Dental cost - broken tooth

BA1985

Hello, 

I will try and do a very long story as short as possible.
 

3 years ago I broke my front tooth in half, shortly after I developed an abscess and ended up in hospital. 

once that died down, I went to my NHS dentist who advised I needed a root canal firstly, and then we would discuss options of what to do, bridge / implant etc. So paid the £282 band 3 cost & went ahead with the RCT, and then I hold my hand up due to work I missed two appointments for the follow up. That dentist then cancelled my account with them. 

I luckily found another NHS dentist locally after a year or so on the waitlist. And attended my first appointment March 2020. I explained the history and he did an X-ray firstly, he advised that when I originally had the root canal treatment the first dentist didn’t get everything out, and it would now need to be redone. But: 

if he couldn’t get everything out, I would need to be referred to a specialist, which he advised would cost over £800 as a minimum. But I would firstly need to pay him for attempt of the root canal and risk losing that money as it probably wouldn’t be successful. 

Covid, unfortunately hit, and I have an appointment in a week to revisit this all. 

My questions are: 
1. can my referral to the specialist be covered under the NHS? I don’t mind paying another £282 again but I can’t afford the £800+ and I feel a bit mistreated by the first RCT not being done correctly. 

2. If not covered under the NHS - can I just request they take the tooth out? Surely all root canal issues go away if it gets yanked out. Then I can proceed with an implant which I believe is covered under band 3 in the NHS costs or am I being too simplistic? 

3. If he still can’t get everything out in the second RCT, can I ask him to proceed with a crown anyway, as it’s now been over 3 years, nearly 4 since that first infection and subsequent root canal 

I’m fully aware I am probably clutching at straws. But I simply can’t afford over £800 for a specialist and then subsequent treatment which I assume will fall under private and I am at my whits end aesthetically & how this effecting me personally. 

Any help or advice would be really appreciated. 

Thank you  

Undervalued

BA1985 said:

Hello, 

I will try and do a very long story as short as possible.
 

3 years ago I broke my front tooth in half, shortly after I developed an abscess and ended up in hospital. 

once that died down, I went to my NHS dentist who advised I needed a root canal firstly, and then we would discuss options of what to do, bridge / implant etc. So paid the £282 band 3 cost & went ahead with the RCT, and then I hold my hand up due to work I missed two appointments for the follow up. That dentist then cancelled my account with them. 

I luckily found another NHS dentist locally after a year or so on the waitlist. And attended my first appointment March 2020. I explained the history and he did an X-ray firstly, he advised that when I originally had the root canal treatment the first dentist didn’t get everything out, and it would now need to be redone. But: 

if he couldn’t get everything out, I would need to be referred to a specialist, which he advised would cost over £800 as a minimum. But I would firstly need to pay him for attempt of the root canal and risk losing that money as it probably wouldn’t be successful. 

Covid, unfortunately hit, and I have an appointment in a week to revisit this all. 

My questions are: 
1. can my referral to the specialist be covered under the NHS? I don’t mind paying another £282 again but I can’t afford the £800+ and I feel a bit mistreated by the first RCT not being done correctly. 

2. If not covered under the NHS - can I just request they take the tooth out? Surely all root canal issues go away if it gets yanked out. Then I can proceed with an implant which I believe is covered under band 3 in the NHS costs or am I being too simplistic? 

3. If he still can’t get everything out in the second RCT, can I ask him to proceed with a crown anyway, as it’s now been over 3 years, nearly 4 since that first infection and subsequent root canal 

I’m fully aware I am probably clutching at straws. But I simply can’t afford over £800 for a specialist and then subsequent treatment which I assume will fall under private and I am at my whits end aesthetically & how this effecting me personally. 

Any help or advice would be really appreciated. 

Thank you  

As I understand it, an implant wouldn't be available under the NHS. If the tooth was to be crowned after the RC then that would put the treatment into band 3 hence the £282. However if it was the root canal only then it would be band 2 which costs c. £65.

However, a NHS dentist (in England) cannot legally charge for missed appointments. So there is an argument that, whilst he is quite entitled to refuse to see you again, as the treatment stopped at the band 2 point you are entitled to c. £220 back? That will go down like a lead balloon both with your former dentist and the helpful ones that post on here regularly but I think you may have a case?

A NHS dentist is entitled to decline to do a treatment that is too complex for his skill level and available equipment so if the RC now comes into that category then it is either pay a private specialist or have the tooth removed (band 2).

brook2jack2

If work was started on the crown, even if it was not fitted then the whole band three fee is payable. 

Implants are not , generally available on the NHS. 

Specialist root treatment is generally not available on the NHS and will have to be done properly. 

As it was 2020 when you last saw a dentist it is not impossible that there will not be enough tooth to work on anyway. But you cannot insist that a tooth is crowned if it is not in good condition to crown . That includes needing a re root treatment. There are many reasons why root treatment can be difficult to do , it is a complex process and you are working to tolerances of a fraction of a millimetre.

it is best to discuss this with the dentist who can see you , your teeth and x rays. 

Undervalued

brook2jack2 said:

If work was started on the crown, even if it was not fitted then the whole band three fee is payable. 

Implants are not , generally available on the NHS. 

Specialist root treatment is generally not available on the NHS and will have to be done properly. 

As it was 2020 when you last saw a dentist it is not impossible that there will not be enough tooth to work on anyway. But you cannot insist that a tooth is crowned if it is not in good condition to crown . That includes needing a re root treatment. There are many reasons why root treatment can be difficult to do , it is a complex process and you are working to tolerances of a fraction of a millimetre.

it is best to discuss this with the dentist who can see you , your teeth and x rays. 

IF it was then yes, however the OP said....

once that died down, I went to my NHS dentist who advised I needed a root canal firstly, and then we would discuss options of what to do, bridge / implant etc. So paid the £282 band 3 cost & went ahead with the RCT

Which, to me, reads as if it was not started which strengthens my view that legally (OK maybe not morally) the OP is entitled to a refund of a couple of hundred quid.

jon81uk

When I've needed work that is too specialised for my NHS dentist they've referred me to a consulatant at a hospital all under the NHS.
I was approved for an implant on the NHS for a front tooth, but the consultant decided it wasn't needed as the tooth remained healthy (and it is still going strong now 9 years later).
Recently I've had a partial root canal but I'm waiting for the referral as my dentist can't complete it but could be a years wait for NHS, although this will be free.

Surprised the dentist offered to refer to a private specialist in your case.

brook2jack2

In the vast,vast ,vast majority of areas specialist root treatment on the nhs is not available at all. So in the vast majority of the U.K. there is no where to refer to on the NHS

I am surprised you were approved for an implant 9 years ago as even then all nhs providers only approved implants for 
Oral cancer patients who need rehabilitation,
major trauma cases
hypodontia (where 6 or more teeth are naturally missing )
and even then funding is not guaranteed.