Dentists refusing to do costly treatments?

The same dentists that not only placed amalgam fillings but also have them in their own mouths but have no more health problems than any other groups.

In the area I worked in many decades of practice not one of mine or my colleagues referrals to dental hospital was ever accepted.

To put into context in our area the total restorative budget , per year , was enough to rehabilitate two oral cancer patients . Anyone else seen was given a treatment plan and sent back to practice . The treatment plans would only be possible privately.

This is a situation that is echoed throughout the country with the possible exception of a couple of big cities but even then acceptance of referral is small.

If you read the referral criteria for Liverpool , which I posted , you will see only priority groups such as oral cancer patients , would be accepted.

Removal of teeth eg wisdom teeth is a different matter as that is surgical , not restorative dentistry , and routine referrals are accepted, albeit with long waiting lists.

Are these the same dentists that put mercury fillings in people’s mouths for decades and told patients they’re perfectly safe because the mercury doesn’t leak despite overwhelming evidence to the contrary? Evidence that was ignored by so called dental experts like the chief executive of the BDA.

m.youtube.com/watch?v=fq8E84PgP3g&pp=ygUiQnJpdGlzaCBkZW50YWwgYXNzb2NpYXRpb24gbWVyY3VyedIHCQkgDAGHKiGM7w%3D%3D&ra=m

@Lollygaggle
I've had treatment within a year, one time it was for dental surgery. My two DD's have been seen, only one has needed sedation removal etc. My partner is on the list for wisdom tooth removal with sedation, we have the availability to track it. He will be done within 18 months of referal. My DD works in a hospital, amongst the Staff there's always people who have been referred to the dental hospital. It's standard. What you linked says things like, 'unlikely ', but in practice a range of people are being seen. Some people wait two years, but it's available.

I don't think it's unusual. If you look on here band 2c is mostly molar root canals (whereas 2a is fillings, individual extractions etc and 2b is non molar root canals and multiple extractions)
https://nhsbsa-opendata.s3.eu-west-2.amazonaws.com/dental/dental_narrative_2025_26_v001.html. There don't look to be many treatments happening in band 2c.

I decided a year or two ago that there is little point staying with an NHS dentist now. They only give you a 5min check up (if that) and no hygienist appointments. You have to pay privately for white fillings and crowns anyway, and seemingly they don't really do many root canals.

In contrast my private dentist spends a good 15min checking my teeth and thoroughly explaining everything to me. It's much better service. Plus I get a scale and polish. DH dental insurance through work covers the checkups, x-rays and scale and polish, and £200 a year towards other treatments. It can still get pretty expensive but what's the alternative? Losing teeth to extraction and having lots of amalgam fillings?

Being a dental nurse a few facts are very incorrect, firstly your dentist is absolutely correct never ever pop a filling onto an infected tooth. Second if a dentist feels after various x-rays and exams that the root filling would be pointless because the tooth is bad anyhow then yes the extraction would be offered. Should a dentist feel that yes a root canal can be done successfully and last a time then that will be offered usually band 2. The comment about bad dentists well I think that's a minority not the majority in England as the 3 practices I've worked at with several dentists in each are all well booked up months at a time. No doubt the odd one makes you question why there doing it but rarely. Also the governments rules regarding what qualifies for treatment and what doesn't is hard and fast. Should a dentist decide yes a root canal needs doing but the government say no should be taken out then the fee then becomes the dentists burden which happens often. Not all decisions made by a dentist are actually what they would choose to do, however there are only so many hits they can take not being paid for NHS work just because a decision isn't agreed with by the higher ups.

You need to ask your dentist why the root canal treatment can’t be done on the nHS as it’s a valid treatment, will help save your tooth, and ( as long as the tooth is restorable) I would have thought ethically the right thing to do is try and conserve your dentition.

is there a specific reason? For example schlerosed canals, an extra micro canal , difficult long or curved roots. If it’s something like that, I would appreciate that a referral to a specialist endodontist would be required. But if it’s a straightforward root filling, why on earth is the dentist not doing it on the NHS?

na, it doesn’t add up. You should be offered this on the NHS

I recently had a look on the Find a Dentist tool (when ours stopped offering NHS treatment) - it showed over 5 around us, but when I rang them not a single one was taking NHS patients on.

Oh stop it, root canals aren't cosmetic - NHS treatment is not and should not be just the barest minimum to keep you alive! I've had two root canals on back teeth and white fillings in the past too.

We need to revisit the dental contract so it's affordable for dentists to provide NHS care.

So in which case you know that the NHS does not, actually , pay for these things , and your dentist has actually lost money providing them .

I haven’t had an NHS dentist in the last twenty years, not my choice, none available. Pay £25 a month on a plan. Implant would be an additional cost.

The nhs is a postcode lottery if you haven't learnt this you're blessed.

I am well aware. My dentist discusses this with me but I have known him a very long time and he continues to treat me. I am extremely grateful to have him.

If it is not too complex then NHS dentistry will provide simplest treatment to secure dental health but on most of the treatment your dentist will be losing money because what the NHS pays will not even cover the expenses in providing treatment the average root treatment and crown loses the practice £21 . https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

private treatment subsidises NHS treatment and keeps the lights on in a practice because the NHS does not pay enough for most things .

Same here! Ive had two crowns put in recently and im glad I have a nice dentist, he normally goes over his allocated time to make sure he doesn't hurt me as I have microstomia.

Makes me appreciate my dentist even more reading about people's very low expectations. Maybe they expect poorer people to be toothless and thankful of it.

No , a tiny minority of dentists have been influenced by discredited quacks such as Weston Price and Mercola and social media posts and a netflix film with no scientific evidence . The vast,vast,vast majority of dentists are of the opinion rooted in treatment is a valuable way of saving teeth.
quackwatch.org/related/holisticdent/

No you wouldn’t . You can try to refer a patient for endodontics (root treatment) but it is extremely unlikely they will be accepted as priority groups such as head and neck cancer patients are given priority for the limited amount of treatment available . https://livheadandneck.co.uk/assets/downloads/referral-guidelines-updated-updated-jan-2020.pdf

Well my NHS dentist did. I also had a cracked upper tooth and was advised to have a crown placed over it,
I paid for the private crown as it had no metal whereas the NHS one did.

Maybe you need to change your Dentist.

I have an NHS dentist and I have root canal work, crowns, bridges and all other treatment on the NHS so it isn’t true it doesn’t pay for those things.

The dentist then needs to explain why they cant do the root canal. If it is too complex then that is one thing. If it is simply because they dont want to do it on nhs that is completely different

If you were on Merseyside, you'd be referred to the dental hospital for your treatment, on the NHS. You'd wait a year, though. It is unfair that this is a postcode lottery.

I'm having to make my peace with having dentures and paying for sedation.

Antibiotics do not treat abcesses they just suppress symptoms, tooth either needs to come out or a root treatment needs to be attempted.

If the tooth is badly broken then the abcess will be draining out and putting a temporary filling in will be just like putting the cork back in a shaken up bottle of pop.

I’d also do a wee bit of research on root canals as plenty of dentists highly disagree with doing them and believe they can cause a myriad of health problems down the line.

As above all endodontic treatments have to be assessed for difficulty and if too complex must be referred to an endodontist.

For the vast majority of the country the NHS has no endodontists so any referral will have to be private .

Many factors affect complexity from curvature of root canal to access to patient medical history etc and there is a standard tool for assessing complexity https://britishendodonticsociety.org.uk/professionals/bes_case_assessment_tool.aspx