Root canal treatment with NHS dentist or specialist?

xxdeebeexx

Hi, I need root canal treatment on one of my top second pre molars.

My dentist has given me some options for the root canal treatment:-

1) NHS treatment £214
2) Private root canal treatment with her £250
3) Referral to an Endodontist £600

I will then need to pay extra for a crown £500

The dentist explained that she is a general dentist and does not have the same expertise or equipment that the Endodontist has. (although she seems to be offering to do it privately!)

I understand that, who ever does the rct that, it can fail.

If this treatment could cost me £1100 would it make more sense to put the money towards an implant? or am I missing something?

I would really appreciate some thoughts,

tia

dx

Toothsmith

£214 is the NHS band 3 charge - so that charge should include the crown as well. If it were just a quote for the root filling, it would be the band 2 charge of (about) £50.

A premolar root filling should be well within the competence of a general dentist. Unless there are any particular complicating features that they should be able to point out to you.

Toothsmith

I didn't read the bit where the 'NHS' dentist is also offering to do it privately.

If she has done that - then that is very naughty and grounds for a complaint. If she takes on a treatment, she is ethically bound to do it to the best of her ability regardless of payment method.

It would be different if she felt it was too complicated for her (and could explain why to you) and referred you on to a specialist.

xxdeebeexx

Toothsmith wrote: »

I didn't read the bit where the 'NHS' dentist is also offering to do it privately.

If she has done that - then that is very naughty and grounds for a complaint. If she takes on a treatment, she is ethically bound to do it to the best of her ability regardless of payment method.

It would be different if she felt it was too complicated for her (and could explain why to you) and referred you on to a specialist.

Thanks Toothsmith,

I think I need to talk with my dentist again so that she can clarify what she has written down and what I remember her saying.

If the root canal treatment is too tricky for her does that mean I can't have the work done on the NHS?

Or maybe she is just outlining all my options.

It seems that she is the Principal Dentist at the practice.

I now realise that she has quoted me £250 for private RCT with another member of the team at the same practice.

I think I need to make a phone call

dx

Toothsmith

xxdeebeexx wrote: »

I now realise that she has quoted me £250 for private RCT with another member of the team at the same practice.

Is that person a registered specialist endodontist, or even a 'dentist with a special interest in' (DWSI) endodontics?

If it's just a general dentist, then being in the same practice, it's still dodgy and possible grounds for a complaint.

NHS dentists should not be farming out NHS patients for private treatment on things they are entitled to on the NHS. That is the bottom line of the new Guidance from the General Dental Council (the dentist's regulator).

Anyone trying it needs to have watertight justification as to why the treatment cannot be provided on the NHS by the usual NHS practitioner.

xxdeebeexx

OK, I have just spoken to my dentist and this is what she has offered:-

1) Root canal treatment NHS £49

2) Root canal treatment with her (same dentist same appointment) £250 - because she will be using superior equipment and superior materials.

3) Root canal treatment with an expert £500-£600

She claims that she has to offer all the alternatives......

Mmm wondering what to do next!

dx

welshdent

Well yes we do have to offer the alternatives and 1 and 3 are completely correct however number 2 is on wobbly ground because our contract states we are not allowed to say that our private treatment is more superior than our NHS. They may well be using better gear however thats not the contract they signed up to. Personally I do not use anything different on an NHS patient or a private one.

welshdent

We cant advise by the way on what you should do. I personally would err on the side of a specialist if it were me but then I can not see your tooth to know if it is difficult nor do I know your dentist to vouch for their expertise. I have a slightly more anally retentive view on root treatment though LOL.

londondent

I suppose the question is do you trust your dentist enough to do a good job on the root canal under the NHS. £49 is a miserly fee for the skill involved and materials needed to complete root canal treatment to a high standard...it doesnt even cover the cost to provide the treatment.
Its besides the point, as any ethical dentist should provide you with the best treatment despite any financial constraints.

Personally, i would choose specialist treatment (if finances allow). I recently suffered trauma to my two front teeth, and they needed Root canal treatment,
the teeth affected are very straightforward, and any competant dentist would have been capable of doing the job, and could have had it done for free with any one of my colleagues. I choose specialist treatment at a cost of over £1200.

as a side note, i would always encourage you to save your original tooth ( as long as prognosis is good after root canal treatment). nothing (even an implant) will ever be as good as you natural teeth.

xxdeebeexx

Thank you for your comments welshdent and londondent.

I hadn't realised how involved everything was.

I had root canal treatment 30 years ago and my dentist 'just got on with it'. After the treatment I had a crown fitted and it's still there!

I just assumed that all dentist would be competent at all aspects of dentistry.

As for trusting my dentist enough to do a good job on the root canal under the NHS - I have no idea as I have had very little work done on my teeth over the past 10 years.

My appointment is on Monday, so I need to make my mind up soon!

£600 is a months income for me so £49 is much more appealing!

thanks

dx

welshdent

Just to highlight the differences, I can hand on heart tell you I am not as good at some treatments as I am at others. Ask me to treat a tooth with an immature root i.e. what we call an open apex or one with weird internal root anatomy and I can confidently have a go. Ask me to take out your impacted wisdom tooth and we are getting in to problems! I am "competent" at taking out most teeth but I wouldnt say it is a strong point and I not only know OF people better than me I work with them daily. Lets not get started on my denture making skills either!! ;-)
What I am saying is all of us have our skills and strong points. We must recognise what they are and bow out of that job if it beyond our abilities.