re root canal not done on NHS?

shandyclover

DD has a tooth that's been bothering her off and on. Managed to see the dentist today. Her dentist has told her she needs a re root canal done. Says that the root canal she had done years ago was not sealed properly and it needs re doing. Dentist stated this is not done on the NHS and she'd have to pay £800 for it to be done privately. Could any resident dentists confirm this? I am myself getting a crown done on the NHS at my dentist which to my understanding is more complicated, but maybe I'm wrong? Daughter doesn't use same dentist as us and to be honest they have misled her before so I wonder if she should try and get a second opinion?

brook2jack2

A re root treatment is almost always done by a specialist , as success rates are far lower than first time root treatments and specialist equipment such as microscopes give best results. 

There are virtually no specialist endodontists (root treatment specialists) who work in the NHS. 

If you need specialist treatment it will have to be private in the vast,vast,vast majority of the U.K.

The price quoted is about average for a multi rooted (back) tooth. 

Crowns are a walk in the park compared to root treatment which is , basically, microsurgery done blind working at fractions of a millimetre in a tiny , confined area .

Undervalued

Sadly there is no doubt some NHS dentists wrongly duck out of doing straightforward root canal treatments, which should be provided as a band 2 treatment. However, they are entitled to refuse those that are complex and need equipment and expertise beyond the level expected of a general dentist. It sounds as though the treatment you are describing is in that category, so the NHS dentist is entitled to decline.

Obviously she could try another NHS dentist who might take a different view, although I suspect that is unlikely. Even if they did would she be willing to "take a punt" on a less than ideal treatment?

What the dentist can't do, under the NHS rules, is say that they can't do it on the NHS but can magically do it if she pays privately! They can (amazingly) refer it to another dentist in the same practice for private treatment, which does always seem a bit of a "Chinese wall".

brook2jack2

Welsh dentist , on this forum, works , or at least worked , in an NHS practice. 

They spent thousands of pounds and a long time gaining training and qualifications in specialist root canal (endodontic ) training. They then spent tens of thousands buying a microscope and equipment to provide specialist treatment. They will continue to spend thousands on training and equipment. 

Why should a colleague , in the same practice , not refer a patient to Welshdentist? 

Is it the dentists fault that the NHS cannot afford, and does not pay for specialised root treatment , that it does not consider spending hundreds of pounds on saving one tooth a good use of public money? The very,very,very limited NHS endodontic budget is normally saved for those , because of radiotherapy to jaws, or taking certain medications , taking a tooth out could be life threatening. 

To put into context a single capsule of specialised cement to help fill up a canal (mdta) on its own will cost £90 , the cost of running one room per hour will cost £160 minimum and complex root treatment can take several visits and several hours. 

A dentist can and will be found negligent if they attempt root treatment that should be referred to a specialist , even if no specialist is available on the NHS. Here is an idea of how difficulty is assessed https://endomishra.co.uk/wp-content/uploads/2021/04/Difficulty-assessment-form.pdf

shandyclover

Thank you for clarifying things for me. There wasn't a lot of information regarding re root canals on the NHS website, to the layperson it seems if it can be done once on band 2 - it can be done again - but obviously that's the misunderstanding. DD is lucky she has an NHS dentist to go to. The dentist has offered to temporarily fill it - giving her time to sort her finances a bit. She's been referred to a specialist endodontist in another practice. It's been a wakeup call to all of our family of now adult children, who are generally in very good health and don't have a habit of sweets and fizzy pop - but have neglected their check ups. This particular DD has that condition where she has less enamel than normal (sorry forgot the correct term), which may have exacerbated the situation. Thanks for taking the time to give us information.

welshdent

brook2jack2 said:

A re root treatment is almost always done by a specialist , as success rates are far lower than first time root treatments and specialist equipment such as microscopes give best results. 

There are virtually no specialist endodontists (root treatment specialists) who work in the NHS. 

If you need specialist treatment it will have to be private in the vast,vast,vast majority of the U.K.

The price quoted is about average for a multi rooted (back) tooth. 

Crowns are a walk in the park compared to root treatment which is , basically, microsurgery done blind working at fractions of a millimetre in a tiny , confined area .

I like to think of it as painting a hallway through a letterbox

welshdent

brook2jack2 said:

Welsh dentist , on this forum, works , or at least worked , in an NHS practice. 

They spent thousands of pounds and a long time gaining training and qualifications in specialist root canal (endodontic ) training. They then spent tens of thousands buying a microscope and equipment to provide specialist treatment. They will continue to spend thousands on training and equipment. 

Why should a colleague , in the same practice , not refer a patient to Welshdentist? 

Is it the dentists fault that the NHS cannot afford, and does not pay for specialised root treatment , that it does not consider spending hundreds of pounds on saving one tooth a good use of public money? The very,very,very limited NHS endodontic budget is normally saved for those , because of radiotherapy to jaws, or taking certain medications , taking a tooth out could be life threatening. 

To put into context a single capsule of specialised cement to help fill up a canal (mdta) on its own will cost £90 , the cost of running one room per hour will cost £160 minimum and complex root treatment can take several visits and several hours. 

A dentist can and will be found negligent if they attempt root treatment that should be referred to a specialist , even if no specialist is available on the NHS. Here is an idea of how difficulty is assessed https://endomishra.co.uk/wp-content/uploads/2021/04/Difficulty-assessment-form.pdf

The practice is still NHS but I am not anymore. I used to be able to dabble and see a few NHS patients when I had space but when contract reform came in it was no longer an option for me. Aside from my ethical objections to the contract, it is no longer possible for me to see a few routine patients due to the obligation to see new patients. Our practice typically is in a high need area. I simply do not have the time available to see at least one new patient per day to meet targets and then manage their current and on going needs. Had to give up being an ES too!!

But yep getting to where I am is completely self funded. I have had zero assistance in training or equipment from the NHS/ Healthboard. I paid for the qualifications, the courses and the essential equipment. I offered to take referrals from their Waiting list when I finished my diploma but that was not followed up by them. So I do my own thing and try and keep my fees down as much as I can to be more affordable to more people. I appreciate it isnt "free" but while I love endodontics, I still have to pay the mortgage of not just me, but my nurse too!!