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  • FIRST POST
    • MrHeisenberg
    • By MrHeisenberg 1st Jul 17, 6:13 PM
    • 131Posts
    • 11Thanks
    MrHeisenberg
    Refused dental bridge on the NHS
    • #1
    • 1st Jul 17, 6:13 PM
    Refused dental bridge on the NHS 1st Jul 17 at 6:13 PM
    Hi all,

    My NHS dentist has refused to provide me with a dental bridge on the NHS. She has been rather unclear as to the rationale and reasoning though, from what I understand, the main reasons are it would be a rather long bridge (UL1 to UR4) and it is around a "corner". She also expressed reluctance to "damage" the surrounding teeth but that would happen with any bridge.

    I lost the teeth due to trauma at a young age.

    Has anyone experienced something similar and if there are any dentists out there I would seriously value your input.

    Sincere thanks.
Page 2
    • welshdent
    • By welshdent 20th Jul 17, 10:32 PM
    • 1,862 Posts
    • 1,226 Thanks
    welshdent
    Many things are technically possible. Doesn't mean it's the right thing to do.

    Personally I don't remember the last time I did a 4 unit bridge. I certainly haven't done one incorporating a canine tooth around the natural arch of the mouth like that. They are extremely difficult to get right at the best of times. For someone who doesn't do them often it's even harder. Also 25% of healthy teeth, when prepared for crowns, end up with irreversible damage to the nerve. So you could end up losing even more teeth.

    I'm afraid I'd be giving the same advice too.
    • junes9333
    • By junes9333 9th Jan 18, 3:16 PM
    • 3 Posts
    • 0 Thanks
    junes9333
    dental charges for a bridge in wales
    Hi i am wanting a bridge to cover 1 gap (missing tooth) i have been told by a NHS dental receptionist that i could possibly have a bridge and would cost up to £200 depending what type of bridge, but my dental appointment is not due until April , i am wondering if my NHS dentist can refuse me a bridge at their discretion because of the work involved, although i am willing to pay the extra?.

    Perhaps "Welshdent" would be able to advise on this matter as to the knowledge produced on this particular thread.
    Last edited by junes9333; 09-01-2018 at 3:21 PM. Reason: type error
    • brook2jack
    • By brook2jack 9th Jan 18, 6:40 PM
    • 4,133 Posts
    • 3,786 Thanks
    brook2jack
    NHS dentistry is there to secure health not to necessarily give treatment the patient would prefer.

    You cannot “top up “ the NHS payment to get treatment you want , if treatment is appropriate to secure dental health it should be provided on the NHS. However if you want treatments not available on the nhs eg cosmetic treatment then you can pay for this privately.

    In general whether a bridge will be provided on the nhs depends on several factors ,
    How many other teeth are missing
    Is the gap a front tooth
    Is there any gum disease
    Is there active decay
    Are the teeth either side of the gap healthy , with good enough roots do they have existing filling
    Has the person any other oral or general health problems that make a Bridge a bad idea

    Only the dentist who can see you and your x Rays will Ben able to tell you if it is appropriate NHS treatment.
    • junes9333
    • By junes9333 11th Jan 18, 12:20 PM
    • 3 Posts
    • 0 Thanks
    junes9333
    Thank you brook2jack for your informative reply, i am paying privately tomorrow for an upper bridge as my current 1 the gum is receding and needs to be replaced, fair play to the old 1 it's been there 30 years, i have also paid privately for my 2 front teeth to be refilled with new composites behind.
    My lower left teeth are good for a bridge but i am unable to afford any further cost, the reason i am wanting a bridge is because when I eat sharp food such as biscuits etc hurt my gum are and catchesy tongue, i had a denture fitted 7 years ago and it caused nothing but problems.
    • junes9333
    • By junes9333 11th Jan 18, 12:21 PM
    • 3 Posts
    • 0 Thanks
    junes9333
    ***Catches my tongue
    • Ilona
    • By Ilona 11th Jan 18, 1:28 PM
    • 2,064 Posts
    • 7,092 Thanks
    Ilona
    Hello June. brook2jack has given you a good reply, but you mention the word 'biscuit', which has prompted me to reply. My teeth are around 60 years old, (I am 68), and I don't expect to eat the same food as I did when I was younger. I have a four teeth bridge at the front top, and two crowns, and would like to keep what I have left for as long as possible, so I have modified my diet. You can manage without biscuits, they are not food.

    I don't bite into anything hard any more, and try and stick to the softer food so I don't put excess wear on my teeth. For instance I have pasta, couscous, avocado, and a boiled egg for lunch. I still eat healthily, and I also eat slowly, being careful how I break the food down in my mouth. I add nuts to my breakfast, I grind them first in a mini Kenwood chopper. I don't eat meat so nothing to chew there.

    Maybe you could try this approach, it might help.

    Ilona
    I love skip diving
    • brook2jack
    • By brook2jack 11th Jan 18, 1:36 PM
    • 4,133 Posts
    • 3,786 Thanks
    brook2jack
    In general , it is very unlikely you will get a bridge to replace back teeth , particularly molars , on the NHS. The other factor is if there is a large gap , and the fact you have had a denture before indicates this , it makes it even more unlikely.

    There is a concept called the shortened Dental arch , which means that so long as you have 20 teeth in total you are regarded as dentally fit. IE even if you have lost all your back teeth (molars) they do not need to be replaced to make you dentally fit.

    People can manage to eat with no bottom teeth at all as the gums eventually toughen up so do not hold out much hope of you getting a Bridge on the NHS.
    • g7ivp
    • By g7ivp 3rd Mar 18, 10:11 PM
    • 5 Posts
    • 0 Thanks
    g7ivp
    Private but not NHS
    While at the dentist the other day arranging for a broken tooth to be crowned, I enquired about a bridge to replace a missing pre-molar in the upper right. the teeth either side of the gap are ok and the dentist said it would probably cost around £1100. When I said I'm an NHS patient not private she said I couldn't have it done on the NHS. I'm going to ask for more detail when I have the crown done next week but I what to know what the official line is. If it can be done privately why not on the NHS?
    • brook2jack
    • By brook2jack 3rd Mar 18, 10:29 PM
    • 4,133 Posts
    • 3,786 Thanks
    brook2jack
    NHS Dental treatment is there to secure dental health only , and in general it will be done in the simplest way.

    A gap does not necessarily need to be filled and , in general, bridges will not be offered on the NHS unless it is a front tooth and there are no other gaps and teeth either side of gap are in good health.

    The NHS fee would probably only just about cover expenses , even for a bridge replacing one tooth.

    There are many instances where treatment can be offered privately Eg anything that is not strictly to improve dental health. You may like to have the gap filled but it probably would not meet criteria of improving oral health.
    • ERICS MUM
    • By ERICS MUM 4th Mar 18, 9:22 AM
    • 3,483 Posts
    • 6,465 Thanks
    ERICS MUM
    I have no proof but a strong suspicion that private dental work subsidises NHS dental work. I cant see its possible to cover the staff costs, premises, rates and insurance costs, equipment and maintenance costs (etc etc) purely by the NHS fees, regardless of how many procedures a surgery does.

    (Apologies for lack of apostrophes, they translate into other characters, very annoying).
    Last edited by ERICS MUM; 04-03-2018 at 9:25 AM.
    • Toothsmith
    • By Toothsmith 4th Mar 18, 1:07 PM
    • 8,847 Posts
    • 10,526 Thanks
    Toothsmith
    You're completely right. It has done for years.

    (And if you go into settings - keyboard - and turn off smart punctuation, it fixes the apostrophe problem - on the iPad, anyway)
    Last edited by Toothsmith; 04-03-2018 at 1:10 PM.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
    • ERICS MUM
    • By ERICS MUM 4th Mar 18, 3:05 PM
    • 3,483 Posts
    • 6,465 Thanks
    ERICS MUM
    You're completely right. It has done for years.

    (And if you go into settings - keyboard - and turn off smart punctuation, it fixes the apostrophe problem - on the iPad, anyway)
    Originally posted by Toothsmith
    Thank's ! I know that apostrophe shouldn't be there, just checking .
    • g7ivp
    • By g7ivp 4th Mar 18, 3:55 PM
    • 5 Posts
    • 0 Thanks
    g7ivp
    Thank you brook2jack. Is the "criteria of improving oral health" published anywhere?
    Last edited by g7ivp; 04-03-2018 at 4:00 PM. Reason: needed to add something
    • g7ivp
    • By g7ivp 4th Mar 18, 4:05 PM
    • 5 Posts
    • 0 Thanks
    g7ivp
    Forgive me, but having paid National Insurance for over 40 years and now needing treatment on the NHS, am I supposed to go private because the dentist can't make enough money out of her NHS contract?
    • Toothsmith
    • By Toothsmith 4th Mar 18, 7:18 PM
    • 8,847 Posts
    • 10,526 Thanks
    Toothsmith
    Forgive me, but having paid National Insurance for over 40 years and now needing treatment on the NHS, am I supposed to go private because the dentist can't make enough money out of her NHS contract?
    Originally posted by g7ivp
    Well, your National Insurance has funded pension and the Welfare State ( Or at least that was the reason for introducing it). The NHS has been funded by general taxation ever since it was set up.

    You are not unable to eat because of your gap in your teeth. It is of no detriment to your 'health' - so why should a 'health' service pay for it?

    I'm presuming you've had your dental check ups on the NHS? And the fillings in your teeth to fix the decay in them? Maybe a root filling in that tooth some time before it was extracted? Then, of course, the extraction itself?

    I'm sure, if you add it up, you'll have had a fair bit for the taxes you pay. Especially if you include the education you received, ( before you paid taxes) any contact you've had with the NHS including your birth, The transport systems you've used including roads, the education and medical treatment any children have had and not forgetting those lovely nuclear bombs that have kept us all so safe!!!

    It really can't be a limitless service. Imagine how much it would cost if everybody with a gap could get it fixed with a bridge? Especially given that Dental health is virtually 99% down to how well teeth are looked after by the patient!

    But either way - the policy of the NHS Dental service is set by the Department of Health, not the dentist. As I said, they have deemed you need to pay privately for the bridge, because the gap is of no detriment to your health, not out of any consideration to the dentist's finances ( they really don't give a stuff about that!)

    If you want to change the system, then write to your MP. I'm sure your dentist would love it if funding for NHS dentistry was increased, and more advanced stuff could be provided.
    Last edited by Toothsmith; 04-03-2018 at 7:26 PM.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
    • brook2jack
    • By brook2jack 4th Mar 18, 8:11 PM
    • 4,133 Posts
    • 3,786 Thanks
    brook2jack
    One of the frustrations with the most recent Dental contract of 2006 is there is no prescriptive list of what is and isn!!!8217;t available on the NHS .

    At the time of the new contract it was supposed to bring in fewer and simpler courses of treatment.

    The back of the NHS form says you accept all treatment to secure oral health.

    The definition of oral health also includes the concept of a shortened Dental arch, in other words if you have 18 teeth in your mouth you have enough . Those teeth can be your own , or dentures etc.

    There is no definition of oral health that says every gap must be filled. You may want it filled but it may even adversely affect your oral health as any tooth prepared for a bridge has a twenty percent chance of dying off and needing root treatment. That makes it more brittle and likely to break and greatly decreases the lifespan of the bridge.

    All bridges need replacing and each time they are replaced either more tooth is removed or you lose one or more of the teeth supporting the bridge.

    The amount your NI contributes to dentistry is a few pennies a month.The total spent each year on each person having treatment , including patient contribution, is between £28 and £34 . It is clearly not enough to provide treatment to secure oral health for everyone as only 50% visit the dentist and that cash is limited despite however many visit. It is clearly not enough to provide all the dentistry people may chose to have.
    Last edited by brook2jack; 04-03-2018 at 8:51 PM.
    • Ms Mop 123
    • By Ms Mop 123 13th Mar 18, 5:25 PM
    • 15 Posts
    • 2 Thanks
    Ms Mop 123
    I had a filling done last January. After what seemed like endless drilling dentist told me that I had more filling than tooth and to see how it went, if it failed I would have to have it out and have a bridge fitted. I have treatment on the NHS, think after reading the posts on here I!!!8217;m very lucky to have such a good dentist.
    • brook2jack
    • By brook2jack 13th Mar 18, 6:09 PM
    • 4,133 Posts
    • 3,786 Thanks
    brook2jack
    If it is just one tooth it is a crown the dentist will have suggested. A bridge is to replace a missing tooth or teeth where you have to drill down the teeth either side of the gap.
    • Ms Mop 123
    • By Ms Mop 123 13th Mar 18, 8:17 PM
    • 15 Posts
    • 2 Thanks
    Ms Mop 123
    No, it’s definitely a bridge, he showed me a poster on the wall to explain what it was. The picture showed teeth either side the bridge covered by what looks like crowns over the teeth with the bridge in between. He did say I would only have one tooth covered because it was a big toothand strong enough to support the bridge. To be honest, apart from the fact that I would have to have the tooth out....aabsolutely scared to death of that....I would of preferred it. At the moment I hardlly dare eat anything that side of my mouth incase the filling fails and I end up with rip roaring tooth ache.
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