Dentists refusing to do costly treatments?

YABU. I used to work for Health Education England so know the ins and outs of the dental contract, it’s one of the worst ones. Dentists are really struggling to cover their overheads and can’t justify undertaking costly work like that for an NHS payment. Be grateful that there’s an opportunity for some of it to be at a cheaper rate because at some point dentistry will all be private, I’ve got no doubt about that.

Is it a front tooth or at the back?

I understand a bridge or implant would be private but I wonders if the NHS dentist had said removal or root canal would be NHS or private then realised I’d missed the last update where root canal not possible

They have already seen a private specialist who has said the tooth is too badly damaged to be saved.

Any replacement will be private , unless they have other teeth missing, in which case they will be offered a denture on the NHS.

Have they said the root canal would have to be private or just that the bridge or implants would be private?

I’ve been with an NHS practice located in the same site for 28 years - but that’s changed hands around 5 times in the last 10 years, previously been owned by a very stable and all encompassing husband and wife dental team.
The treatment offered has seriously declined since Covid. Now we have junior dentists, quite often from the Middle East with heavy gutteral accents (no problem with their origin but try understanding what they’re saying whilst in the chair!). Check up and the odd easy filling only. My DH recently had a four hour wait to get a prescription to treat an abscess, having to wait for someone qualified enough to sign it off.
I have the back upper right tooth needing extraction after half of it fell away, apparently having a long standing bad crack but one never mentioned at check up. The practice declined to do it and have referred me to a hospital dentist. I find out yesterday that there’s a minimum 6-9 months wait. Luckily I have no pain at the moment but is this really the way to go??

A good friend of mine is a dentist, who has always done NHS work as a sort of moral duty. But practice policy has changed- she says dentists are de-skilled by the system, they just do basic checks, monitoring and simple treatments if the practice is mainly NHS. So equipment, training and expertise may be lacking to do those specialised treatments that you mentioned. The NHS won’t pay so your dentist will be working for free and spending his salary on tools to do the work for you.

I agree with all Lollygaggle’s comments on this ( fellow dentist). Amalgam is just that- an amalgam of metals that in the mouth are very stable and don’t leak mercury. I have patients with amalgam restorations in their mouth that have lasted over 30 years. Composites don’t have anywhere near the same longevity. On balance, they are cost effective, work well, easy to place compared to alternatives, cheaper and have low evidence that they cause harm in the mouth.

the issue is that when an amalgam is removed, the mercury vapour is the issue. We use high volume aspiration/rubber dam, ventilation and other measures to try and minimise the effects.

the environment concerns are huge though. See the Minimata conventions. Amalgam has now been banned in EU, and is being phased out in the UK. The question is what is a safe, Cost effective and easy to use alternative?

watch this space!!

It's been this way for years, surely? I had a middle tooth removed twenty years ago and my only option (back when I had an NHS dentist) was to have it pulled, and I'm sure the only treatments available generally were filling or extraction. Like most I've had to go private now, but I would never be able to justify the cost of cosmetic treatment, other than something simple like a white filling. My teeth are structurally fine, cosmetically am absolute mess, but would be a ball park figure of 7k to put right so it'll never happen! I pay £20 a month for the basics, 2 check ups and hygienest a year.

I know.. but I get treated differently.

Going without teeth because one cannot afford private care or because it’s not available on the NHS is disgusting. It’s physically and mentally damaging for someone to endure the pain, embarrassment and misery of bad/ missing teeth. It’s not luxury or cosmetic to have decent teeth, it’s part of your whole well being, and it’s time the Government sorted out the NHS contract with their dentists.

Sedation treatment is available on the NHS with the community service , but will need referral and in most areas the waiting list is years .

It has always been that way. Many low income families have bad teeth. My DD needs one out and a filling with sedation, sedation is only available privately, there is no way she could have it removed without sedation, even a teeth cleaning procedure causes her to get in a state, we’re on the waiting lists for private sedation.

Whether you contribute to the NHS fee or not the practice gets paid exactly the same amount , the government just pays 100% of it instead of around 10% .

YANBU. I thought I struck gold when I finally got an NHS dentist.
I am in and out of the chair in less than 8 minutes. I have a hole in one tooth. was told it was due to a breakage, and not a cavity. I was told I can have it extracted when it causes me pain. No other fix in the meantime.
I also have a missing tooth (top and in smile line). That is cosmetic, so I will have to go private.... even for a denture.
I am on benefits so don't even pay for the NHS rates. I am convinced that is why I don't actually get any treatment. This is the second practice this has happened with too.

When I needed a root canal there was no NHS dentist at all at my dental practice. There were no dental practices who would register me, even as an emergency.

I went twice to a ‘sit and wait’ dental hospital an hour away and didn’t get seen as there were so many people there and everyone was triaged. I was in a lot of pain but there were elderly people who had fallen down stairs and knocked all their teeth out and teenagers who had been punched in the mouth.

I went private and I can’t remember what the root canal cost as it paled into significance when compared to the three thousand pounds for the implant.

WTF. An advert for Ocean Village dental practice has popped up.

i was coming in to say there’s a lot of pseudoscience about endodontic treatment! It is recognised now that the failure rate can be higher than previously thought (I had a root canal on a top central incisior fail and had pay an eye watering amount for an implant).

teeth can shift if there is an extraction with no bridge or implant and this can cause bite issues later. But many people do manage. It’s not ideal though and saving the tooth would be preferable.

The point is that amalgam fillings would never pass safety trials today if proposed. In fact, such a person would be laughed at for even suggesting that the second most toxic element be placed in a patients mouth. They are also not even a good filling material as corrode and often crack.

And the environment is a get out for a dirty industry that ignored the evidence that amalgams leak mercury. Explain how they are toxic enough to be disposed off in biohazard waste bins but somehow safe in a patients mouth?

And there is a plethora of studies linking dental amalgams to ill health. Mercury is a well known neurotoxin that is known to bioaccumulate. Why anyone thought this was a good idea defies belief. And some dentists even used to use it in root canals. Maybe some still do.

It is understood that there is risk / benefit to procedures, devices etc. but only a fool could argue amalgams are safe on balance.

Fascinating, amalgam was first used over 150 years ago , before randomised clinical trials. There have certainly been many studies since , however compelling evidence has not been produced.

The toxicity of all dental materials has been studied for decades before I studied , which in itself was many years ago. Many dental materials have been discarded because of safety concerns eg endomethasone , whitening with perborates etc.

The largest trial is that of dental staff who not only have amalgams in their own mouths , but also place amalgam, and in terms of mercury exposure more importantly remove amalgams every day. You would expect them to have higher morbidity and mortality rates to the general population. They do not .

All dental materials ,except perhaps gold, have problems. Composite fillings have BIS GMA etc . In the end it’s a risk benefit ratio. Time is running out for amalgam because of environmental, not health concerns and because the alternatives are improving every day.

In terms of health we are becoming aware of more detail of how untreated dental disease , particularly gum disease which around 90% of the UK population have some form of , affects general health from type 2 diabetes to heart disease to dementia.

The very early posts have it.

Your NHS will treat it. Extraction will solve your problem and avoid any complications in future. Anything beyond that is cosmetic and wouldn't be on the NHS for any other body part either. You will be able to get a denture on the NHS if that is appropriate.

There is a crisis in NHS dentistry, but you have an NHS dentist so that is not affecting you.

Because those dentists were never educated about the dangers of amalgam fillings and that they leak mercury, the second most toxic element on the planet. This information has been available for a century but the dental industry chose to ignore it. Never ever put through a randomised clinical trial before use on the public and amalgam waste must be removed specifically in biohazard bins. But apparently totally safe in a patients mouth.

To compare dentists to other groups doesn’t really count for much given that billions of people have amalgam in their mouth and we see disease and ill health symptoms everywhere. Very few people are truly well these days.

I had an accident when very young and lost my two front teeth. I have had 2 NHS bridges but the last was done almost 30 years ago. I have an NHS dentist she has said the NHS won’t replace, there is too much bone loss. My original NHS dentist sent me to some regional appeal to get the first one. She isn’t offering private at all. It will eventually totally fail. I will need a denture regardless while it heals. Then I make the decision of bone graft and implants or maybe a snap on post denture.

I am in Ireland currently and noticed you can travel here for private treatment. I may consider this for implants as apparently there is the possibility of tax relief.

That’s crazy prices

I had two root canals and a bridge and several crowns last year in Turkey cost me £3330 and was done in 4 days

I know people laugh at Turkey teeth but I can see why people go there when it’s so expensive in the uk and you don’t have to have the Katie price fake look.

same treatment in the uk would have been around 15k plus

my uk private dentist will still give me a check up and I can still see the hygienist
and I’m going back to Turkey for a holiday so
will also get a check up there next year