    Thank you - no, he said that the extraction would possibly not be available (as complicated) on NHS and other dentists may also decline to do it on NHS. If they are NHS dentists can they decline to do treatment (and if they do both, can they decline to do both but offer to do it as Private)?

    Anon
  • If your your dentist is NHS registered and you are on his books as an NHS patient, he is trying to con you.

    http://www.nhs.uk/NHSEngland/AboutNHSservices/dentists/Pages/dental-faq-best-practice.aspx

    Can a dentist decide what treatment to do privately or on the NHS?

    No. You can have all treatment on the NHS that your dentist feels is clinically necessary to keep your mouth, teeth and gums healthy. If your dentist says you need a particular type of treatment, you should not be asked to pay for it privately. The exception is cosmetic treatment, such as teeth whitening, which is not covered by the NHS.
    If you're ever offered any private treatment as part of your NHS treatment plan, your dentist should always tell you that it's optional. Separate details of private treatment and charges – usually on the same form as your NHS treatment plan – should always be given in writing before you commit to it. If it is not, query this immediately with the dentist or seek advice from your PCT.
  • fluffnutter
    fluffnutter Posts: 23,179 Forumite
    You've merely heard the opinions of one particular dentist. I have every expectation that this work would be available on the NHS; you'll just need to find a dentist prepared to treat you on the NHS. One thing I've discovered in recent years - you can't expect one individual to represent the views of the health service, particularly in something like dentistry where they're outside of the NHS anyway. If you ask ten doctors the same thing, you'll get ten different replies.

    If you find his charges too high, look for an NHS dentist. Finding one prepared to do this work might be easier said than done, however. IME there's little incentive other than altruism or a firm faith in free healthcare for dentists to continue providing NHS care.
    "Growth for growth's sake is the ideology of the cancer cell" - Edward Abbey.
  • Anon
    Anon Posts: 14,552 Forumite
    Part of the Furniture 10,000 Posts Name Dropper
    If your your dentist is NHS registered and you are on his books as an NHS patient, he is trying to con you.

    http://www.nhs.uk/NHSEngland/AboutNHSservices/dentists/Pages/dental-faq-best-practice.aspx

    With him discussing NHS or private options, but recommending the private course of action, I assume he is NHS as well.

    From what others have said, dentists can refuse to do the treatment on NHS even if required?

    Anon
  • CoolHotCold
    CoolHotCold Posts: 2,158 Forumite
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    Sounds like the dentist doesn't do NHS treatment, as the initial charge should of only been £17.5 (ala, Band A).

    Hence the referral to another dentist if he thought NHS would be better. It could simply be that a NHS dentist will look at the teeth and go "Yup, all need pulled" whereas the current dentist you've seen has private tools/procedures not on the NHS due to NICE deeming it not worthwhile.


    Without more info really can't say.

    Also, it may be the current dentist is private only and only has old NHS patients and isn't accepting new ones. After 10 years it's fair to say you'd be stuck off the patient list by now.
  • Is he not also saying that its a dental hospital job. That is quite different from saying no you cant have it done, rather yes you can but I cant do it here.
  • Anon
    Anon Posts: 14,552 Forumite
    Part of the Furniture 10,000 Posts Name Dropper
    Sounds like the dentist doesn't do NHS treatment, as the initial charge should of only been £17.5 (ala, Band A).

    Hence the referral to another dentist if he thought NHS would be better. It could simply be that a NHS dentist will look at the teeth and go "Yup, all need pulled" whereas the current dentist you've seen has private tools/procedures not on the NHS due to NICE deeming it not worthwhile.


    Without more info really can't say.

    Also, it may be the current dentist is private only and only has old NHS patients and isn't accepting new ones. After 10 years it's fair to say you'd be stuck off the patient list by now.

    The treatment involves taking out the wisdom tooth which the filling has come out of, as he said it wasn't worth keeping, and putting in some sort of filling in the next tooth, then most of the cost is regular hygienist treatment (at £90 a pop!) to resolve the gum problem.

    Is there anything to stop me going to another NHS dentist "new" based on my filling falling out and see what they say? Would I have to say I had already been to see someone else? I see on the NHS choices website that this practice isn't taking new NHS patients, therefore if I was off the list (which I hadn't realised) due to the time since my last appointment I have perhaps unwittingly been signed up as private?

    There seem to be a couple in my area that are apparently still taking NHS - I don't want to pay out all this money if I could get it much cheaper on NHS (as I pay signficant taxes like most other people, and therefore in my mind couild be paying twice!) but don't want to cancel if this wouldn't be available on NHS anyway (though bad/broken tooth needs to come out, I would think that would be covered no matter what it would take to pull it out?).

    From the above quote, if they accept you as NHS and treatment needs doing, they cannot refuse to do it on NHS and then offer to do it private - but can they simply refuse to do it anyway?

    Many thanks

    Anon
  • Anon
    Anon Posts: 14,552 Forumite
    Part of the Furniture 10,000 Posts Name Dropper
    Is he not also saying that its a dental hospital job. That is quite different from saying no you cant have it done, rather yes you can but I cant do it here.

    No, he can do it and is planning to do it in the surgery in a normal 30 minute appointment (private for a £150+ fee), just apparently not as straightforward as pulling it out.

    Anon
  • After 10 years it's fair to say you'd be stuck off the patient list by now.

    Quite possibly, but surely the dentist or the NHS should inform the patient that this is the case and ask if they wish to stay with the same dentist but as a private patient.
    I would have thought that the OP would have been required to sign a form of some sort stating that they agree that all work would be carried out on a private basis.
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