Dental Insurance that is reasonably priced?

justme111

ManofLeisure wrote: »

A really interesting thread. I thought it might be useful to add my experience of both NHS and Private dentistry.
For 25+ years I was registered with a NHS dentist (chap who worked on his own) and the treatment I received was brilliant. I guess I was fairly lucky as my teeth aren't in too bad a shape. Anyway, I attended on a yearly basis and a couple of fiillings here and there were required. Everything always looked top-class after treatment and I never had any problems following. Anyway, this dentist retired and the Practice became a Private establishment. I decided to continue at this Surgery, but wish I had not. The new dentist decided that one of my fillings (no xray taken) needed to be replaced. It was an amagalm filling which had apparently seen better days. I must stress that I had never had a twinge from this tooth and it looked ok to me - but I'm not a dentist. So it was out with the amalgam and in with the composite. A few months late an abscess then formed at the site of this tooth and I underwent a root canal proceedure in an attempt to save the molar that had always served me so well. I was told that I would require 2 sessions, but in the end only one was required. Despite being told that the canals were very narrow, the proceedure took less than 1 hr. I thought nothing of it at the time because I had no experience to draw upon. Anyway, a few months later several tiny blisters formed around the gum of this tooth. Xrays were taken and I was told that everything was fine and the tooth was still healing. I returned home quite thankful that this was the case. The tooth then cracked and I returned to the dentist to be told that the root canal hadn't failed, but I now had a root fracture and the tooth would have to be extracted. I have since visted a dental implant specialist who told me that the root canal had in fact failed. What more can I say. The check up cost me £40, followed by the filling at £120. The root canal totalled £350 and I now face a bill of £2200 for the implant. I must admit that the thought of another trip to the dentist terrifies me - particularly from a financial point of view.

Well sounds typical I am afraid . Difficult to say what if anything was due to bad luck and what if any due to incompetence / dishonesty of the dentist. My advice would be to always question what dentist advises , I welcome questioning as it gives me an opportunity to give better picture of what we doing to the patient so that they understand better risks and reasons , if dentist does not make sense then chose another one. You my want to write to your last dentist (I assume you are not going to continue seeing him as you dont trust him) and rise a complaint. If his position is weak he may offer refund at least partial or alternatively put your mind at rest that everything was done properly although to be honest molar root canal treatment in less than an hour does raise eyebrows.

freeyaeco

Thank you for illustrating my point, and glad you shared your experience.

This could be either one of two things : your tooth was cracked before root canal treatment, probably because of the large amalgam filling, RCT made your tooth more fragile because it enlarges the canals and necessitates a large opening to access those canals, in most cases a crown or overlay is needed after root canal therapy to reinforce properly the treated tooth. In that case the RCT was well conducted and the tooth not well reconstructed.

Other option : bad RCT but it would only provoke abcess not fracture.

The point being that any case can go bad and end up costing quite a lot to anyone. Dentistry isn't an exact science yet and treatments even well conducted are prone to unforeseeable medical complications which could end up costing quite a lot of money to the patient.

Justme : If you do pulp extirpation and wait six month on a previously vital tooth (irreversible pulpitis), you go from a situation where you have no bacteria what so ever in the canals to a situation where the canals are completely filled with bacteria thus reducing your chances of success a lot. Sure you go from a 98% chance to about 92%-93% (at 5 years) if well conducted, but that difference is gigantic! And a tooth which has had RCT should be permanently restored within 3 weeks to a month to reduce chances of bacteria infiltration of the treatment. Same thing statistics! Try not to base practice on empirical findings, we have a good enough literature with statistical analysis of any method, use it!

I am not telling you that private dentistry is expensive in most cases it won't be, but you really don't wan't to be in the cases where it is, that's why insurances/mutuals exist and they should cover you for anything, because statistics don't work on 1 person (you are either concerned or not, won't be half way) but when talking about a wide group they do, and the risk can be easily calculated and covered, and you don't have such a insurance in UK, which is sad.

I'll try to put it in place in my practice, and see how it works out. I'll keep you posted on the progress.

ManofLeisure_2

Thank you for your thoughts on this matter gentlemen - really helpful. In particular, I will 'always' question treatment in the future.

welshdent

Just as an additional point, you don't need to take an x ray to see if a filling needs changing, likewise lack of pain is not an indication that nothing is wrong. The beat time to re new a failing filling actually is before it hurts and before any changes are visible on an x ray because it means there is less damage to the hard tissue of the tooth and its nerve

justme111

freeyaeco wrote: »

Thank you for illustrating my point, and glad you shared your experience.

This could be either one of two things : your tooth was cracked before root canal treatment, probably because of the large amalgam filling, RCT made your tooth more fragile because it enlarges the canals and necessitates a large opening to access those canals, in most cases a crown or overlay is needed after root canal therapy to reinforce properly the treated tooth. In that case the RCT was well conducted and the tooth not well reconstructed.

Other option : bad RCT but it would only provoke abcess not fracture.

The point being that any case can go bad and end up costing quite a lot to anyone. Dentistry isn't an exact science yet and treatments even well conducted are prone to unforeseeable medical complications which could end up costing quite a lot of money to the patient.

Justme : If you do pulp extirpation and wait six month on a previously vital tooth (irreversible pulpitis), you go from a situation where you have no bacteria what so ever in the canals to a situation where the canals are completely filled with bacteria thus reducing your chances of success a lot. Sure you go from a 98% chance to about 92%-93% (at 5 years) if well conducted, but that difference is gigantic! And a tooth which has had RCT should be permanently restored within 3 weeks to a month to reduce chances of bacteria infiltration of the treatment. Same thing statistics! Try not to base practice on empirical findings, we have a good enough literature with statistical analysis of any method, use it!

I am not telling you that private dentistry is expensive in most cases it won't be, but you really don't wan't to be in the cases where it is, that's why insurances/mutuals exist and they should cover you for anything, because statistics don't work on 1 person (you are either concerned or not, won't be half way) but when talking about a wide group they do, and the risk can be easily calculated and covered, and you don't have such a insurance in UK, which is sad.

I'll try to put it in place in my practice, and see how it works out. I'll keep you posted on the progress.

Erm so you call a reduction from 98 to 93 % drastic ?
I do not want to engage in p...ing contest who knows more about dentistry and would appreciate you not telling me what to do , when you give a course and I pay to attend it that would be appropriate place and time for it .
I just pointed to general public that private dentistry does not HAVE to be unaffordable , that they have choices which caring dentist would give them and I bet people could see the didference between extracting the tooth there and then and having a reduction of 6% in positive outcome .

Yes of course Vetter if money is not an issue at all. I just stressed that it is possible even if money is an issue. I am foreign as well and I am utterly annoyed with a common public perception that private dentistry is unaffordable which in part is perpetuated by people like you who start dwelling on how it can not be done rather than on how it can.

ManofLeisure_2

My feeling is that if the average salary in this country is around £26,000, then Private Dentistry will be out of the reach of many people.

justme111

Ok. Interesting to see why you think so. So if we are talking about averages - how much average person would spend on private dentistry in an average year in your opinion ?

ManofLeisure_2

I'm afraid I wouldn't be able to provide any accurate figures. However, let's look at my Private Dentist's Prices. A check-up is priced at £40 and this is 'always' accompanied by a professional clean costing £40. So, that amounts to £80 a visit and as he always books the next appointment in 6 months the total is obviously £160 a year. If treatment is required, that's a different matter entirely.... A filling would cost £100 + etc. By the time this year has finished I'll be looking at having spent nearly £3000... on one molar. I'm in the fortunate position of being able to afford the fees, but I'm very aware of the fact that many people are not so lucky.
Here's hoping one of my daughters' will marry a dentist or I won't need any more treatment .

justme111

Ok. First of all 6-monthly exams are not necessity for all , it depends on caries risk and for many people one yearly exam is enough. Scaling is optional , if you have gum disease then that would need to he addressed but if not value of the procedure is largely cosmetical and even if you do have.gym disease in most if cases home oral higiene is more important than scaling at £40.
How many fillings you think one needs in a mouth in a year ? Even if we say one (would not be a new filling as if there is a new cavity in the mouth every year than something fails with prevention - diet , oral higiene etc and if something fails on that front its not an issue of money , its as if complaining that one can not afford driving while constantly crashing and changing the car) - so , if we say one has already restored dentition and needs changing old fillings (assuming one has 10 fillings and needs changing one a year ) - its £150 a year , not sure why you convinced average earner of £26000 can not afford it. Being realistic probably once every 5 year one needs either new or replacement crown or root canal treatment. Front teeth root canal treatment 200-300 , back ones 400-700 , crown 400, on average let's say £500. Which does mean £250 a year expense , still not sure why you convinced one earning £ 26000 can not afford it.

With regards to tour personal expense this year - first of all it is not imperative you do it in one year , we are talking about affording private dentistry in principle , not affording all most expensive options in one year. And second you.been unlucky /did not have the best denist , it does not happen every day that one's tooth needs rct and rct fails. As discussed above rct 's success rate is in 90s percentagewise. Besides £2.5 grand for an implant is a bit steep.
It's like someone havig bought a Versace dress stating people can not afford to dress themselves.

freeyaeco

justme111 wrote: »

Ok. First of all 6-monthly exams are not necessity for all , it depends on caries risk and for many people one yearly exam is enough. Scaling is optional , if you have gum disease then that would need to he addressed but if not value of the procedure is largely cosmetical and even if you do have.gym disease in most if cases home oral higiene is more important than scaling at £40.
How many fillings you think one needs in a mouth in a year ? Even if we say one (would not be a new filling as if there is a new cavity in the mouth every year than something fails with prevention - diet , oral higiene etc and if something fails on that front its not an issue of money , its as if complaining that one can not afford driving while constantly crashing and changing the car) - so , if we say one has already restored dentition and needs changing old fillings (assuming one has 10 fillings and needs changing one a year ) - its £150 a year , not sure why you convinced average earner of £26000 can not afford it. Being realistic probably once every 5 year one needs either new or replacement crown or root canal treatment. Front teeth root canal treatment 200-300 , back ones 400-700 , crown 400, on average let's say £500. Which does mean £250 a year expense , still not sure why you convinced one earning £ 26000 can not afford it.

With regards to tour personal expense this year - first of all it is not imperative you do it in one year , we are talking about affording private dentistry in principle , not affording all most expensive options in one year. And second you.been unlucky /did not have the best denist , it does not happen every day that one's tooth needs rct and rct fails. As discussed above rct 's success rate is in 90s percentagewise. Besides £2.5 grand for an implant is a bit steep.
It's like someone havig bought a Versace dress stating people can not afford to dress themselves.

Yes I'm saying it is a gigantic difference : A 3 to 4 times higher risk of failure. You call that not a drastic difference?

I really really disagree with what you say. It's as if we practice totally different dentistry, it's incredible. Scaling is an imperative for most people, if you let calculus accumulate you get people more prone to gum disease. The only thing I am OK with in your speech is that for most a yearly visit is sufficient.

You underestimate risks a big deal! ww w . hscic . gov . uk/pubs/dentalsurveyfullreport09 (I put spaces because I can't post urls.) have a look at the statistics!

The problem is not what it costs when everything goes according to plan. The problem is what happens if anything goes wrong?
Same thing with your car insurance, if you drive well it shouldn't pay for much, yet it still costs a lot, because it covers for the unexpected!
That's the key, being covered for the unexpected!

And most 26000£ earners are not able to pay straight up a 2000£ or more treatment they could need (one tooth having to get extracted, look at the statistics), and what happens? The patient can't get his implant -> the teeth move are harder to brush -> cavities, calculus -> needs more fillings, more RCTs more crowns, or even perio, or ortho -> ends up costing a lot. Why? because he isn't covered for implants (just an example). Of course it's over a long period of time (3-5 years), but in my experience, a patient who can't afford the treatment right now, just tells himself it's out of his range and forgets about it, most will never save up to have it done.