The seemingly common NHS "scale & polish" problem

WLC

Can anyone clarify how staining is removed from your teeth? By that I mean, is it done during the scaling or polishing part of a scale and polish?

Had to see a different dentist at my practice today, as my usual one has now left. My usual dentist has previously always provided a scale and polish during check ups (I do get a build up) and I always walk out with stains gone.

I understand that it has to be clinically needed, as per NHS website:
"If your dentist recommends a scale and polish, it should be provided under the NHS Band 1, whether it is done by a dentist or a hygienist. If your dentist says a scale and polish is not clinically necessary but you want one anyway, you will have to pay to have it privately. An NHS scale and polish should be carried out as thoroughly as a private one".

However when I saw the dentist today (different dentist, same practice), she scaled my teeth (removed the plaque between my teeth), but did not remove staining or polish them. She has told me to see the hygienist to remove the staining, as its cosmetic.

So why have I never encountered this before with my usual dentist? She claims my usual dentist was providing private treatment on the NHS. Well then so has every dentist I have ever been to!?

And why was a polish not provided?

My understanding is scaling is the dental treatment used to remove the plaque and tartar, and polishing is the treatment to smooth and shine the teeth so that calcium and bacteria cannot as easily attach to the tooth surface.

Surely if she has deemed I clinically need a scale, then doesn't that also include a polish, so bacteria cannot easily attach to tooth surface, as above.

That's in advance

Also, if anyone knows if there is anyone I can contact in order to find where my old dentist moved to. All the practice told me today was he is still in the county. Can I check where he has gone anywhere?

j.e.j.

I had a small stain removed from my bottom front tooth. (I am an nhs patient). It was really quick, as far as I remember. I suppose she could in theory have told me that it was 'just cosmetic', and not done it. I think it varies a lot from dentist to dentist. Maybe you were lucky with your last dentist, and this new one is following the guidelines more strictly.

brook2jack

The dentist removed the tartar. If you do not clean properly tartar will start to reform after 72 hours. Removal of staining has no health benefit it just makes you feel better. Effective use of floss , tepe brushes and tooth brush is what gives the real health benefit.

From government guidance quotes

. Many
commentators, from the 1994 Government Green Paper (Ref. 28) onwards, have said
that far too many procedures are being carried out. According to the scientific
evidence, straightforward ‘scaling and polishing’ does not keep most peoples’ teeth
and gums healthy – it might make them feel and look cleaner for a while, but this is a
cosmetic effect and not a health gain.

It may be that once a year cleaning ‘has questionable health benefit’; or that ‘intervals
between recalls should be increased.’ It may well be the NHS should not pay for the
so-called ‘worried well’, or for a scale and polish because the patient is going to a
wedding.



this is the link for the quotes http://archive.audit-commission.gov.uk/auditcommission/sitecollectiondocuments/AuditCommissionReports/NationalStudies/Report-Dentistry.pdf

Gelly123

I very much look forward to hearing peoples replies as I too have problems with my dentist regarding scale and polish and am considering moving dental surgery.

I've seen the same dentist since I was a child - I always go for my routine check ups and he always books 3 people for every appt so it's never on time. I go in, he checks them over and 30 seconds later, tells me I'm all done and to rebook for a scale and polish. For years, I've been going back for my second appt (to see him again - no hygienist at my surgery) and all he does is de-scale them, they've never been polished for £18 standard charge.

Fast forward to my latest visit a few weeks ago, same thing but he tells me to come back again for S&P, I re-book at reception and ask what I get for a S&P as it's quoted at £48 and she says he will polish as well as de-scale.

Turn up for my appt, double check it for an S&P, receptionist confirms, I'm in out and in less than 5 mins and all he's done is de-scale them again but has done the back teeth (normally only does the ones round the front) so I ask receptionist what he's done differently as he didn't polish them and apparently "they didn't need doing". So how come, every time I go, I'm told to re-book for a scale and polish and yet I've never had them polished - surely after 34 years they would need it!!!

My husband goes to a different surgery and is booked to go on Weds this week so we are going to find out what he gets for his NHS price tag and decide from there.

It's so annoying as I've £48 lighter and still not had my teeth polished - just deep de-scaled!!!

Gelly

brook2jack

See link above, polishing has no effect on dental health. Effective cleaning is far more important.

Your £48 charge is an English band two charge for treatment of gum disease. Polishing has no effect on gum disease. Hoever removing tartar deposits to make it easier for you to effectively clean using floss, tepe brushes etc does have an effect on dental health so long as you follow advice re cleaning

brook2jack

WLC most dentists sign a contract stating they cannot poach patients from their old practice as the good will belongs to the practice owner. The practice obviously is not going to tell you where the dentist has gone to but if they have a nhs contract you may be able to trace them via your pct dentists website though these are not kept up to date well.

Checking their registration on the gdc website may give their new practice address.

welshdent

I dont generally "polish". The effect of me removing calculus will often remove some stain along the way. Occasionally I may if there is a small amount and nothing else really going on.

The £48 refers to a band 2 treatment so a "deeper" cleaning thus treatment of a condition whereas a "scale and polish" as a band 1 would be an attempt to prevent that condition in the first place.

busiscoming2

God how I hate it when they decide to do a scale. My dentist usually takes the scale away between the bottom two teeth annually. I have only ever once had them polished and flossed and that was done by a locum dentist.

Outer_Limits

If it's for health that's one thing... but if you just want to have stain-free teeth then you might want to try an electric toothbrush, preferably sonic, and bicarbonate of soda.

One of the lovely dentists on here :smileyhea confirmed that it's quite safe to use on teeth. The toothbrush might cost a bit more than usual, but you might save a lot on 'cosmetic' cleaning...

Toothsmith

Bicarb toothpaste is OK - but not neat bicarb. That is quite abrasive.

sweetcheeks33

Oh dear tooth smith I was using my usual toothpaste and on occasion dipping it in neat bicarbonate.

Too sensitive so now on occasion just use bicarbonate toothpaste instead.....

Doh!!!!