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[Deleted User]

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brook2jack

Providing the root canal is not too complex and is clinically appropriate root canals are available on the NHS and crowns , where clinically appropriate , are also available on the NHS , although on back teeth these are going to be metal not white.

Have you been told you need root treatment and crowns? Edit reading your last thread if you need a root treatment redoing then it's specialist treatment.

The only caveat is if the root treatment is too complicated eg on a back tooth with difficult to clean roots , then referring to a specialist who will be private, as NHS specialists are not generally available is appropriate.

Likewise if the practice is one on the new NHS pilot scheme you will not be able to have root treatment or crowns unless your oral health is scored excellent .

Undervalued

brook2jack wrote: »

Providing the root canal is not too complex and is clinically appropriate root canals are available on the NHS and crowns , where clinically appropriate , are also available on the NHS , although on back teeth these are going to be metal not white.

Have you been told you need root treatment and crowns? Edit reading your last thread if you need a root treatment redoing then it's specialist treatment.

The only caveat is if the root treatment is too complicated eg on a back tooth with difficult to clean roots , then referring to a specialist who will be private, as NHS specialists are not generally available is appropriate.

Likewise if the practice is one on the new NHS pilot scheme you will not be able to have root treatment or crowns unless your oral health is scored excellent .

In who's opinion?

We touched on this in another thread. Between the extremes there must presumably be a grey area where different NHS dentists will take different views if they were presented with the same tooth?

Some (hopefully most) will want to do their best for the patient. However I seem to remember you saying in the past that whatever the NHS pay the dentist for doing a root canal is not really adequate for the time and materials involved?

So inevitably it seems to me some such decisions will be made on financial or laziness grounds, which is far from ideal for the patient to say the least!

brook2jack

As I understand things this tooth has been root filled once already , and re root treatment is automatically a specialist job ,particularly on a back tooth.

This is a criteria for root treatment difficulty https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/10/2006casedifficultyassessmentformb_edited2010.pdf

On the NHS the fee generated for root treatment is band two which includes check up x Ray, scaling and all necessary fillings and root fillings. That will earn the practice, on average, £75.

A molar root treatment on its own will take an hours surgery time. A cheap NHs surgery will cost £140 an hour to run. The instruments which can only be used once cost £35 each and more than one may need to be used on a Molar. Plus the costs of the other materials and disposables and the costs and time of the other treatment.

A NHS dentist loses money on every root treatment they do.

brook2jack

ciaccino wrote: »

If I wanted to go back to my previous NHS dentist, do I have to de-register me from the current one?

There is no such thing as registration in England and Wales. Your previous dentist is not obliged to take you back on and you must play any outstanding bill to the dentist you have just seen and cancel any appointments made.

Undervalued

brook2jack wrote: »

This is a criteria for root treatment difficulty https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/10/2006casedifficultyassessmentformb_edited2010.pdf

On the NHS the fee generated for root treatment is band two which includes check up x Ray, scaling and all necessary fillings and root fillings. That will earn the practice, on average, £75.

A molar root treatment on its own will take an hours surgery time. A cheap NHs surgery will cost £140 an hour to run. The instruments which can only be used once cost £35 each and more than one may need to be used on a Molar. Plus the costs of the other materials and disposables and the costs and time of the other treatment.

A NHS dentist loses money on every root treatment they do.

So you would agree that there is a significant financial incentive for an NHS dentist to decide "it is too complicated"?

Not a good situation!

Undervalued

ciaccino wrote: »

No, this is a tooth on which no previous root canal was performed. Only a couple of standard fillings.



But what the dentist said was he never performs root canals or crowns on the NHS.

Well if that is what he said then, as I understand it, he is breaking the rules and should be reported.

The trouble is, do you want somebody drilling holes all the way down your tooth because he is forced to?

However, as a patient, the difficulties imposed by the system under which he works are not your problem.

brook2jack

ciaccino wrote: »

No, this is a tooth on which no previous root canal was performed. Only a couple of standard fillings.



But what the dentist said was he never performs root canals or crowns on the NHS.

Did you get a copy of your treatment plan? It should detail what is NHS and what is private treatment. You should write a letter to the practice pointing out that root treatment and crowns should be provided on the NHS and ask for the reasons for a private referral. The practice must reply within a reasonable time and give details of how to escalate complaint if not happy.

Of course the sensible thing is not to use this dentist anyway .

brook2jack

Undervalued wrote: »

So you would agree that there is a significant financial incentive for an NHS dentist to decide "it is too complicated"?

Not a good situation!

Any patient who requires multiple fillings, extractions , crowns, bridges , gum treatment, chrome dentures etc will lose a NHS dentist money.

The laboratory fees also will often be more than the treatment earns.

This is a well known problem and why for at least 10 years the government has been trialling new contracts. The difficulty is the amount spent per patient treated has been falling year on year and how much high quality dentistry can be bought when the average spend per person treated each year is £36? This pays for all the surgery costs,training equipment , etc etc etc

At a cost of £140 an hour to run one room in a practice it is easy to see where NHS Dental maths fails.

Undervalued

brook2jack wrote: »

Did you get a copy of your treatment plan? It should detail what is NHS and what is private treatment. You should write a letter to the practice pointing out that root treatment and crowns should be provided on the NHS and ask for the reasons for a private referral. The practice must reply within a reasonable time and give details of how to escalate complaint if not happy.

Of course the sensible thing is not to use this dentist anyway .

However they will presumably reply claiming it is too complex and the the OP misunderstood what the dentist said!

So unless the OP gets a second opinion staying it is actually straightforward (if indeed that is the case) and then makes a formal complaint this dentist will continue to get away with unprofessional practice.

brook2jack

ciaccino wrote: »

All valid points! All I want is to kick the can down the road, until I have enough money to go private (possibly abroad). Extracting the tooth is too radical. But if I wait too long, I might get an infection.


I'm resigned to the idea that an NHS dentist won't do a decent job, at least not in my area.

If your tooth needs root treatment there is already an infection there that could blow up at any time.

If you are having multiple teeth that need root treatment and crowns you need a regular dentist who can do treatment and help you to make changes that are necessary to stop you needing so much treatment in future. You are not going to get that by going abroad , having a shed load of treatment in a short time with no long term follow up.