What are the limits of NHS Dentistry?

Tao81

I am off to see my NHS Dentist today, I have only had check ups in the recent past and have not been offered any attention by the dental hygienist, such as a clean and polish which I could really do with.
Am I entitled to request this level of treatment on the NHS?

judderman62

I recently had a full clean from the hygeniest and I'm an nHS patient at our Surgery

Magenta_Wolves

I'm also an nhs patient and I had to pay £30 to see the hygienist. It was a complete waste of money, only lasted about 10 mins.

judderman62

Magenta_Wolves wrote: »

I'm also an nhs patient and I had to pay £30 to see the hygienist. It was a complete waste of money, only lasted about 10 mins.

How long would you expect

Can't remember what I paid and I'd have to very roughly guesstimate ... yes prob somewhere between 10 and at very most 15 mins - did a very good and thorough job and was very friendly too.

Most satisfactory for me.

Toothsmith

An NHS patient is entitled to all treatment necessary to secure and maintain dental health. But the dentist is entitled to chose the most 'cost effective' way of achieving this.

It is wrong for dentists to tell an NHS patient they 'need' a hygienist appointment, but that it is only available privately.

Either the dentist must do the treatment 'necessary' him/herself, or they must send you to the hygienist on the NHS.

As you've not been told you need a clean-up, then it's probably not 'necessary' to secure your dental health.

Personally, I feel this is a question of defenition.

Since I went private, and brought in hygienists, and sent patients regularly to the hygienist (3 or 4 monthly in some cases) I have seen the amount of work that my patients need drop away quite dramatically. It's not just the 'clean-up' but the time they spend talking to the patient about things that affect the teeth, and enabling them to make better decisions about how they look after their teeth (Most of my patients are on Denplan, and this is included in the monthly fee, but for those that pay, it's £59.50 for a 30 min appointment)

NHS dentistry is turning into an emergency-only service.

If nothing hurts when you attend for your check-up, then obviously nothing is wrong, and so you don't need anything doing.

Preventative dentistry are just words to health ministers and dental planners.

Although there are still a few excellent practices out there still offering a decent level of NHS care, they are coming under more and more pressure to 'dumb down' their services.

If decent preventative care is what you want for your family, then my advice would not be to put yourselves down on the PCT's waiting list for an NHS place.

judderman62

Hey TS :wave:

thought you might appear in this thread :rotfl::rotfl:

I am having that extraction tomorrow (shudders with fear and anticipation )

I'm guessing though that private dental care is pretty darned expensive ?

nuttywoman

My sister this week has had an app with dental hygenist ( her nhs dentist refuses to see them unless they go to hygenist) who cleaned her teeth, scale and polish etc.She should have been having a check up on friday with the dentist but had to see dentist yesterday as an emergency because the hygenist was too rough, broke skin to roof of her mouth which caused an infection.She`s on antibiotics now and has`nt been able to eat properly.Her dentist gave her a check up while she was there and she did`nt need any treatment.The dentist tried to say it was her fault for not cleaning her teeth proplerly, but she`s a 50yr old woman with hardly any fillings and has lovely teeth.

nuttywoman

nuttywoman wrote: »

My sister this week has had an app with dental hygenist ( her nhs dentist refuses to see them unless they go to hygenist) who cleaned her teeth, scale and polish etc.She should have been having a check up on friday with the dentist but had to see dentist yesterday as an emergency because the hygenist was too rough, broke skin to roof of her mouth which caused an infection.She`s on antibiotics now and has`nt been able to eat properly.Her dentist gave her a check up while she was there and she did`nt need any treatment.The dentist tried to say it was her fault for not cleaning her teeth proplerly, but she`s a 50yr old woman with hardly any fillings and has lovely teeth.

BTW it cost her £30 too!

Toothsmith

judderman62 wrote: »

Hey TS :wave:

thought you might appear in this thread :rotfl::rotfl:

I am having that extraction tomorrow (shudders with fear and anticipation )

I'm guessing though that private dental care is pretty darned expensive ?

Just to answer Nuttywoman first, a dentist is in breach of his contract if he 'insists' on a patient having something done privately prior to seeing them on the NHS.

Also, he is in breach of GDC regulations, which state that a dentist MUST examine and refer a patient to a hygienist. A new patient may not see a hygienist FIRST. (This is true for private or NHS)

I would contact the local PCT, who would be very interested to hear of this condition being placed on NHS acceptance.

As to the bit about infections - this can sometimes happen the first time a patient gets a really good clean up.

If tartar and it's associated bugs are living around the teeth and under the gums, then they often don't cause much actual pain. Swelling and bleeding yes, and it damages the attachment of the tooth slowly, but it normally doesn't hurt.

When all these bugs are suddenly released, it can upset the mouth a bit. It doesn't happen very often, but when it does, it really does feel like it was the hygienist's 'fault'.

Now - to Judderman.

Yes - private dentistry often is more expensive - particularly if you are entitled to free NHS care. However, in most towns there is a choice. There will be places that operate at different price points.

In my town, I am probably one of the dearest dentists. My prices are nothing compared to something like a city centre cosmetic and implant practice though.

There is a guy down the road operating at not much more than NHS prices though.

The difference is that he has to see more patients than I do in order to meet his overheads.

Therefore, I get the patients who value a bit of extra time being spent with them, a bit more explaination, and an appointment within hours of ringing up because they have lost a filling or are in pain. (Not that many of them ever experience such things!! )

The ones that go down the road are the ones for whom a quick check up and polish are all they want. and don't mind waiting a day or two if they have a problem.

Those that go to the NHS place across the town apparently don't mind waiting for a couple of months in pain, don't mind seeing a different dentist (with varying commands of English) each time, and don't mind paying £43 if they need a single filling (Which would cost them £35 at the cheaper private practice near near me) or £193 for a single tooth denture (Which would cost £75 at my practice!!! Or £140 if you include the extraction of the tooth as well - Which would also be covered in the NHS fee)

I would urge everybody to not just assume private dentistry in unreachable and only for the rich. I think I have a dozen patients I would call 'rich' the rest are just ordinary people.

NHS dentistry is extortionate for what it often provides.

alimac23

I think NHS dentistry gets a bit of a bad name on this forum. I'm an NHS dentist and scaling/polishing if offered in 3 ways at our practice:

1. I will do it - only very simple scalings or unless the patient really cannot attend on the days our hygienists work

2. NHS hygienist - 15 min appts - £9.76 for a single visit or £20 ish ( cannot remember exact NHS fee for more complex scalings (2+ visits). Under the NHS complex scalings are available every 23 months with 3 or 6 monthly visits (single visits) between times. This service is free to those on benefits.

3. Private hygienist £19.50 for 20 mins - can go any many times as needed with each visit at this price

I offer my patients both and make the differences clear, and although I do think the private option is definitely the best for those patients with more advanced periodontal (gum) disease, I think these services offer affordable options for our patients and make dentistry accessible to all. Not everone can afford private dentistry.

As for waiting weeks for a pain appt - part of my contract with the NHS is to see emergency patients - i.e those with pain - within 24hrs and as such this is what is offered to our patients. Those with acute emergencies i.e trauma, haemorrhage, swellings are of course seem immediately.

I do appreciate that as I am in Scotland where the NHS contact is different, that it is easier for me to fulfill my contract than it is in England/Wales. However, I feel strongly that it should be pointed out than many NHS dentists DO care and don't compromise patient care or choice for financial gain. I certainly don't earn the big bucks or else I wouldn't spend so much time on this site!!!!

Toothsmith

Point taken alimac, and I do point out in a post further up this page that there are still some good NHS places out there.

South of the border though, there are many NHS dentists looking back nostalgiclly on the days of patient registration and fee-per-item NHS payments.

I myself would still be seeing kids on the NHS if it weren't for the cr£p new system foisted upon us a year last April.