Need info about private dentists - costs etc

november

Bit of background. Added at end - Sorry its turned out to be a long background so feel free to skip it all and go straight to the questions if you like

I am dental phobic having had a couple of bad experiences, once as a small child and once as an 18 year old.

I had an NHS dentist about 10 years ago who went private and I couldn't afford to pay as I was a single mum at the time. I haven't been to the dentist since. I moved and there were no NHS dentists there and then moved again and haven't 'got round to sorting it out'

I did when I moved here enquire about NHS dentists and there were 2, one of whom is still accepting patients I believe. However, given that I am quite irrational when it comes to dentists and need to build up a good professional relationship with one (like I had before with my NHS dentist who was very patient and who I trusted) I have discounted both of those. One because they send people elsewhere for some stuff so I couldn't necessarily just see the one person and the other because they are on the top floor of a building and I have vertigo (physical not fear of heights) and don't want to deal with that on top of a phobia.

There is also one private dentist nearby. It has just occured to me that maybe if I am paying I will feel more 'in control' (like I do with my chiropractor). I think I am better off with a very local one because distance may be all the excuse I need not to go and I really need to go now. I have just discovered I have a raw nerve in my back tooth

I know I need quite a bit of work doing - I have the broken tooth which is now flashing nerve (one side) plus another on that side which feels 'tetchy' (a hole probably) and a very old capped tooth which plays up (other side).

I DON'T want to embarrass myself by going in and then finding I have to go home again as its too expensive Plus if anything puts me off I'll be back to square one (not thinking about it)

Questions as follows:

1) How much is it likely to cost? I mean how much is a check up and how much is, say, capping a tooth for example?

2) Do different dentists charge different amounts e.g. you have to shop around for the cheapest as well as the best or are they are pretty similar by location (where in country)?

3) What if I go in and they say I need 3 things doing but I can't afford all of them at once? Are they likely to insist I have it all done (like the NHS) as they say I need it? Or can I do the most urgent thing first then go back when I can afford the rest?

4) Do private dentists charge by appointment (for check ups) or strictly by time - what I mean is if I make an appointment just to 'settle in' but feel unable to let them do anything so have to go back when I've got the nerve up I am fine with paying for that appointment as I've still had it but will it affect the cost if I have to go and calm down for 10 minutes during an appointment?

5) Do private dentists like NHS dentists make you go for check ups ever so often? If so how often is it? (as that would be a regular outgoing to budget for)

5) Is it cheaper to pay on a credit card for what you have done or join one of those plan things?

6) If a plan thingy is better are they limited like medical ones e.g. exclude any known conditions (which is probably most of my teeth so useless )


All advice gratefully received. I really must do something before I end up with personal worst case scenario - the NHS dental hospital for emergencies :eek:

Toothsmith

november wrote:

Questions as follows:

1) How much is it likely to cost? I mean how much is a check up and how much is, say, capping a tooth for example?

2) Do different dentists charge different amounts e.g. you have to shop around for the cheapest as well as the best or are they are pretty similar by location (where in country)?

3) What if I go in and they say I need 3 things doing but I can't afford all of them at once? Are they likely to insist I have it all done (like the NHS) as they say I need it? Or can I do the most urgent thing first then go back when I can afford the rest?

4) Do private dentists charge by appointment (for check ups) or strictly by time - what I mean is if I make an appointment just to 'settle in' but feel unable to let them do anything so have to go back when I've got the nerve up I am fine with paying for that appointment as I've still had it but will it affect the cost if I have to go and calm down for 10 minutes during an appointment?

5) Do private dentists like NHS dentists make you go for check ups ever so often? If so how often is it? (as that would be a regular outgoing to budget for)

5) Is it cheaper to pay on a credit card for what you have done or join one of those plan things?

6) If a plan thingy is better are they limited like medical ones e.g. exclude any known conditions (which is probably most of my teeth so useless )


All advice gratefully received. I really must do something before I end up with personal worst case scenario - the NHS dental hospital for emergencies :eek:

Answers
1&2

It is a bit like saying "How much does a car cost". Prices can vary considerably.

It is all pretty time dependent though. The cheaper the prices the less time a dentist is likely to be able to spend with you.

A dental practice has running costs. The building costs money to buy and upkeep, the equipment costs (A lot!) of money to buy and maintain. The staff want wages (Nomatter how often I tell them they should pay me for the privilege of working with me!) etc etc.

The ONLY time a practice is earning money is when a patient is occupying the chair. (Which is why we get crabby about missed appointments!)

Now, in the same town, the building costs will be pretty similar, and the equipment costs will be pretty similar too. However the costs may still vary as different practices may have different levels of staffing. (An extra receptionist may mean smoother functioning at the desk at busy times which would give a much more professional feel to the practice, and, a more relaxed and welcoming telephone manner - but you, the patient, will be paying for that). Qualified dental nurses are more expensive than ones the dentist has just trained himself to hold an aspirator and mix materials, however they will be much better with patients (particularly with nervous ones) and again add something to the 'feel' of the practice. Again though, it is the patient that pays their wages in the end. Materials can also vary in quality and price.

On top of all that, a practice can make it's fees cheaper if the dentist is prepared to get through more work in a day. So although this is most likely a lot better than an NHS conveyor belt, it is still likely to feel a bit rushed. OK if you're an 'in and out' sort of patient, but the relationship is likely to become a bit strained if you're not.

If you need ball park figures though, I would say an initial check up is likely to cost between £35 and £90 depending on the practice and what is included in the 'package' (eg, an initial exam with me is £75, but that includes any necessary x-rays - some places may be cheaper, and charge an additional fee for x-rays). Crowns could vary from £100 ish to over £1000 again depending on the type, practice and position in the mouth)


3

You are the patient and you are in control! Remember that!

There will always be options. Some things may be able to be done temporarily to put you on until you can afford the proper job. Bear in mind you would have to pay for the temporary thing and then the proper thing though - so it might work out a bit dearer in the long run. But the key is to discuss things. don't just nod and then run a mile afterwards. that won't help you, and the dentist will wonder why you haven't come back when everything seemed to be going so well!

You could consider a loan to get the work done. Interest rates are low at the moment, and getting it all sorted now with a loan may be cheaper in the long run - even after interest charges - than getting bits shored up and waiting 'till you've saved up.

4

It varies. But you should find out in advance what the system is.

To be brutally honest, it has been shown that nervous patients calm down a whole lot quicker when they know they are paying for their 'panic time'

Personally, my price list is based on what time I usually take for the set proceedure. My day is such, and my prices enough, that I can have a little leaway. What I tend to do, is if a patient is straightforward to treat, and we get lots done at each appointment, I tend to discount the price. That way, patient thinks I'm a very good bloke, and relationship is strengthened.

If I get a nervous patient, who fidgets about a bit, then again, that's fine, we slow down and take it at his/her pace and they're still only charged what was on the estimate in the first place. So again, patient thinks I'm a good bloke, and relationship is strengthened. The more often the patient comes, the better they generally get, then discounts start slipping into the bills, and patient thinks I'm wonderful.

If I get a patient who keeps missing appointments, is awkward to me or my staff, and generally makes a right pain in the a**e of themselves, I suggest that they would be better off at Mr Fangfettlers practice on the other side of town!

5

The cheapest way to look after your teeth is to have regular care. Not only because things caught early are cheaper to fix (I did a tiny filling for a patient FREE at their check up yesterday :j ) but also because the more frequently you go, the less you will be worried about it, and the less you are worried about it, the cheaper your care is likely to be!

How often will be down to your dentist, but I would probably have you back 4 monthly to start with going up to 6 monthly as things stabilised.

Many dentists offer monthly payment schemes to cover routine stuff though.

6 (You had 2 5's!)

Ask your dentist. Some prefer fee per item, some have a scheme thingy.

7

To join a dental plan you have to be 'dentally fit' that is, you've had all the initial work done and everything has been fixed.

The plan will then normally cover the maintenance if your mouth. So if a filling breaks it will be replaced, if a tooth needs crowning you will only be charged the technicians fee (Considerably cheaper than the full fee) i.e how much it cost to 'make' the crown.

There may be some 'exclusions' to the cover, but that is only likely to be stuff that the dentist has said needed doing, but you wanted to put it off for the time being. E.g if the dentist had said that a big filling looked a bit dodgey and needed crowning, but you said 'well it's been like that for 20 years and never given any trouble. - The dentist may well say, that's fine then, but I will exclude it from cover for the next 5 years. This is just so that if the filling then breaks the week after, the dentist isn't financially responsible for fixing something he thought was about to break anyway!

Hope this has been helpful.

For finding a dentist in the first place, I would always go with the recommendations of friends or family definitely not price!

Don't be afraid to visit the practice and even meet the dentist before making a committment. See what the fees are, how they work them out, does the practice look like it's had the money from the fees spent on it - or is it run down but there is a very nice Porsche outside. If the practice looks good AND there is a Porsche outside that's fine, (But it's not mine - honest ) there's nothing wrong with the dentist making money so long as his practice is invested in as well!

Most importantly, get into the habit of going regularly! It IS cheaper in the long run.

Best wishes

T.S.

november

Toothsmith wrote:

Answers
1&2

It is a bit like saying "How much does a car cost". Prices can vary considerably.

It is all pretty time dependent though. The cheaper the prices the less time a dentist is likely to be able to spend with you.

That makes sense.

If you need ball park figures though, I would say an initial check up is likely to cost between £35 and £90 depending on the practice and what is included in the 'package' (eg, an initial exam with me is £75, but that includes any necessary x-rays - some places may be cheaper, and charge an additional fee for x-rays). Crowns could vary from £100 ish to over £1000 again depending on the type, practice and position in the mouth)

But unfortunately I think £1000 would be way over what I could afford so I shall keep my fingers crossed.

3

You are the patient and you are in control! Remember that!

Thanks I think thats why I am after info as being in control makes me feel better. Hence my looking for a private one as my having choice is important - my having to pick the only dentist still taking NHS patients just makes me feel 'choice-less'. I also like dentists who will discuss things rather than tell me what they will do and I promise to try not to run a mile

You could consider a loan to get the work done. Interest rates are low at the moment, and getting it all sorted now with a loan may be cheaper in the long run - even after interest charges - than getting bits shored up and waiting 'till you've saved up.

Unfortunately I already have a loan and a cc balance (hence my finding this place ). I am credit worthy though and do have payment sorted but am not debt free yet. You are right though it may still be worth me getting a 0% card for this as I've closed a couple lately and am down to 2 (one with my balance on and one for spending and paying off monthly).

4

It varies. But you should find out in advance what the system is.

To be brutally honest, it has been shown that nervous patients calm down a whole lot quicker when they know they are paying for their 'panic time'

Makes no difference to me actually - I'm a genuine irrational full blown panic attacker Given time though I do know how to control it and can.

The more often the patient comes, the better they generally get

Thats generally true with me. I was fine with my previous years ago NHS dentist but only with him because I 'knew' him.

If I get a patient who keeps missing appointments, is awkward to me or my staff, and generally makes a right pain in the a**e of themselves, I suggest that they would be better off at Mr Fangfettlers practice on the other side of town!

I wouldn't dream of it. Very polite punctual person me

5
but also because the more frequently you go, the less you will be worried about it, and the less you are worried about it, the cheaper your care is likely to be!

True and to tell you the truth I wouldn't be so bad now if I had been able to find another dentist after my NHS one went private and then found there were none when I moved again. It was all too easy to get 'out of the habit' and back into full fledged fear of going. (Note I am not allocating blame to the dentists for the NHS/Private scenario).

6 (You had 2 5's!)

Well my excuse is I get nervous even thinking about it never mind typing about it. Last time even checking out the Yellow Pages bought on a weeks worth of nightmares

7

To join a dental plan you have to be 'dentally fit' that is, you've had all the initial work done and everything has been fixed.

Thats that idea out of the window then - its more like 'find the whole tooth' in my mouth at the moment

Hope this has been helpful.

Yes very helpful thank you

For finding a dentist in the first place, I would always go with the recommendations of friends or family definitely not price!

I have no family in this area. I don't know that many people locally due to having always worked full-time while living here although I now know a few more than when I first moved so I will see if they have any recommendations.

Don't be afraid to visit the practice and even meet the dentist before making a committment.........

Thanks for telling me you could do that. I wasn't sure if it was welcomed or not having only had the 'this dentist will take you' option before

Most importantly, get into the habit of going regularly! It IS cheaper in the long run.

Aha now you do sound like a dentist No doubt by the time my knashers are fixed I will have been going regularly for some time

Many thanks once again. It may sound stupid but even talking to a dentist online on a discussion board helps me remember they are human too

Toothsmith

november wrote:

But unfortunately I think £1000 would be way over what I could afford so I shall keep my fingers crossed.

That is a very 'top end' price

november wrote:

Thanks for telling me you could do that. I wasn't sure if it was welcomed or not having only had the 'this dentist will take you' option before

What I was really meaning was go to the practice to make your enquiries rather than ring up. You'll pick up so much more about the place being there in person. Don't worry, you won't be dragged into the chair!!! If they happen to have a spare appointment whilst you are there, say 'my bus goes in 5 mins' or 'I'm meeting somebody in a couple of minutes' - unless of course, everything checks ot to your satisfaction, and your happy with the prices, then just go with the flow. It'll save worrying about it for days beforehand!

Savvy_Sue

november wrote:

I DON'T want to embarrass myself by going in and then finding I have to go home again as its too expensive Plus if anything puts me off I'll be back to square one (not thinking about it)

By the sound of it, a private dentist should not have a problem with you asking what they charge, what it's for etc etc etc and you then comparing prices with the competition. So going for a visit with a planned 'script' in your head which makes it clear you are just doing your research at the moment and not necessarily ready to sign on the dotted line straight away should be acceptable.

I've got an NHS dentist, but tbh I'm not that impressed, and with what Toothsmith and Down in the Mouth keep saying I start wondering if I'd be better off biting the bullet and going private. I could possibly even stay within the same practice and I wonder how much work I'd be told I needed to become 'dentally fit' if I decided to do that!

november

I was wondering about NHS & private dentists too Sue. Two of the ones round here having checked the Yellow Pages seem to do both. Whats the difference? Do you get a better service if you pay?? The other one is private only. There are only 3 dentists in my immediate locality.

The whole thing took on an urgency this morning when I came downstairs and my broken tooth shouted at me - hurt so much it made me feel sick. Two paracetols later and I can see again (I rarely take painkillers - can't remember the last time I took 2). I'd forgotton how much teeth can hurt Trouble is when they hurt that much I don't want to go because I know if they touch it I will go through the roof I hope they still don't poke everything with a metal spike, I used to hate that.

I think I may need to take some time off Monday to find a dentist but still can't decide which one of the 2 to check out first (the private only or NHS and private). I've definately discounted the one which has small offices high up as I can't face their building even though they may be good. When I've asked people before (only 2 I'm a bit limited in people I know) one used one NHS one and the other the other which was no help. I think I may have to phone the 2 I haven't discounted and call in to see how much they charge/what the atmosphere is like/how sympathetic they seem.

Thanks for all your help Toothsmith. I don't think I've got days to worry about this now anyway

Toothsmith

november wrote:

I was wondering about NHS & private dentists too Sue. Two of the ones round here having checked the Yellow Pages seem to do both. Whats the difference? Do you get a better service if you pay??

I have my own opinions on practices that do both private and NHS.

It is very difficult to do both.

There are certain things that can be done 'privately' such as crowns and dentures where there is a distinct difference in quality if you pay more.

White fillings in back teeth is also something that's not available at the moment on the NHS (but come the new contract - nothing is excluded. One of the many reasons it is going to fail.)

My personal feeling though is that a 'private' practice is more about the service level and time spent with patients. This is not really something that can be turned on for one patient then switched off for the next.

I do see the children of my private patients on the NHS as a 'loss leader'. I subsidise their care from the private side of the practice.

The problem on the horizon is that after April, the idea of beng a registered NHS patient is disappearing.

My NHS contract, if I was going to accept one, would be based on the amount of treatment I had done on the NHS in the past, but I would not have full control over who I gave that treatment to.

So, say for example I have spent 150 hours treating children last year. After April, I would be contracted for 150 hours of NHS treatment.

If my PCT sees patients with toothache as a bigger priority to check ups for basically healthy children, they would have the right to ring me up and ask me to see someone who had contacted NHS direct with a toothache. That person could be better off financially than my 'private' patients, but I would still have to treat him on the NHS. This is because I would not, by the terms of the new contract be allowed to discriminate on the grounds of age or 'ability to pay NHS fees'.

I would retain the right to say no - so long as I am 'at capacity' although God knows what that means!

If I said no too often though, the PCT could have a look at who I was seeing on the NHS, and if it were all children, then I would be up a well known creek!

So, these toothaches would eat up some of my NHS time. So come the end of the year, I could be in the position of having to tell some regular patients that I couldn't see their kids on the NHS until the start of April when I was allotted my new quota of hours!

This is going to force dentists to think which side of the fence they want to live on.

If they stay NHS, they will have to see virtually anybody, provide everything they need, with little opportunity to do anything private.

If they try to stay mixed, it will be increasingly difficult to choose which patients they offer their NHS hours to, and this may lead to resentment amongst the regular patients, which could destroy the 'goodwill' of the practice.

I forsee a large amount of dentists jumping off the NHS ship altogether and going purely private. It's what I'm in the process of doing at the moment. For me, they could withdraw this contract tomorrow, and I would still carry on with my move into purely private practice. I'm sick of lying politicians trying to tell me how to do my job.

Rant over!

november

Toothsmith wrote:

I have my own opinions on practices that do both private and NHS.

It is very difficult to do both..............My personal feeling though is that a 'private' practice is more about the service level and time spent with patients. This is not really something that can be turned on for one patient then switched off for the next.

Thats what I was thinking. If I am paying because I need a bit of 'cosseting' rather than rushing and am willing to pay I want to know I'm not just paying extra for exactly the same thing that I could be getting on the NHS.

There are certain things that can be done 'privately' such as crowns and dentures where there is a distinct difference in quality if you pay more.

I've heard of that before - is that where NHS patients can pay extra to have e.g. a white filling.

If my PCT sees patients with toothache as a bigger priority to check ups for basically healthy children, they would have the right to ring me up and ask me to see someone who had contacted NHS direct with a toothache.

Don't mention toothache. I think my weekend has just been written off as I'm in agony nubbed only by swallowing parocetomal and I can still feel my neck and face thumping but at least the feeling of someone stabbing me with hot irons has subsided somewhat.

I'm sick of lying politicians trying to tell me how to do my job.

Rant over!

Thats OK. My sis works for the NHS (hospitals rather than dentist) so I'm used to it Anyway seems only fair you have a chance to rant having given me so much useful advice.

I've just asked a friend of my daughter's. Seems like most people round here use the NHS one which according to their ad also takes Denplan and private. Now part of me is thinking they must be OK because of this, part of me is thinking 'yeah but they are the most accessible and NHS so they would be busier, and another large part is shouting 'Blinkin heck they must be really busy (this is a very very large estate) so how much time have they got per person.

Don't know anyone that uses the private practice but I may start with them. At the moment I definately feel like I would pay for sympathy and efficiency and last but not least lots of skill with not causing additional pain rather than be rushed in and out.

Part of my phobia by the way was caused by a child (me) misunderstanding something. The rest was caused by a NHS dentist I saw for emergency toothache age 18. He started filling the tooth (no painkilling) then lost his temper and held me down and pulled it out leaving me to get home with blood pouring down my face. I didn't go to a dentist again until my mother pursuaded me about 5 - 7 years later. By then I need work on the other side of my mouth as my new excellent dentist explained because having a large back tooth removed (even he said almost undoubtedly uncessesarily) on one side meant I had been doing all my chewing with the other side.

Thanks for talking Toothsmith. I know one bad apple don't etc and I had years with my good dentist but given a gap and a need to go back because I'm in agony I only ever seem to remember the bad things. I think I may phone on Monday and see if I can visit the private one.

Excuse any typos, bad spellings etc - I'm feeling a little whoozy - what a waste of a weekend - sometimes I could really kick myself.

Savvy_Sue

I think my current practice has one NHS dentist and the others only do private. You may find yours is the same.

I seem to have had a lot of Scandinavian dentists over the years - all NHS. Why is that, Toothsmith?

Toothsmith

I don't know! Lucky??

Savvy_Sue

Toothsmith wrote:

I don't know! Lucky??

Oh, so the Scandinavians make up for the English one who developed Parkinsons or something similar and started trembling all the time and never wanted to do anything as a result, leaving me with a rather neglected mouth when he finally left?