Dentistry work

MsPaw

Hi,
New here and just looking for advice on some dentist work. 
During lockdown I lost a crown and the tooth snapped with it. I saw my dentist today who said the tooth left is beyond repair and so I'll need it extracted. It's quite near front, the one behind 'canine' teeth. 
I was quoted 3 options : 
A 'tile' for free. Ie a removal false tooth. 
A bridge at £1400 &
An implant at £1800.
I asked about the bridge and whether it could be done on the NHS as I have a tax credit exemption due to being a single parent on a low income (work part time). I was told 'no' the only NHS option would be the 'tile'. 
I'm pretty surprised by this as I previously had a crown replaced on the NHS for free due to it being close to the front, and the tooth in q is actually even closer to the front. 
I'm wondering if I should see another dentist and see what they say? Any advice please on this. 
Thanks in advance. 

brook2jack2

nhs dentistry is there to secure dental health in the simplest way possible. Particularly if there are other missing teeth you will only be offered a denture. You might prefer a bridge but nhs dentistry is not there to provide complex treatment based on preference. 

More particularly in covid times the time required for a surgery to lie fallow after drilling for a bridge means it is very unlikely , even if indicated, it would be done at the moment. 

Toothsmith

I have never heard a denture called a 'tile' before - but I'm sure that's what you're referring to, and why Brook has called it a denture.

Even with the bridge & implant, you would need a denture first whilst the socket heals, so having this won't stop you having a bridge or implant in future if finances improve and you can have the private options 

Undervalued

brook2jack2 said:

nhs dentistry is there to secure dental health in the simplest way possible. Particularly if there are other missing teeth you will only be offered a denture. You might prefer a bridge but nhs dentistry is not there to provide complex treatment based on preference. 

More particularly in covid times the time required for a surgery to lie fallow after drilling for a bridge means it is very unlikely , even if indicated, it would be done at the moment. 

Presumably though, where the line is drawn is a bit of a judgement call on the part of the dentist? That is assuming the judgement is not being wrongly influenced to "sell" a private treatment. As we know that happens from time to time with root canals and other time consuming treatments where the dentist will be well out of pocket working on NHS rates!

How easy is it as an NHS patient to get a second (NHS) opinion? Obviously easy enough if you pay for one privately.

Toothsmith

Undervalued said:

brook2jack2 said:

nhs dentistry is there to secure dental health in the simplest way possible. Particularly if there are other missing teeth you will only be offered a denture. You might prefer a bridge but nhs dentistry is not there to provide complex treatment based on preference. 

More particularly in covid times the time required for a surgery to lie fallow after drilling for a bridge means it is very unlikely , even if indicated, it would be done at the moment. 

How easy is it as an NHS patient to get a second (NHS) opinion? Obviously easy enough if you pay for one privately.

None of it is easy at the moment. Getting seen in the first place and being offered treatment options is a result in itself!

brook2jack2

Bridges are inherently destructive , unless they are adhesive and adhesive bridges have a short lifespan, in general. 

The only case on the NHS that might qualify for a bridge is in someone with no other missing teeth, with excellent cleaning habits and gum condition, excellent bone levels  , no active decay who is only missing a very front tooth. That is really just about it. 

MsPaw

Thanks for the responses. I have no other missing teeth on that side of my mouth. It was pretty unlucky my crown snapped off with the tooth in it so there is not much tooth left to do anything with. It is near the front and so I thought I may be eligible for something a bit better than a removable tooth. I haven't ever heard of a 'tile' before either but that's what my dentist called it. I've been looking at info on bridges and sounds like they eventually fail and I'd also have to have a healthy tooth drilled to fit it so not actually sure this is a good option anyway. I did think try the 'tile' and if it is terrible get another quote/opinion on the work. Re covid : it seems pretty random how dentist's are operating. Some seem to be doing routimr stuff more atm but I've waited 5 months just to be seen for this. The dentist seems happy enough to go ahead though. Thanks. 

MsPaw

Toothsmith said:

I have never heard a denture called a 'tile' before - but I'm sure that's what you're referring to, and why Brook has called it a denture.

Even with the bridge & implant, you would need a denture first whilst the socket heals, so having this won't stop you having a bridge or implant in future if finances improve and you can have the private options 

Yes I wondered if I could get an implant later but the dentist said it's better not to wait as bone deteriorates or something. I'm not sure..she's v pushy I've found so tbh I think I need to get another option. 

Toothsmith

That is true. Your dentist is much better placed than me to see how much bone there is in any particular place in your mouth.

I have had patients have implants placed without issue many years after a tooth loss though, although I have also had others where the bone was very marginal even before the tooth was lost. 

Apollonia

Toothsmith said:

I have never heard a denture called a 'tile' before - but I'm sure that's what you're referring to, and why Brook has called it a denture. 

I wonder if it's a translation error depending on the dentist's first language. Tile instead of plate would be my guess.