Denplan Dentist Advice please

LoubyLoo

I wonder if anyone can advise if they have received any refund or suspension of premiums from Denplan during this current time. My husband and I have been paying our £52.50 a month premium and have recently had our dental check ups cancelled for the second time. Our dentist is blaming the fact that he can’t get PPE equipment still.  However, I should mention he is a one man band and has been off work since 6 weeks ago due to having his hip replaced. He has a part time locum 2 days a week but we have been told we can’t see her due to being with Denplan.  I fully appreciate things are difficult due to Covid but is it right to keep taking our money and providing no service.

Undervalued

Amazingly, unlike say a British Gas boiler service contract, Denplan apparently isn't insurance so it doesn't seem to be regulated! 

Without wishing to sound harsh, the dentist's hip replacement and his apparent inability to get the necessary supplies are his problem, not yours. However unless you are prepared to walk away and claim your money back (sooner or later there will be some legal claims over this) do you really want a dispute with somebody that is going to stick sharp instruments in your mouth? Some, more cynical than me, would say that is what they rely on!

Toothsmith

If the only reason you can't see this Locum is 'because you're with Denplan' then this really isn't good. I would get this confirmed by someone more senior in the practice by making a written complaint mentioning this and just make sure it wasn't something said by someone who was having a bad day on reception and said the wrong thing.

it is a very hard time in dental practices at the moment, but my Denplan patients are the bedrock of my patient base. It's their regular payments still coming in that have enabled me to get the PPE I need, as well as good processes within the surgery to mitigate theoretical problems of aerosol. 

I did have a couple of Denplan patients enquire about refunds, but I didn't give any, and now were back, the patients are grateful we're up, running and can see them again. Even though it's not quite the same as it used to be.

LoubyLoo

Thank you.  Could I just further ask Toothsmith, as I take it, you’re a dentist is it now possible to carry out general cleaning of teeth if you are wearing PPE?

brook2jack2

It is handscaling only as using the Ultrasonic  machine means the surgery has to be shut down for an hour afterward to let the aerosol settle, then cleaned before it can be used again. In practices where there is only one or two surgeries then patients who need treatment need to be prioritised and hygiene appointments may need to wait until urgent/delayed treatment is done as one dentist has to use two surgeries to get drilling and other treatment done to allow for one hour fallow followed by cleaning after each patient. Even then they can only treat a fraction of the people a day they were treating before. 

For this reason ,in many practices, dental hygiene services have not yet resumed, or have resumed in a limited manner.

Toothsmith

Much as I hate to disagree with Brook, she is presenting the ultra-orthadox view here. There are respected operating procedures that identify mitigating factors to do with aerosol generation, and do allow reduction of fallow period if you are using them. On top of that, no other country worldwide have such stringent opinions on fallow time as the UK. Many countries operate perfectly normally with no fallow time and in PPE very similar to what was used pre-pandemic. In many ways, the evidence base for operating normally is much stronger that the evidence base for aerosol and the need for fallow time. No country can demonstrate a risk to dental professionals that is higher than general population. In the UK, in the most dangerous time of the pandemic - which were the weeks between people going abroad en masse for Feb half term, and lockdown, dental professionals did not suffer disproportionately from COVID, and no clusters have been identified with a dental practice as the source.

NHS practices do have to obey Public Health England guidelines more religiously than private practices do, no matter how out of step with the rest of the world they are. Practices with mixed NHS and private income also have to be very careful, in the sense they could get into trouble if not 'following orders'.

Purely private practices have more leeway to take a sensible approach, and many mixed practices are taking a safe but pragmatic approach as well. 

NHS practices are currently getting full pay for only operating at 20% of targets. 

So out there you will find quite a range of treatments that dental practices are willing to provide. What is pretty universal though, is that none of them will be operating at the capacity that they were before the lockdown. That simply wouldn't be safe. So whilst many are able to keep up with the basic demands of their regular patients, there are very very few that will be in the position where they could contemplate taking on new patients. So essentially, what you have now, you may well be stuck with for a fair while yet.

brook2jack2

TS I agree that the one hour is ultra orthodox , in Wales we are allowed to mitigate this somewhat , however in the other countries of the U.K. everyone is still waiting on the urgent scdep report on mitigation . 

It is true that NHS practices in Scotland and NI are very restricted in what they can do , but even private practices in England, even with all mitigation in effect will still only see a fraction of their normal patients and very very few will have the spare surgery space and equipment in to allow hygienists to use ultrasonics scalers. 

Toothsmith

Agree with that - although my hygienists do ultrasonic if they feel the need. 

I am at a stage in my career though where I don't need a 'busy' practice though. Loans were paid off years ago, and I have a happy cohort of low-need patients who the vast majority are on Denplan, and my Denplan rates are a bit above the local average. 

That has put me in a position where I could get PPE despite the price, could get mitigating factors in place easily (all my surgeries have nice big opening windows too!) and although nowhere near what I did before, I'm cracking on with it, and the patients are really seeing what they've been paying for, and why their loyalty has paid off - especially when they read forums such as this and see what other people are going through! 

But it's important that patients don't get the message that the hour long fallow is the ONLY safe way to operate a dental practice, as that is a long way from the truth. There are also a tranche of practices out there who are being paid for being inactive, and that to my mind is highly unethical. God bless the NHS dental system!

brook2jack2

I am no fan of what the NHS does to dentists but to put the other side the 20% is only in England and the NHS dentists are expected to deal with all toothaches where possible. 

In our part of the world it is nigh on impossible to source Fp3 masks as NHS England have reserved them . NHS dentists in our part of the world cannot afford the £10 a piece per dentist and nurse per patient or to keep on fit testing as one mask becomes difficult to source and the health board which is supposed to deliver masks to every practice just has....... 20 masks in total per practice , enough for twenty patients only, the first delivery since the crisis began. 

Yes it is a lot easier in private or mixed practice , we have bought papr hoods and reusable masks to get over the mask problem and obviously have immense gratitude to plan patients who have kept us going. We started agps at the end of June but despite working much longer hours and six days a week are still not caught up on the backlog. 

However I have sympathy for NHS colleagues because the screws are now tightening and nhs practice which was precarious to start with now looks very very difficult to sustain. Particularly as claw back is now being mentioned. 

NHS , private , mixed all practices are really struggling to catch up with the backlog and I don't see a return to "normal dentistry " until the middle of next year at the earliest. Even then , rather like the furore around cjd , I think covid will have long term ramifications on the way dentistry is practiced. 

LoubyLoo

Thank you to all that have replied.  It has certainly answered my queries.  Looks like our choice now is to either cancel Denplan and go private or try to get another dentist which is not a possibility I think.  Or continue paying Denplan and getting no service as our dentist is still recuperating from his hip replacement.  

Toothsmith

LoubyLoo said:

Thank you to all that have replied.  It has certainly answered my queries.  Looks like our choice now is to either cancel Denplan and go private or try to get another dentist which is not a possibility I think.  Or continue paying Denplan and getting no service as our dentist is still recuperating from his hip replacement.  

I would try a written complaint to the practice first, to confirm what you've been told that you 'can't see the locum because you're on Denplan'. If that is the case - I would get in touch with Denplan to have a word with them about that. It's really not very good!