Root Canal needed but my NHS dentist won't do them

Roy1234

My dentist still only does NHS.  In his fifties I think, he says he has resisted the trend to go private later in his career, perhaps partly due to his locality.  He's in a poor area where two thirds of his patients are on benefits, and for those who do pay, for extraction is the common choice over a crown etc, as much cheaper.  He tells me half of the UK doesn't even go to the dentist.  If the NHS is in trouble, its dentistry wing feels like an early vision of the future.

welshdent

Speaking as someone whose day job is 90% root canal treatment and assessments for it - its not a simple procedure. Nor is it cheap. We spend anywhere from 3-5000 a month on JUST treatment files. 

But they DO work well. I saw someone I treated 5 years ago by chance today. It was a difficult tooth to treat but its working great with zero issues. 

They need time, patience and copious disinfection. The NHS barely pays for a filling on top let alone the procedure. Its disgusting how little value it places on this procedure. 

There are no easy teeth. All have their own challenges. Most go fine because with experience you can figure out the quirks. But most days something will challenge you. Someone like myself that does them all day long has seen enough to manage most scenarios but a dentist without the equipment may not have all the equipment and experience to do this. If your dentist is telling you that they arent comfortable doing it - I would be inclined to take them at their word FWIW

Roy1234

welshdent said:

Speaking as someone whose day job is 90% root canal treatment and assessments for it - its not a simple procedure. Nor is it cheap. We spend anywhere from 3-5000 a month on JUST treatment files. 

But they DO work well. I saw someone I treated 5 years ago by chance today. It was a difficult tooth to treat but its working great with zero issues. 

They need time, patience and copious disinfection. The NHS barely pays for a filling on top let alone the procedure. Its disgusting how little value it places on this procedure. 

There are no easy teeth. All have their own challenges. Most go fine because with experience you can figure out the quirks. But most days something will challenge you. Someone like myself that does them all day long has seen enough to manage most scenarios but a dentist without the equipment may not have all the equipment and experience to do this. If your dentist is telling you that they arent comfortable doing it - I would be inclined to take them at their word FWIW

What you say makes a lot of sense.  The NHS has killed root canals via it's pricing, although it sounds like even the top band of £319 wouldn't help much.  But it does leave Joe Public in a hell of a dilemma.  Just who do you use privately and how much is fair?  I was shocked by the £1,300 (root+crown) quote of a few years back, but in a random conversation yesterday with a friend who also needs a root canal & crown, and who assures me the dentists he uses are not 'posh', I learned he had two quotes for his work of £2.5k and £3.5k.  The cost of an implant or more in fact.  Are these figures reasonable?  Better work than one half that price?  The general public is now left making impossible choices at prices many will find unaffordable.

welshdent

I agree that it doesnt help the public. The frustration I have is that anger is very often directed at the dentist not the elephant in the room - namely politicians of both sides and all UK governments (devolved and otherwise). 


Price wise it varies a lot. Depends on where in the country you are, what levels of training the dentist has and what materials they use. Crowns depends on material choice as well. 
I would imagine that the 3.5K is a tad on the high side mind. Probably the 2.5K is maybe on the upper end too but I hjave no idea what their overheads are. Id expect the implants to be more though. The impact of the budget has yet to kick in too so I would expect prices to rise soon to cover the extra charges. 

Spoonie_Turtle

welshdent said:

I would imagine that the 3.5K is a tad on the high side mind. Probably the 2.5K is maybe on the upper end too but I hjave no idea what their overheads are. Id expect the implants to be more though. The impact of the budget has yet to kick in too so I would expect prices to rise soon to cover the extra charges. 

Slightly off topic but I will be having a private crown at some point (NHS one fallen out twice, dentist was going to recement it but a comment he made under his breath about them being so thin whilst taking the old cement off prompted me to ask about a private one) - is this something likely to be affected and if so how soon will the prices rise?  I had a rough quote but nothing specific agreed.

welshdent

Every practice is different re price rises. I suspect they review them annually but I know we are looking to review ours in April. It would be worth checking with them to see how long they would honour a treatment plan quote for

Spoonie_Turtle

welshdent said:

Every practice is different re price rises. I suspect they review them annually but I know we are looking to review ours in April. It would be worth checking with them to see how long they would honour a treatment plan quote for

Thank you.

brook2jack2

To expand , slightly, dental inflation is running at above 10% a year ie the cost of materials , laboratory fees utilities etc is increasing by this a year. On top of, this year , will also be increase in national insurance for staff. 

Many labs will now either refuse to do NHS work as they can no longer make it pay, or are closing as technicians are becoming older and there are not the new technicians coming in to replace them in what is a very highly skilled job ,requiring at least 5 years to train , that is very underpaid. 

As a slight aside the below dental inflation  4% NHS fee increase agreed from April 1st last year has still not been paid to most practices . Just when you thought the total disregard of government of NHS dentistry couldn’t get any worse. 

Roy1234

brook2jack2 said:

To expand , slightly, dental inflation is running at above 10% a year ie the cost of materials , laboratory fees utilities etc is increasing by this a year. On top of, this year , will also be increase in national insurance for staff. 

Many labs will now either refuse to do NHS work as they can no longer make it pay, or are closing as technicians are becoming older and there are not the new technicians coming in to replace them in what is a very highly skilled job ,requiring at least 5 years to train , that is very underpaid. 

As a slight aside the below dental inflation  4% NHS fee increase agreed from April 1st last year has still not been paid to most practices . Just when you thought the total disregard of government of NHS dentistry couldn’t get any worse. 

Through my work connection with this industry, I am well aware that dental lab technicians are the Cinderellas of the dental world.  As you say, a highly skilled but poorly paid job, whilst I was always told that some dentists may play them off against each other down to the penny for the work they do.  It is increasingly hard to get any young person to do a physical job, just look at the lack of young people entering the building trades.  Life behind a Laptop and a nice hybrid Work from Home number, with little commute, seems the new desired normal, whilst 5 days a week at work and dirty hands is almost an affront to many young people.

Yes it seems like dentistry is being allowed to quietly die, or at least fall to the private sector for those who can still afford it.