Gum disease - How do the dentists charge?

cybervic

Hi all,

A friend of mine recently visited a dentist under NHS and was told she has got a gum disease. (she's been having some bleeding and pus on the gum every now and them). The dentist said she needed to visit a hygienist 4~8 times and each visit would cost her £45. Her understanding is that visiting the hygienist is the treatment for gum disease, is this correct? I thought the treatment should involve something more than just "cleaning?"

She also thought she was paying the NHS price until yesterday when I told her about the band 1~3 charges under NHS. She was sure the dentist has never mentioned anything about seeing the hygienist privately. We're wondering if it is normal for dentists to change the service from NHS to private without telling patients?

Also, does anyone know if gum disease treatment is covered under NHS. if so, what should she be expecting?

Any opinions/suggestions/advices is much appreciated!
Thanks in advance.

floyd

I can only answer the first part about treating gum disease. Visiting the hygenist IS the first line of treatment for gum disease as the pockets and inflammation arise because of bacteria that are stuck below the gumline so a deeper clean is needed to remove the buildup. It is also possible that there is calculus below the gumline that the bacteria stick to so it is harder to brush away. This can be removed with a manual dental probe or an ultrasonic cleaner (I had both).

I had 12 months of deep scaling (root planing) that was done by a hygenist at my local dental hospital after I was referred from my own dentist (private Denplan).

If your friend responds well to this cleaning, she may not require any other intervention than maintaining through cleaning at home, possibly using interdental brushes as somethimes when the inflammation reduces, there are larger spaces between the teeth.

Sorry I can't advise on cost as I am a Denplan patient so I didn't pay a penny extra for any of my treatments, surgery (gum-flap procedure and wisdom teeth removal) or x-rays

Toothsmith

If your friend was accepted as an NHS patient, then she is entitled to have anything wrong with her teeth treated under the NHS.

If she has a gum condition that requires several good cleans to get right, then that should happen under either the 15.90 NHS price, or, more likely the 43.60 price. (The classification is a bit grey for cleans or intensive cleans).

Paying 45.00 per appointment is a private fee, and should not have been charged.

Unfortnately, this sort of thing does seem to happen quite a lot on the NHS, as the new NHS contract as written is practically unworkable if a dentist wants to stay in business.

The bottom line, though, is that if a dentist cannot operate properly on the NHS, then he/she shouldn't have signed a contract saying they would. It does nothing to help the problem of NHS dental provision in this country if all it is is a sham.

Your friend is entitled to ask for any amount of money over 43.60 back, and she should have a word with the local PCT if the dentist refuses to do this.

alison999

Toothsmith wrote: »

Your friend is entitled to ask for any amount of money over 43.60 back, and she should have a word with the local PCT if the dentist refuses to do this.

though i agree i hope none of the patients at my work read this or i'll be having a lot of "bad days"!

Toothsmith

That's a good point - it's the dentist who's not playing ball. His staff are just doing what they're told. Be nice with them!!

cybervic

THANK YOU, floyd, for a detailed explanation.

Toothsmith, thanks for the reply though I have more questions .
Do dentists do the cleaning for treating gum disease or is it strictly hyginest's jobs? Is there a NHS hygienists available? (just want to know what my friend can do if her dentist told her that she needed to be referred and the only hygienists available is private service.)

Also, does the NHS contract you've mentioned require dentists to carry out the necessary works under NHS if the patient is first seen under NHS?
I have been rejected a NHS root canal treatment about 14 month ago because my dentist (now ex-dentist) didn't think NHS pay her enough to do the job. My option then was to either change to another NHS dentist (which I did) or go private, and I wasn't very happy about it. I had spoken to my local PCT and they couldn't do anything. Has the rule changes now?

Toothsmith

If you are an NHS patient and you NEED a particular treatment, then you are entitled to it on the NHS.

Dentists are perfectly capable of treating gum disease, they just generally employ hygienists to do it for them so that they can concentrate on the more complex treatements. If the dentist only wants to send people privately to the hygienist, that's up to him, but somebody has to treat the problems on the NHS.

If dentists can't work the NHS contract as written, then they shouldn't have signed it.

I'm surprised the PCT was so laid back about this.

afm_2

I had exactly the same problem this week.

I have complained to my dentist about bleeding gums for the second time. He told me that my gums are much better now than in the previous appointment, but that I had to see an hygienist every 3months. I have followed everything he told me in the previous appointment. I have even bought a very good eletrical tooth brush, changed to sensodyne as he told me, and bought interdental brushes (and used them, of course ). Because I tried really hard, my gums are better, but now he decided that I needed to see an hygienist immediately.

The appointment with the NHS dentist was last week, and this week I went to the hygienist as I've been told to. I thought she would do something amazing but I was shocked when she only did a cleaning, a polish and told me that my gums were not that bad. It was a 10minute appointment and I had to pay £25. I really feel ripped-off and he even wants me to go to the hygienist every 3 month; which means £25 every time I go there.

I read that you only have to pay once for the treatment of a certain problem; even if it takes more than one appointment to fix it. So, shouldn't I just pay one of the NHS charges and get a full treatment for my gum disease? Also, isn't a cleaning and a polish included in a check-up?

I paid £16.20 + £25 in less then one week to treat one problem. It would be ok if that included all the sessions that I need with the hygienist but it doesn't. Also, in the check-up, the dentist has only looked to my teeth for one minute. He did nothing to my teeth. I think that, if I am entitled to a cleaning and polish in a check-up, then these extra £25 could have been avoided. I feel deceived. It is very expensive to me (and to most of us) to go to the dentist but even so I go there because I want to prevent problems. Now I feel that I shouldn't go there anymore for the regular check-ups.

Can anyone please give me advice on what should I do? I have sent an email to NHS regarding this and I really want to know my rights. I feel that my dentist is always rushing me out of his office and after this I feel that he must be making fun of me.

I would really appreciate to hear your opinions.

All the best,
afm

Toothsmith

Get in touch with the PCT dental person and let them know what has happened.

The £25 isn't an NHS charge. You have been charged privately to see the hygienist - and if you need to have your teeth cleaned so frequently, then somebody should do it on the NHS. Either a hygienist or the dentist.

Plus - 10 mins with a hygienist for £25.00 is rubbish! Admittedly, it's £68.00 for one of my hygienist appointments, but that's always a full half hour, and with me being purely private, nobody comes to me thinking it will be NHS and then gets stiffed with 'extras'.

alison999

afm wrote: »

I had exactly the same problem this week.

I have complained to my dentist about bleeding gums for the second time. He told me that my gums are much better now than in the previous appointment, but that I had to see an hygienist every 3months. I have followed everything he told me in the previous appointment. I have even bought a very good eletrical tooth brush, changed to sensodyne as he told me, and bought interdental brushes (and used them, of course ). Because I tried really hard, my gums are better, but now he decided that I needed to see an hygienist immediately.

The appointment with the NHS dentist was last week, and this week I went to the hygienist as I've been told to. I thought she would do something amazing but I was shocked when she only did a cleaning, a polish and told me that my gums were not that bad. It was a 10minute appointment and I had to pay £25. I really feel ripped-off and he even wants me to go to the hygienist every 3 month; which means £25 every time I go there.

I read that you only have to pay once for the treatment of a certain problem; even if it takes more than one appointment to fix it. So, shouldn't I just pay one of the NHS charges and get a full treatment for my gum disease? Also, isn't a cleaning and a polish included in a check-up?

I paid £16.20 + £25 in less then one week to treat one problem. It would be ok if that included all the sessions that I need with the hygienist but it doesn't. Also, in the check-up, the dentist has only looked to my teeth for one minute. He did nothing to my teeth. I think that, if I am entitled to a cleaning and polish in a check-up, then these extra £25 could have been avoided. I feel deceived. It is very expensive to me (and to most of us) to go to the dentist but even so I go there because I want to prevent problems. Now I feel that I shouldn't go there anymore for the regular check-ups.

Can anyone please give me advice on what should I do? I have sent an email to NHS regarding this and I really want to know my rights. I feel that my dentist is always rushing me out of his office and after this I feel that he must be making fun of me.

I would really appreciate to hear your opinions.

All the best,
afm

can i just ask why you didnt ask BEFORE you paid, or after your hygienist when you went to pay for it? also, just b/c your dentist says you should see the hygienist every 3 months doesnt mean you HAVE to. he cant refuse to see you b/c of that.

afm_2

Toothsmith, many thanks for replying to my message. I have sent a message to my local PCT. Let's see what they say.

alison999 wrote: »

can i just ask why you didnt ask BEFORE you paid, or after your hygienist when you went to pay for it? also, just b/c your dentist says you should see the hygienist every 3 months doesnt mean you HAVE to. he cant refuse to see you b/c of that.

Why should I ask something? Shoudn't the dentist do the best for me?That's what I've paid him for.
Anyway, I wasn't sure of the NHS rules so I couldn't ask much.

Of course I don't have to do everything that my dentist says but if he says that I have gum disease and that I need to treat it by going to an hygienist every 3 months, then of course I'll go. I have to treat the problem before it gets worse. What's the point in going for a check-up if your not going to treat the problems you have?!?!

It's not about him refusing to see me. It's about taking care of my teeth. That's why I went for a check-up in the first place!

What matters here is if the dentist did or not did what he should and what is his obligation. I've paid for a consultation in which the cleaning and the polish is included. I shouldn't have been told to go there again and pay more. That's what really matters .