Dental advice please

Blue_Mermaid

I hope you're right but that wasn't the impression I was given by the receptionist. Hopefully, he'll reply tomorrow. I'll let you know. He might just say something to get rid of me, like, "we feel you might be happier going to a different practice..."

Who would do the sub gingival debridement on the NHS though? The more I read about treatment for gum disease on the NHS, the more elusive it seems.

welshdent

In my practice? - I would ... do I want to? No not really I would rather a hygienist or therapist do it but as I said, I would lose half my income ish.
A prinicipal contract holder may find it is their interests to get then to do it but most dentists are associates.
Neither hygienist or therapists can treat directly on the NHS in general practice they have to be sub contracted and the fee comes out of the derisory fee paid by the NHS so in that setting its not sustainable. In private practice then it is more likely that the dentist would treatment plan and then get them to do it as the fee is separate.

So in summary - Dentisys, hygienists or therapists CAN do it. Who does it depends on the practice, arrangements you are being treated under and what staff they have

Blue_Mermaid

Well, I wish I lived in your neck of the woods...I'd be knocking on your practice door! Your patients must really appreciate you.

I only ever saw a hygienist when I was a teenager, back in the 70's. Never been offered the opportunity since, as my last dentist did the job himself, like you and I'd been going to his practice for many years.

Blue_Mermaid

Had a reply from head dentist:-

"We are not refusing to provide any treatment on the NHS which is clinically necessary. However, we are unable to comment further on your clinical situation until you have had a full examination by a dentist."

I'm happy with that.

justme111

Blue_Mermaid wrote: »

I emailed the head dentist again and said I thought it would be best to see the dentist first (NHS), as I hadn't seen one for 4 or 5 years. He replied and said he's cancelled the hygienist appointment and it was ok to see the NHS dentist there but she does not carry out any gum treatments other than very simple scaling and polishing.

Now I don't know what to do again! I phoned the British Dental Foundation helpline for advice and they said if I could afford it, it would be better to see the hygienist. She said they do have to offer you a NHS solution if you see a NHS dentist but she said that would be a referral to a hospital.

I thought I would be able to have treatment with a dentist, unless a Periodontist was needed.

My friend has gum disease and I spoke to him yesterday. His dentist does everything a hygienist does and he has 3 monthly appointments with him and is getting his disease under control.

The advisor at the BHF said that what I was being advised by the head dentist was correct though and again, she advised seeing the hygienist first if I could afford it.

Confused!

you confused because official party line is that all treatment necessary is available on nhs while to do that treatment the dentist would be working for free and as surgery upkeep costs money the dentist would in effect pay to do your treatment. Hence dentists try to wiggle out of it. Your choice is either try to force them to stick to the letter of law and get that treatment (guess how good it will be ) or pay for it. That is it.

Blue_Mermaid

justme111 wrote: »

you confused because official party line is that all treatment necessary is available on nhs while to do that treatment the dentist would be working for free and as surgery upkeep costs money the dentist would in effect pay to do your treatment. Hence dentists try to wiggle out of it. Your choice is either try to force them to stick to the letter of law and get that treatment (guess how good it will be ) or pay for it. That is it.

I think you're absolutely right and as such, I've gone for a mixture of both. Probably what a lot of people do.

I saw the NHS dentist yesterday. Had x-rays and she measured the pockets. Bad news is, she said the gum disease is quite advanced, so I do have bone loss (smallest pockets 2 or 3 but biggest are 7 or 8!).

Good news is she said she doesn't need to take any teeth out at present. There's the definite loose ones I found and she said there are some others that are borderline loose but I'm not going to lose any at the moment. She thinks we've caught them in time. I asked about the future and she said, if the disease stays the same or worsens, I could lose them in the future. She said if I get the disease under control, the 2 loose ones could possibly stablilise a bit more or could stay the same.

So, as expected, she said I need to see the hygienist. No mention of NHS treatment, so not following protocol there (ie they are not supposed to suggest private treatment first). She said I'd need to see hygienist for a couple of deep cleans and then it will be every 2 months after that (meticulous cleaning needed at home of course as well).

If the disease doesn't improve, she'll then suggest I see their Periodontist, who visits once a month. She quoted £350 for that. I didn't ask what that included (I will if I do have to see them).

I asked if I could have the cleaning on the NHS. She said she could do a couple of cleans and then see how things are after that but she recommended I see the hygienist, as "that's what she does" and "she has better equipment down there".

I have saved money having the x-rays and measuring on the nhs, so only need to see the hygienist for 30 mins, rather than an hour and it's £40 for 30 mins. I didn't think that was too bad every couple of months and I do want the best treatment, so I agreed to seeing the hygienist.

Of course, if I do have to see the Periodontist, that is going to be very expensive.

I need a filling as well. I went for private with that too, as I want a white one (because of health).

So, I have appt next Wed for filling and hygienist. Dreading pain with hygienist! It hurt enough with the measuring of the pockets yesterday and still hurting a bit now, so it's going to be worse with the deep cleaning.

I do feel a bit niggled that they just expect that people can pay for private treatment, without even asking you. I'm lucky that my mum wants to pay for me and wants me to have the best treatment. Not everyone is so lucky though.

justme111

Ask to have hygienist treatment under local anesthesia . If you managed home cleaning then hygienist appointments unlikely to be needed every two months

Blue_Mermaid

justme111 wrote: »

Ask to have hygienist treatment under local anesthesia . If you managed home cleaning then hygienist appointments unlikely to be needed every two months

Thanks for your replies Justme111.

Hope they'll agree to it. Of course, some of mouth will probably still be numb from having filling. They do still give you an injection before a filling don't they? So long since I've had one! Gums will be painful when anaesthetic wears off after cleaning though, so I suppose I'll have to take painkillers if it's bad. Still tender after all that poking and measuring yesterday!

Hope you're right about less than 2 months but that's what she said was needed.

Incidentally, she was asking me if I've used Corsodyl in past and I said yes, under original dentist. I told her it makes my gums really sore, as if they've been cut. She said she'd never heard of that before. I had an old unopened bottle at home (expires this month) and looked at side effects this morning. Soreness and even peeling of gums is listed as possible side effects, so strange she'd never heard of it! Says about diluting with same amount of water but I tried that in past and it still made me sore.

Secondly, when x-ray was up on screen she said it looked very black and white. I joked about whether it was supposed to be in colour? I asked what it was supposed to look like but she didn't reply. Just said it was good enough to make assessment with.

What did she mean about it being too black and white? Just curious!

welshdent

FWIW I havent had anyone say corsodyl makes their gums sore either. Side effects listed are usually overkill just to make sure the manufacturer covers their back.

Blue_Mermaid

Well it's obviously true because it happened every time I used it and I've had a few courses of it over the years. The gel and the mouthwash. Both had same effect on me each course and I don't believe I can be the only one in the world!