Dental Trust!

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Dental Trust!

Postby tyreon » 4 Mar 2015, 3:03pm

I know,it's a funny place to ask about dental advice and practice. But this site might be as good a place as to ask about others experience or advice as anywhere else! Here goes.

Old dentist retires. New dentist arrives. After some dental issues new dentist inspects my teeth and, examining one problem tooth, says he cannot do the proposed dental practice he suggests,but his colleague a cost(a private job!) His alternative option is for me to go to my local hospital to have the tooth removed,and, which he says, he cannot do because it is so 'impacted'. I say I will opt to go to hospital. He(the dentist)says there will be a wait to get into the hospital++. I say,never mind,I will wait. When the dentist's letter gets to the hospital the hospital writes to me with a copy of the letter it has sent to him. Basically,it says,Mr so-and-so,you can do this operation,you have been trained for it,any trouble and there's gonna be trouble! Next time I am with the dentist he is as nice as pie: no 'pushing' for private consultation or evasion,the extraction is done,no probs.

Fast forward. Another problem with a tooth. I get an x-ray,prescribed antibiotics. Still the pain continues. On examination he says he will see if it can be saved. Exraction £. Root canal treatment and recrowning ££. I go for the latter. But with mouth wide agape,drilling done,he says this tooth cannot be saved,it will have to come out. Cost £.

Mmmm. Why am unsure? He's explained it all. Shown me x-rays and pictures...but would the cost of the root canal treatment and recrowning be worth his while or...just whip out my tooth as Time and cost is costing him ££££. That is, he thinks he aint getting enuf £££ from government these days.

Please forgive my(unwarranted?)suspicions. You really don't know who to trust these days. I think my first tooth may have been saved by root canal treatment,but the Time and effort involved didn't pay him. No proof of course

What are your views and experiences. How do you find a dentist you really can trust? I feel sure most are fine but...

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Re: Dental Trust!

Postby Psamathe » 4 Mar 2015, 3:21pm

I think different dentists have different opinions about what can be done.

Last summer I had horrendous toothache. Emergency dentist said that whilst as an emergency they could not do it, a root canal filling is needed. Once infection subsided, returned to my own dentist who wanted to remove tooth. I asked "Can't you root canal it and then put on a crown". Dentist answered yes, but they would have to refer me to private practice for root canal filling at around £800 (then add £200 odd for NHS crown).

So I change dentist (actually to the same company that did the emergency but different surgery/dentist). They checked me out and said that root canal and crown is not a good idea as the tooth would still break, more a question of when rather than if. They would be prepared to do it (on the NHS) but they don't think it will "meet my expectations".

So 3 different dentists and 3 different opinions. And I don't think any of them were trying to rip-me-off. Just that often there is no right answer, just different opinions about the best way forward.

I have found on a couple of occasions that my (now) previous dentist would not undertake certain work. I even had to be referred once just to have a tooth taken out (though that was done under the NHS but in a private practice). I suspect it might be that as she works as only dentist in her practice she has limited backup and so maybe refers on anything that might have any complications (or are outside her comfort zone).


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Re: Dental Trust!

Postby hondated » 4 Mar 2015, 7:46pm

Oh dear don't forget you started this. For years I had the same dentist and never had a problem with either cost or treatment. Whether it was because it was situated on a large council estate and he recognised that it was in an area which was not particularly affluent I don't know but whatever a great practice.
So three years ago we move down here and then the problem began. Every day I would go on the Web to locate a local dentist who all said on their forums that they took NHS patients but when contacted said " not at this time " .
So it was only when I began to get a tooth ache that I thought I need to see one urgently and duly signed on to one. To be fair they took me on as a no NHS patient but also not private but the long and short of it was that it still cost me £600 to get the problem solved. And guess what after I had paid that they agreed to take me on as an NHS patient.
It was only after all this that I realised just how difficult it was to find an NHS dentist and without wishing to get political this came about during Blairs reign which miffed me even more as I am someone who support the working class unlike him.

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Re: Dental Trust!

Postby Tangled Metal » 4 Mar 2015, 9:20pm

There is a real problem with this malpractice. Basically nhs dentists get given these payment units by the local commissioning group of the nhs. This is based on so many in each of the payment groups. Can't remember the details but IIRC these are £15, £50 and more for the patient depending on the type of work. The dentist is then paid the rest by the NHS. If the dentist has used up the units allocated to them in that year they have to apply for payment which is sometimes not given. This means they try to ration the work before they run out.

By ration I mean they try to push you on to private colleague, do it privately or try to push you up to another level that they have more units in. This can be as simple as you need to see a dental hygienist for descaling. This is first level at £15 to the patient and can be done by the dentist too. No units left they might say they can't spend more than 10 minutes on it which isn't enough but i can see you privately for much more money. This is against their NHS contract and could result in them losing it.
The other is root canal work is in the same unit level as removing a tooth. Trouble is it takes at least 40 minutes whereas it's 10 for removal. So they get more work in they say it can't be saved when it can. Malpractice!

There's a guardian online article about this by a female journalist who's suing her dentist. She interviewed some people also.suing their NHS dentists. One guy won £32,500 in compensation but ended up shelling that out to get his mouth and teeth sorted!

The trouble is the last contract negotiations with dentists resulted in a system that saves money by not guaranteeing the dentist for work he/she does that the patient needs once the dentist has passed a certain quantity of his/her allocated units. Add to that the way unscrupulous dentists can exploit by not doing the best for their patients. I guess there is also inadequate oversight too. I guess the saying "if you want to help people become a doctor, if you want to make money become a dentist!" Unfair that because there are good dentists and the professional body is also questioning the system. It has been in place for some time now.

Basically put, assuming you can even get an NHS dentist you need to know the system and watch out for inappropriate treatment or practises. I believe they can't chase you from a treatment under NHS into private, they can't choose to do the quick removal if the tooth can be saved and you can always politely question everything they say. Get them to explain your options under the NHS. If you are unsure I guess you might need to ask for second opinion.

Personally the best thing is to look after your teeth so you don't need dental work. Too late for adults but if you have kids make sure you teach them good dental hygiene. I'm very lucky in that my mum did that with me and my sister. She's had 1 or 2 filings due to her sweet tooth, I've had none. It works that looking after your teeth.

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Re: Dental Trust!

Postby tyreon » 5 Mar 2015, 8:41am

Thank you for comments and observations.

On the balance of probabilities and on private reflection...I think my tooth could have been saved. Of course now I have no tooth and have no evidence to pursue any redress. On examination and reflection I see that which I have heard and read: the dentist sees no profit or reward in spending X£ in completing 40 minutes work when he is going to be paid the same amount of money for an extraction. The sums make sense: it's easier to take out my tooth. In the 'broader-scheme-of-things' I might even champion his defense: he thinks the government is shafting him,root canal treatment takes longer and is more complex than simple extraction and the money he is paid is just the same: case made. Nevertheless I guess his professional guidelines would support and endorse a less radical approach than what I was given!

I guess it all makes sense...somehow? Having worked in mental health you can see how multifactorial issues that have complex underlying conditions and which need addressing to resolve them are resolved on-the-cheap ... with drugs. It is a cost saver! Housing,upbringing,abuse,education,psycho-social malfunctions,poverty: mix 'em all in a pot and got problems. You got time to sort them all out,or the money? No. Get out the tablet bottle or,dare I say it,a little CBT. It's the cheaper way.

No,I guess I must reconcile myself(and my lost tooth!)to having saved a few pence,and that few pence having been forwarded to the purchase of two new aircraft carriers(no planes...well,not at the moment),and the renewal of Trident. Wow! What a journey! I feel assured that those at the Top Table have their own set of full gnashers. I guess I can still spit out expletives.

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Re: Dental Trust!

Postby mjr » 5 Mar 2015, 9:39am

To find a decent dentist, ask around locally and check reviews on the NHS website. Sadly, it's probably worth searching news websites and local forums for the dentist names - I think one from the practice I visit now (but not my dentist) has just been found guilty of sexual harassment - but maybe treat reports with caution - the Care Quality Commission criticised my former dentist for various things that I don't consider a problem (such as their 1970s building looking "tired" - plus one problem that I would be concerned about, to be fair) and the local tabloid went rather sensational with it.

If you have concerns about a dentist, contact your local Patient Advisory and Liaison Service or the CQC (in England at least).
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides
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Re: Dental Trust!

Postby PDQ » 5 Mar 2015, 9:46am

It all about making money and little to do with dental care IMHO.
A recent photo on the BBC showed a fossil jaw bone with teeth 2.8 million years old; those teeth look better than mine after just 20 years of Denplan insurance scheme :(
and much better than a friend of mine who also paid for the same scheme and now has no teeth at all!!!

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Re: Dental Trust!

Postby 531colin » 7 Mar 2015, 1:29pm

In posh Harrogate, you can't get an NHS dentist, period.
My (private) dentist wanted to do a root canal, I wasn't keen, I wear contact lenses which I can take out myself, complex dentistry isn't on my wish list.
He said..."Look, you have already had a root canal done on this tooth, here on your X ray". Oh, I said, you mean that tooth you took out when I was in agony last year?...take the bloody thing out now.
Years ago, somebody wanted to do me a "bridge", which I refused. Both teeth he wanted to use to support the bridge on have now gone.
I think complex dentistry is only a temporary fix, I think I'm better off with a partial plate.

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Re: Dental Trust!

Postby 661-Pete » 7 Mar 2015, 7:41pm

Everyone who feels like having a moan about dentists - remember, it could be a whole lot worse :lol: :
I think, for most of my adult life, I've been quite lucky with dentists. In my teens, and early twenties, I went to the same dentist as my parents, NHS, I have a strong suspicion that the old geezer who did my teeth was a bit free-and-easy with the pointy-thing, making 'holes' where there weren't any. Piecework! Anyway I have rather a lot of fillings - nearly every tooth.

But since getting married and coming to live in Sussex 33 years ago - well I went to the dentist recommended by a colleague, and I've been with the same practice ever since - albeit with three different dentists - all of them impeccable. The first one took one look at all my old fillings, tut-tutted a bit, then took them all out and replaced them with new ones. All this was under NHS, in those days. Then I had a face-plant and broke all four of my upper incisors. One of them had to come out, but I had a bridge and crown put in - again under NHS - and I couldn't complain about the result, almost as if my teeth had grown back!

Come about 15-20 years later, the dentist explained apologetically that he just couldn't provide the same level of treatment, under NHS. So after a long sales pitch, he talked me into going Denplan. Yes it's costly - the fees are not fixed rate but calculated based on your existing dental health and risk factors - for my wife and myself it comes to a bit over £600 per annum. For that we get free checkups, fillings and hygienist work, and a discounted rate for crowns, bridges and dentures. Over the years I've often wondered whether it's really worth it, but for the present I'll keep on with it.

A few years ago I had a second face-plant, and the original bridge was knocked out, so I had it replaced under Denplan. The replacement is in excellent condition.

The only other major work was a molar crown I had put in a few years ago. After a year or two I developed an abscess below the crown, and the dentist offered to do a root canal filling by drilling through the crown, the filling up the hole in the crown as if it were a natural tooth. He said this is quite normal practice, and a simpler (and cheaper) process than replacing the crown. Whatever, it seems to have worked, the root filling gave no trouble and the tooth has been fine ever since.

So mine is a more upbeat account than the others on here.... :?

Et qui rit des curés d'Oc?/De Meuse raines, houp! de cloques./De quelles loques ce turque coin./Et ne d'anes ni rennes,/Ecuries des curés d'Oc. - Louis d'Antin

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Re: Dental Trust!

Postby Psamathe » 7 Mar 2015, 9:12pm

Following comments here I decided re: my root canal filling that another dentist said would need a private referral but would "work" and my new dentist said "would not work"; I've now dug my heels in with new dentist (when I had some repairs done the other day). And he's now going to do the root canal work, and he's not as pessimistic though wants to wait 6 months before putting a crown on to make sure the infection clears up first. Of course there is a risk it will fail but I don't see it a massive risk from my perspective. Root canal work is £50'ish on NHS so it might be wasted money but against losing the tooth seems a worthwhile attempt.