Root Canal NHS or Private

davinci_3

I need root canal treatment on both of my two upper incisors. My dentist told me that I have the option to do this on the NHS but if done privately (£250 each) result will be better becuase they'd use a file(?) of a better tapering profile (or something like that). The NHS work will be done manually with a file of inferior tapering profile.

Will private option give a better result in terms of risk of failure and longevity? Is there anything else I should consider?

brook2jack

A root filling on a front tooth without any complicating factors or difficult anatomy should be easily treatable by any dentist. It is a different kettle of fish to a molar tooth which may have several difficult roots for which specialists with microscopes and specialised equipment get much better success rates than general dentists.

On a straight forward root filling the biggest factor in success us the use of rubber dam to keep the area clean ( a rubber sheet that fits over the tooth)

Continued ....... As such teeth that are not complicated ,providing rubber dam is used, should have a good success rate on the NHS. Hand files are just slower and much less expensive than rotary files.

It is one thing to have to refer to a specialist for difficult root treatment (and this will almost always be private as I don't know of any nhs endodontist specialist funded by the nhs) and another to say a good job won't be done on the nhs. The problem is that what the nhs pays for treatment won't even cover the costs on using even the cheapest equipment for root treatment, but if a dentist signs the contract they have to provide treatment.

Toothsmith

davinci wrote: »

I need root canal treatment on both of my two upper incisors. My dentist told me that I have the option to do this on the NHS but if done privately (£250 each) result will be better becuase they'd use a file(?) of a better tapering profile (or something like that). The NHS work will be done manually with a file of inferior tapering profile.

Will private option give a better result in terms of risk of failure and longevity? Is there anything else I should consider?

I really have a problem with dentists who say this.

If you are an NHS patient, then you are entitled to have the work on the NHS. It is perfectly possible to do a satisfactory root filling using hand files so long as you're careful, and take your time. I know of at least one specialist endodontist (root filling dentist) who still uses hand files. And he's not an old dinosaur, but quite a young bloke!

Rotary files are quicker, and probably more predictable, but to me, that would mean they would be the things to use on the NHS patient where it will cut down on the chair time! Ok - they are more expensive especially as they have to be disposed of after a single use - but, if the dentist signed the contract to do NHS work, then root fillings are part of NHS work. To suggest that he would use a lesser degree of skill than his best unless you were willing to pay a premium is, to my mind, unethical.

One thing to consider is having the proceedure done by a specialist endodontist.

This will be done privately (I have read on these pages about a PCT somewhere funding specialist endo on the NHS, but I can't find out where it is, and no colleagues have heard of it) and the cost is likely to be quite a bit more than your dentist has quoted. But - if you want these teeth to have their best chance of lasting as long as they possibly can, this is the option t go for.

brook2jack

The problem is TS a set of rotary instruments will be £35 plus a tooth making the costs of rotarys alone at £70 plus more than the total the dentist will have received for all the treatment, check up, fillings, x rays , other equipment etc (£63 average ).

Root fillings are so underfunded in the nhs the dentist would be better off giving everyone who needed one a tenner to go elsewhere.

It was such economics that made many of us leave the nhs in 2006 as we couldn't make the sums add up to stay in business.

welshdent

I do molar and incisor root fillings on the nhs. Sorry but if it is good enough for me then others should do it on the nhs too if thats what they agreed to do. It is a different kettle of fish if they feel a specialist referral is needed but I am in the middle of a PgDip course, use a microscope and take my time following recommended protocols. If I have to then so do they.

brook2jack

Exactly welsh dent. But how much does your equipment cost and how much your course?
£15,000 on a microscope I'd guess , £35 each rotary set, pgdip course £9000 ish? All to provide a quality service on which your practice will lose how much per patient? Do you forsee these skills being maintained in the nhs or are you planning an exit strategy?

Yes these root treatments should be done on the nhs but people should be aware every nhs dentist who is as thorough as welshdent is entirely uneconomic and ultimately unsustainable on the nhs.

welshdent

very much an exit strategy. My aim is to take in local referrals privately then have small denplan/dpas list to keep me ticking over
I just get annoyed when I hear colleagues saying they dont do molar endo on the nhs then charge privately .... but still do not do it to the same level I am aiming for. I hear those words from ever younger graduates too! more of a concern!

The NHS do not care about quality. If they did I would not be forced in to a corner to provide a treatment that costs ME so much to provide. I have to be very selective about how many people I can see at a time. We operate an unofficial list. I do not see "new" patients or anyone that has not seen me for a few years. I simply could not do treatments to a standard I am happy with such as endodontics if I was seeing every patient that came through the door. I in effect fund the root treatments with the low need exitsing patients. I am sure my LHB would be horrified but frankly I like how I work. I enjoy my job and have genuinely appreciative patients so I aint changing I thing