Dentist , is this right ?

Damon_Hawthorn

Hi there
My elderly father has a NHS dentist, he recently had an old crown fall out, he is not vain but unfortunately it is a front tooth so is very visible.
He visited his dentist, who stuck it back on, a couple of weeks later it fell off again ( this time he swallowed it )
His dentist has said that he needs root canal and a new crown, and if that doesnt work he will need an implant. However as the previous crown was done many years ago the dentist said that she did not know what type of metal it was and as he also has a piece of a needle that has been stuck in his gum for 50yrs she did not know how to do it.
She said she would need to refer him to another dentist clinic and it would need to be private as this is considered cosmetic work.
He has already paid £180 for a consultation with the new dentist, and is now looking at costs of £800 for the root canal and £600 for the crown.
I have googled and seen that crowns are available on the NHS so i am thinking should they have referred him to another NHS dentist and not a private one.
If it wasn't visible he would not bother, he is a limited income and this money could be better spent elsewhere.
I am thinking of going to the dentist to ask why he has not been refereed to another NHS dentist , but i am wondering who else i can raise this with.
Any advice is appreciated.

brook2jack

Without your fathers permission in writing the dentist cannot discuss anything about his treatment with you.

It is always difficult to judge what has gone on third hand. Possibly the tooth was a post crowned tooth that has broken off inside the root. If this is the case the dentist might not be confident of getting the broken piece of post or possibly broken piece of root canal file out.

If this is the case then the options may be take the tooth out and add it to a denture or make a denture, or refer to a root canal specialist to get the broken ? Post? File out and have a new crown. Root canal specialists are , on the whole, not available on the NHS and this would need to be private.

If your father is not clear as to what his options are and is happy for you to accompany him then he can make an appointment to discuss this with the first dentist before he continues on with treatment to clear up what is or isn't possible.

McKneff

When does teeth treatment become private rather than nhs
Legit quesrion. My hubs goes evry 6 months and his teeth are wearing away badly, 2 fronts are capped but others are worn to tiny stumps along with bone loss.
Cant cope with a denture though.
Dentist isnt very good at explaining

brook2jack

In general NHS dentistry will only provide the simplest treatment to obtain dental health.

Worn down teeth can be very difficult to treat. Anything used to replace tooth is not as strong as the original teeth. If you are missing teeth these need to be replaced to take the strain off the worn teeth. Dentures are the only option that is likely to be offered on the NHS .

It is pointless building up worn teeth without sorting out the reason for wear otherwise the fillings or crowns will pop off within days or weeks.

If someone can't tolerate dentures then implants might be the answer but they are not available on the NHS.

Toothsmith

Damon_Hawthorn wrote: »

Hi there
My elderly father has a NHS dentist, he recently had an old crown fall out, he is not vain but unfortunately it is a front tooth so is very visible.
He visited his dentist, who stuck it back on, a couple of weeks later it fell off again ( this time he swallowed it )
His dentist has said that he needs root canal and a new crown, and if that doesnt work he will need an implant. However as the previous crown was done many years ago the dentist said that she did not know what type of metal it was and as he also has a piece of a needle that has been stuck in his gum for 50yrs she did not know how to do it.
She said she would need to refer him to another dentist clinic and it would need to be private as this is considered cosmetic work.
He has already paid £180 for a consultation with the new dentist, and is now looking at costs of £800 for the root canal and £600 for the crown.
I have googled and seen that crowns are available on the NHS so i am thinking should they have referred him to another NHS dentist and not a private one.
If it wasn't visible he would not bother, he is a limited income and this money could be better spent elsewhere.
I am thinking of going to the dentist to ask why he has not been refereed to another NHS dentist , but i am wondering who else i can raise this with.
Any advice is appreciated.

Picking through this - although it's a second-hand retelling of what your Dad remembers from his visit, it does sound about right.

Just trying to stick an old crown back on again is perfectly OK - as it's a low-cost fix, and if it lasts, then things may well be OK for a fair while again.

Obviously, it hasn't worked, and so a new crown is needed. If a new crown is needed then you have to look very critically at the state of the tooth you're going to be crowning, as even on the NHS it's going to cost the patient over £250, and you need to be sure it's going to last & be trouble free.

The 'piece of needle stuck in his gum for for 50yrs' could be one of 3 things (I really don't think the dentist will have used that phrase - but it is probably what it looked like on an x-ray if your Dad was shown it)

1. An old silver point. Silver points were used as a root filling material up to about 25-30 years ago. On an x-ray it would look like a 'needle' down the middle of the root of the tooth (Not in the gum). Silver points can be an absolute pig to get out of a tooth if the root filling needs to be re-done, and it's better sometimes to have it done by a specialist endodontist in the first instance rather than 'having a go' and failing then having to send the resulting broken silver point to the endodontist. Specialist endodontist are nearly always private.
2. An old post in the root canal that supported the previous crown. - again, a pig to remove and better off in the hands of a specialist
3. A broken instrument from when the tooth was originally root filled. Again - really needs a specialist to get it out.

Although these things have been trouble free for 50 yrs - the disruption of losing the crown, and preparing a new one for it could easily kick off a dormant problem underneath - so it is as well to get the foundations right before anything is done.

I can't really see why the crown couldn't be provided by the original dentist once the root filling has been successfully completed - but you would need to know exactly what was discussed between your Dad and the dentist, and as others have said - that is a confidential conversation. If your Dad and the dentist are happy - you could go along with him and discuss it with the dentist too.

Just because he is elderly though doesn't mean he lacks mental capacity.

Dentists often have tales of either wives, husbands or older parents coming for a consultation and wanting and agreeing to nice, but costly treatment - only for that to be found out by a bossy overbearing other half or son or daughter who then come storming in demanding that their relative be treated as cheaply as possible!!

I'm sure that's not the case here - but that's the other side of the coin if the dentist is reluctant to discuss your father's treatment with you. It can be a very delicate situation sometimes.