Dental advice please

brook2jack

peachyprice wrote: »

OK yes, I'm stupid, my daughter didn't see a peridontist I got it all wrong, she didn't clean her teeth for her and I didn't pay £55. Is that better? Maybe I dreamt the whole thing?

Jesus.

It has to be said that no practice I know of that has a periodontist that visits the practice has them in more than once or twice a month , because their job is primarily diagnosis and surgery. The main work they prescribe is done by a hygienist / therapist because it is way more cost efficient. Even periodontists working in specialist practices
Tend to work in several practices and perhaps hospital/teaching work as well.

Your daughters visit to the periodontist is highly unusual in terms of cost, and length ,considering the periodontist did some treatment as well. Even with x rays already done most periodontist so would be hard put to formulate and explain a treatment plan in that time.

The costs I have posted previously are much more in line with the norm .

Toothsmith

peachyprice wrote: »

OK yes, I'm stupid, my daughter didn't see a peridontist I got it all wrong, she didn't clean her teeth for her and I didn't pay £55. Is that better? Maybe I dreamt the whole thing?

Jesus.

In all honesty - that is more likely!

If something has feathers, sits on a pond and goes quack - chances are, it's a duck.

If someone charges £55 for an initial 45 min appointment, and then cleans the teeth themselves - chances are, it's a hygienist!

Does the practice have a website that mentions the Periodontal specialist, and has the scale of charges? That would confirm things one way or the other.

Toothsmith

Blue_Mermaid wrote: »

What if the problems I have now are not due to gum disease? The teeth that are loose are hurting. What if I have an absess or something else? Shouldn't that be diagnosed now? Will the hygienist be able to diagnose such things?

It will be fairly obvious to the hygienist what is going on - and if she's worried by anything she will call in a dentist, or not treat and refer you to the dentist.

But from what you have written already, I would not be worried by the approach they are taking.

Plus - you have corresponded with a dentist at that practice who has suggested this approach. So that's the advice you should go with.

Blue_Mermaid

Thanks to everyone for your latest replies.

Toothsmith wrote: »

It will be fairly obvious to the hygienist what is going on - and if she's worried by anything she will call in a dentist, or not treat and refer you to the dentist.

But from what you have written already, I would not be worried by the approach they are taking.

Plus - you have corresponded with a dentist at that practice who has suggested this approach. So that's the advice you should go with.

After further correspondence, he has now advised me to see the NHS dentist. He agreed I need a thorough check up with the dentist first and then she can say what is required next.

So, I've made an appointment for Wednesday. Receptionist has given me 45 minutes, so should be able to fit in X-Rays etc. She sounded surprised when I said about scale and polish, as she said that's what hygienist does. Head dentist said in email: "she does not carry out any gum treatments other than very simple scaling and polishing." So, I thought it was ok to say to receptionist about scale and polish. I didn't say a very simple one though!

Blue_Mermaid

Just phoned them again to ask what happens about deposit I put down for hygienist. They will refund that. Receptionist just informed me that head dentist said they will not do scale and polish! He definitely said in email about NHS dentist doing one, albeit a very simple one. I've read in other threads that you should be offered this by NHS dentists if it's clinically needed and they shouldn't say you can only have it done privately. Anyway, receptionist said they've cut my appt down to 30 mins now and she said to ask NHS dentist when I see her about the scale and polish because receptionist getting mixed messages from head dentist and me.

Blue_Mermaid

I'm now realising that my original NHS dentist was not so bad after all! He was obviously doing the best he could under the NHS contract. He *always* gave me a scale and polish at the end of every check up and the last one was quite a deep clean. I'm thinking I should have gone back there now. Not sure he would have had me back after 4 or 5 years though.

Blue_Mermaid

I've just drafted the following email to the head dentist. Do you think I should send it or do you think it will get his back up and he'll cancel my appointment and not want me as a patient there?

I was surprised to hear from your receptionist that you've said I won't be able to have a scale and polish on Wednesday. You said in your first email today that Samantha does not treat gum disease apart from a very simple scale and polish.

I'm not trying to cause any trouble or be rude in any way and I am apprehensive about saying the following, before I've even been to visit your practice but I was under the impression that if a NHS dentist decides a treatment is clinically necessary, then they are required to offer it on the NHS and shouldn't ask a patient to pay for it privately.

The following info was taken from the NHS website (http://www.nhs.uk/chq/Pages/nhs-and-private-dental-charges.aspx?CategoryID=74&SubCategoryID=742)

NHS dental treatment

The NHS will provide all treatment that your dentist feels is clinically necessary to keep your teeth, gums and mouth healthy.
If your dentist says that you "need" a particular type of treatment, it will be available on the NHS. You should not be asked to pay for it privately.


On the same website, it lists scale and polish under Band 1 treatment (http://www.nhs.uk/chq/Pages/nhs-dental-band-charges.aspx).

Band 1 dental treatment: £18.80

Depending on what’s necessary, this can cover:
a clinical examination, assessment and report
an orthodontic assessment and report
advice, diagnosing and planning of your treatment
X-rays
moulds of your teeth – for example, to see how your teeth bite together
taking coloured photographs
advice on preventing future problems, such as diet advice and cleaning instructions
applying sealants or fluoride preparations to the surfaces of your teeth
a scale and polish
marginal correction of fillings
taking a sample of cells or tissue from your mouth to examine (pathological examination)
adjusting false teeth (dentures) or orthodontic appliances, such as braces
treating sensitive cementum (the tissue that covers the root of a tooth)
Urgent treatment when you need to see a dentist immediately also costs £18.80.

Band 2 lists deep scale and polish:-

Band 2 dental treatment: £51.30

Depending on what’s necessary, this can cover everything listed in band 1 above, plus:
non-surgical treatment of periodontitis (a severe form of gum disease) – such as root planing (cleaning bacteria from the roots of your teeth) or deep scaling and a polish
surgical treatment of periodontitis – such as removing some gum tissue (gingivectomy)
free gingival grafts – when healthy tissue from the roof of your mouth is attached to your teeth where the root is exposed

I'm sure when I visit, it will become apparent that I do clinically need a scale and polish, so I don't understand why I won't be able to have one with Samantha.

Again, apologies for bringing this up with you and I fully understand you have a business to run but at the same time, I don't understand why I would be refused a treatment, which should be available to anyone on the NHS who has a clincial need for it.

Many thanks.

Blue_Mermaid

Hmmmm, I am now thinking he could say, yes it is available on the NHS but we we don't have to offer it ourselves and will refer you elsewhere if you need it. The BHF said to me today that they will probably refer me to a hospital hygienist if I want it on NHS and said that could take ages.

Blue_Mermaid

Didn't send the drafted email but sent a much shorter version instead:-

Apologies for bringing this up but I don't understand why I would be refused a scale and polish if Samantha decides it is clinically necessary?

A scale and polish is listed under both Band 1 and Band 2 NHS treatments for patients who have a clinical need for it.

Please could you explain this to me?

Many thanks and apologies also for so many emails. I thought after I'd made the appointment with Samantha, I was clear about everything.

welshdent

Maybe they just meant it wouldnt be offered there and then because it is an assessment appointment? It takes me ages to do all the appropriate measurements and radiographs. If I had to do the clean as well I would be there forever. I tend to do an initial diagnosis based on a "BPE" score and then re book for longer for measuring and treatment. Sometimes 2 visits. To be honest I would get someone else to do it if i could but if I did i would end up halving my NHS income if I paid for a hygienist.

Just for clarification, a scale and polish would be a band 1 which is literally scaling off calculus above the gum line.

If you have gum disease you will also have have calculus below the gum line called subgingival calculus. This requires "sub gingival debridement" which is "deep" cleaning but to most people feels the same! It falls in to band 2.