Costly 'scale and polish' service at the dentist 'may be unnecessary'!

boozercruiser

So then, after many years of dentists trying to scuttle me off for a 'scale and polish' at the hygienist (this instead of carrying out the procedure him/herself as per charge band) at possibly great extra cost, looks like 'scale and polish' has always been what I considered it anyway.
Namely.
Nothing more than a rip off Con in most cases!
Please read the below fully in todays newspaper item before judging the issue though.

https://www.dailymail.co.uk/health/article-6583581/Costly-scale-polish-service-dentist-unnecessary-good-teeth.html

For years, dentists have insisted that a traditional scale and polish is an essential part of proper oral hygiene.

But the often costly service may be unnecessary for those with good teeth after evidence found it makes ‘no difference’ to dental health.

The professional clean involves scraping to remove deposits of plaque and a polish to make the teeth smooth. Many patients are offered the treatment during a check-up once their teeth have been examined.

Now a review of evidence has found that for most adults with healthy teeth who regularly visit the dentist, the treatment makes ‘little or no difference’ to certain indicators of dental health such as the early stages of gum disease. There may also be ‘little or no difference’ in plaque levels over two years.

brook2jack

I find this posting somewhat ironic when op has lost teeth due to gum disease which is the number one cause of loss of teeth .

However to put into context scale and polish is a waste of time and money if you do not change the way you clean your teeth. Tartar starts to return 24 to 48 hours after having a scale if you are not cleaning effectively. So basically all scaling does is give you a "clean sheet" so you can improve your oral health by cleaning better.

Unfortunately many people do not change their cleaning regime so are doomed to having plaque and tartar damaging their gums for 363 out of 365 days of the year.

Ilona

The OP posted about this topic over ten years ago, he is still peeved about it. Not much point in bringing it up again.

ilona

Undervalued

Surely there are two issues here.

The medical necessity of a scale and polish comes down to the dentist's judgement of the patient's teeth, backed up by their training and current research into best practice.

However, as I understand it, if an NHS dentist decides it is needed then it should be provided as part of a Band 1 charge? There shouldn't be an extra charge, regardless of whether the dentist does it themselves or sends the patient to their hygienist?

On the other hand if it is not considered necessary, but the patient would like it doing for cosmetic reasons, then it is perfectly reasonable to offer the service for a fee?

If I am right and the NHS dentist is pushing a necessary S & P out to a hygienist for a fee then they are breaking the rules?

This is a bit like the often reported "I can't do this root canal on the NHS as it is too difficult but my colleague in the room next door can do it privately"!

I understand that complex root canals need specialist equipment and training but I do sometimes wonder if decisions in borderline cases are influenced by financial motives?

brook2jack

Actually treatment of periodontal disease (gum disease) is band 2 so in some cases treatment with the hygienist may be the same or cheaper.

Yes , if a patient has gum disease they should be offered NHS treatment. However if someone continuously does not do what they are advised eg start using tepe brushes , floss every day , brush right down to the gums that treatment becomes merely cosmetic as the tartar will start to reform within 24 to 48 hours and their gum condition will not improve. After repeated cycles of this there is a case to argue that no further gum treatment should be offered on the NHS until their cleaning has improved.

Indeed on the new NHS Dental pilots there is a traffic light system and no treatment can be offered beyond simple fillings and extractions until the patient has invested themselves in their health problems and improves their diet and brushing.

Undervalued

brook2jack wrote: »

Indeed on the new NHS Dental pilots there is a traffic light system and no treatment can be offered beyond simple fillings and extractions until the patient has invested themselves in their health problems and improves their diet and brushing.

That is interesting and I don't disagree with the concept.

However, how far should the NHS as a whole take this principle? What about repeated sports injuries from higher risk activities? Should they be treated at the tax payer's expense or should insurance be mandatory for whatever activities are classed as high risk?

Cigarettes and alcohol are heavily taxed so, to some extent, that contributes to the medical costs they generate. However unhealthy foods are not, perhaps they should be though heaven knows where you draw the line.

boozercruiser

[QUOTE=brook2jack;75304684]I find this posting somewhat ironic when op has lost teeth due to gum disease which is the number one cause of loss of teeth .

However to put into context scale and polish is a waste of time and money if you do not change the way you clean your teeth. Tartar starts to return 24 to 48 hours after having a scale if you are not cleaning effectively. So basically all scaling does is give you a "clean sheet" so you can improve your oral health by cleaning better.

Unfortunately many people do not change their cleaning regime so are doomed to having plaque and tartar damaging their gums for 363 out of 365 days of the year.[/QUOTE]

I have already challenged you on another thread for making that assumption Brook, and I don't intend wasting my time going into that here.
The news article is merely providing readers with the latest thinking on this matter.
That is all.
Dentists would be inclined to say the opposite of those particular findings now.
In other words.
The would say that.
Wouldn't they?
No disrespect meant of course.

boozercruiser

Undervalued wrote: »

Surely there are two issues here.

The medical necessity of a scale and polish comes down to the dentist's judgement of the patient's teeth, backed up by their training and current research into best practice.

However, as I understand it, if an NHS dentist decides it is needed then it should be provided as part of a Band 1 charge? There shouldn't be an extra charge, regardless of whether the dentist does it themselves or sends the patient to their hygienist?

On the other hand if it is not considered necessary, but the patient would like it doing for cosmetic reasons, then it is perfectly reasonable to offer the service for a fee?

If I am right and the NHS dentist is pushing a necessary S & P out to a hygienist for a fee then they are breaking the rules?

This is a bit like the often reported "I can't do this root canal on the NHS as it is too difficult but my colleague in the room next door can do it privately"!

I understand that complex root canals need specialist equipment and training but I do sometimes wonder if decisions in borderline cases are influenced by financial motives?

I agree with everything you say there Undervalued.:T
However I do note that Brook2Jack it seems to me, tries to push all responsibility back onto the patient as an excuse not to carry out work that should already be done under the band 1 charge.
So it's, well he/she isn't supposedly looking after his/her teeth very well, so I refuse to carry out the scale and polish.
But I know a nice friendly hygienist that will.
At extra cost of course.
'Hey Hygienist.
I got another mug customer here!
How convenient!

brook2jack

98% of all dental treatment is entirely preventable.

Gum disease , in particular is not ever cured , it is only ever kept under control by the patient. A dentists and therapists job is to give the patient the information and tools to make the changes they need to make to improve their oral health. They carry out scaling or other periodontal treatment (gum treatment) in order to give the patient a relatively "clean sheet" to make those changes.

Unfortunately many people do not make those changes , and as discussed before as tartar begins to reform 24 to 48 hours after scaling if proper cleaning is not instituted then scaling becomes a merely cosmetic exercise.

Scaling is not a "right" on the NHS it is a treatment prescribed and carried out , as necessary, when disease is present and under the new NHS pilot system when patient cleaning is improved.

There are , of course , exceptions.... those with limited dexterity due to eg arthritis , those with learning and physical difficulties may never be able to carry out good oral care and they will need frequent and more intensive interventions but because of these problems may very well be destined to lose teeth early and often.

boozercruiser

brook2jack wrote: »

98% of all dental treatment is entirely preventable.

Gum disease , in particular is not ever cured , it is only ever kept under control by the patient. A dentists and therapists job is to give the patient the information and tools to make the changes they need to make to improve their oral health. They carry out scaling or other periodontal treatment (gum treatment) in order to give the patient a relatively "clean sheet" to make those changes.

Unfortunately many people do not make those changes , and as discussed before as tartar begins to reform 24 to 48 hours after scaling if proper cleaning is not instituted then scaling becomes a merely cosmetic exercise.

Scaling is not a "right" on the NHS it is a treatment prescribed and carried out , as necessary, when disease is present and under the new NHS pilot system when patient cleaning is improved.

There are , of course , exceptions.... those with limited dexterity due to eg arthritis , those with learning and physical difficulties may never be able to carry out good oral care and they will need frequent and more intensive interventions but because of these problems may very well be destined to lose teeth early and often.

I do admire your patience of a saint way of answering posts Brook, without taking off as they say. As I have just said in another thread, I respect and value the time you have taken to give valued input and advice.
I shall take all you say on board as very well meant respected information.
Thank you again. :beer: