Dental Therapist

rubble2

I went for my regular check up today, same practice but new dentist ( originally was under the practice owner but I got a letter given to me six months ago explaining that he had taken on a new role as some sort of Director of a Clinical research group. This apparently would take up much of his time and he would there fore not be continuing with his NHS patients - however if I wanted to go private...........)

So anyway as I say I went for my checkup with the new dentist knowing I would need some work done as I had lost part of a couple of fillings. The dentist confirmed what needed doing and explained the cost but then said that he would not be undertaking the fillings himself but it would be carried out by a 'Dental Therapist'. I can only assume that this is a less qualified dental person? It is a new one on me just wondered if anyone had come across this before and if anyone could explain the difference between a Dentist and a Dental Therapist please?

Also, therefore, what type of dental work is considered to warrant the attention of an actual dentist?

brook2jack

A dental therapist has a three year oral science or equivalent degree. They are trained to do fillings, X Ray's, extractions of baby teeth, impressions etc. They are the dental equivalent of a nurse practitioner.

A dentist does a five year degree and at least a further year/two years post graduate training.

They do the above plus advanced dentistry eg crowns,bridges,root treatments, dentures, oral surgery,advanced extractions , treatment planning etc.

Dental therapists are more often used in community dentists where they treat people who cannot be treated in the general dental service.

welshdent

Everything brook said. Also with regards to the "however if I wanted to go private ...." Comment. I think that's a little unfair. They have not stopped you having NHS care and no one is forcing you to go private. If your original dentist has a different role then frankly that's their business. To make a living on the NHS you have to do ALOT of work. If you do other work hitting the allocated targets becomes almost impossible. Many dentists take this approach of "keeping their hand in" by seeing a handful of private patients and focussing on their other roles. It's not a gun against your head. It's an option. One that I doubt the original dentist really minds if you take up or not.

rubble2

Thanks for the replies, I guess it is similar to the difference between an Architect and a builder, the architect designs the building and the builder does the donkey work.

welshdent wrote: »

Everything brook said. Also with regards to the "however if I wanted to go private ...." Comment. I think that's a little unfair. They have not stopped you having NHS care and no one is forcing you to go private. If your original dentist has a different role then frankly that's their business. To make a living on the NHS you have to do ALOT of work. If you do other work hitting the allocated targets becomes almost impossible. Many dentists take this approach of "keeping their hand in" by seeing a handful of private patients and focussing on their other roles. It's not a gun against your head. It's an option. One that I doubt the original dentist really minds if you take up or not.

I agree, but that was pretty much how it was presented to me - if you want to carry on seeing the same dentist then sign here to pay privately. I don't imagine for a minute that he is crying himself to sleep because I opted out and from my perspective I don't really care who my dentist is as long as they are competent - you don't really need to develop any sort of relationship with a dentist, it is not the same as a doctor/patient situation.

brook2jack

I think most people would disagree with you there. A good relationship between dentist and patient is seen by many as crucial as in the end dentistry is the only microsurgery done internally whilst the patient is awake. There has to be a high level of trust.

rubble2

No disrespect meant to dentists in general, but my experience has been mixed to say the least.

I recall a few years ago going to my then dental practice to be met by (yet another) new face just out of dental school who informed me that I need three crowns fitting. As I had no perceived problems with my teeth at the time I had my doubts about the necessity of the treatment and I actually moved to another practice (solo dentist) who did a examination and declared that my teeth were fine and no treatment was needed.

In fact I stayed with this dentist until he moved back to Manchester during which time he always joked that he couldn't make any money out of me because I never needed anything other than 6 monthly examinations.

On the subject of building a relationship with a dentist I refer back to my previous comment, in my experience Dental practices seem to have a huge turnover in staff with newly qualified people appearing for a year or so before being replaced with the next batch of graduates (presumably cheaper to employ). Not the best situation to build a long term relationship under.

welshdent

my point re the offering private though was meant to illustrate that it is just a way for the dentist to thin their patient list out given they can not now service the level of patients they once did. As I said, they are not depriving you of an NHS option just telling you that you can not see THAT dentist on the NHS. It seems pretty reasonable to me given the situation outlined.

and I DO think a relationship based on trust is important. Recent graduates do not mean bad either. Far from it! They may be a bit slower but they are not bad in my experience.

System

rubble2 wrote: »

I went for my regular check up today, same practice but new dentist ( originally was under the practice owner but I got a letter given to me six months ago explaining that he had taken on a new role as some sort of Director of a Clinical research group. This apparently would take up much of his time and he would there fore not be continuing with his NHS patients - however if I wanted to go private...........)

So anyway as I say I went for my checkup with the new dentist knowing I would need some work done as I had lost part of a couple of fillings. The dentist confirmed what needed doing and explained the cost but then said that he would not be undertaking the fillings himself but it would be carried out by a 'Dental Therapist'. I can only assume that this is a less qualified dental person? It is a new one on me just wondered if anyone had come across this before and if anyone could explain the difference between a Dentist and a Dental Therapist please?

Also, therefore, what type of dental work is considered to warrant the attention of an actual dentist?

By no means irrelevant.

'Dental therapist' salary goes from £20k to £26k per annum
Dentist salary anywhere between £38k and £80k+

NHS patients don't generate as much income, ergo they are given the cheaper option!

rubble2

Nothing against recent graduates, I was one myself a long time ago! My point really was that it is difficult to build up a relationship with a recent graduate when you seldom see the same one twice.

brook2jack

Actually many nhs practices do not use dental therapists because the tight economics of nhs dentistry means that it can be difficult not to make a loss using a therapist. Eg patient sees dentist for check up , sees therapist for fillings but one filling is deeper than first thought so needs a root treatment. Therapist cannot do that so has to go back to dentist.

Dentist needs to be paid for check up appointment and separate root filling appointment so let's say a minimum of 50 minutes. Therapist needs to be paid for fillings let's say a minimum of 20 minutes. Plus the dental nurse with them needs to be paid plus practice expences. All of this comes out of approx £63.

The few practices that use therapists tend to do so sparingly as it quite often is more economically viable for the dentist to do the work.

Toothsmith has been in his practice many years, Welshdent is the second generation of his family to work at his practice and I have worked decades at mine. However the NHS graduates we train are only on a one year contract because the ccg or lhb will not fund permanent contracts for them. Nhs work requires you to work at an unsustainable rate and new colleagues with debts of £80,000 to pay off for training often have to take jobs where the high needs of new patients make it difficult to sustain that level of work. So they move on until they have sufficient training and experience to specialise, get a private job or get a job in a nice family nhs practice with a stable ,low needs patient base.

brook2jack

No dentists are employed in practice. They are self employed and pay a percentage of their earning (50 to 65%) to the practice owner to cover costs.

Because a newer graduate is slower than a more experienced dentist they will actually earn less for the practice. It is in a practices financial interests to retain a dentist but there are difficulties outlined above.

A dentist will hit peak productivity in their mid thirties. As you get older you slow down again as the physical and mental strain takes its toll.