Any NHS dentists out there?

[DramaAtTheDentist]

Hi

Just looking to know how this situation would be handled in your practice.

I have a primary school age son who fell at school and broke his front, adult tooth in half.

I immediately took him to our NHS dentist who has seen him since he was a baby. They did a composite repair that was painful and looked absolutely shocking. My son and I were both very upset so I arranged an appointment at a private practice around a week later to have it redone. The difference was remarkable. Not only in the cosmetic side but also the bedside manner. I have written to the NHS practice today to see if they will change us to another one of their dentists as I am loathe to loose an NHS place however I am also worried whether this is the individual dentist or just poor treatment of NHS patients at their practice.

My son was given no numbing gel before the injections and sobbed with pain while they were done.

He was not x-rayed to check for nerve damage- just told that I would know in a few months if it started to change colour.

The repair was not even close to the original tooth colour.

The edge of the repair was jagged and didn’t line up with his original tooth and was lumpy and scratchy on the back surface.

Is this standard procedure for NHS treatment? What would you do if you were presented this situation as an NHS dentist?

Thank you.

My guess is your son was booked into an emergency appointment . Unfortunately you have to work at such a pace and often there is no space for emergencies time is at a premium.

It is always difficult working in the immediate aftermath of an accident which has broken a tooth. Everyone is shocked and upset , apprehensive and having to give an injection and possibly the first treatment a child has ever had in their life is always difficult. Quite often the lips and gums are bruised and swollen and bleeding and this also causes difficulty.

My main emphasis on this sort of appointment would be to repair the tooth well enough to stop any more damage . Very often a repair at this stage will look very rough and ready , will often come off because it's not ideal circumstances.

You can tell at this point of nerve is still alive but days,weeks,months or years later the nerve can die off . It's a lottery. However if I can get co operation at this point I would take an x Ray to check the root isn't broken , but this is not always possible .

What I would do is make an appointment in a week to 10 days time , to check how everything is now shock has gone and hopefully swelling , bruising and pain has settled down. I would take an x Ray then , if I hadn't already , and rebook for a proper filling if I hadn't been able to do a good enough job first time.

What I am saying , in synopsis , it's a very different thing treating a child who has only just had an accident bad enough to break a tooth , with the pain,shock and anxiety that involves , squeezed in with other patients in the waiting room getting irate because they are kept waiting , and with the problems that trying to get something to stick in that situation entails contrasted to an appointment that is booked out in plenty of time, after the accident when bleeding , bruising and selling has settled down with ideal situation and time to get a good result.

@Lollygaggle has covered absolutely everything. To be seen straight away he was probably squeezed in between patients, it is so stressful running behind. You will be able to tell from the time the private dentist took how long a "good job" takes. The repair may have just been what we call a "bandage", a rough and ready covering to protect any exposed tooth. NHS dentistry is so so tough, the general public have no idea, I really am loathe to critisise any dentist working in those circumstances.

Absolutely what @Lollygaggle and @Kylie1977 say, a fractured front tooth in a child is a very difficult situation to manage, and one every dentist dreads. It sounds like your NHS dentist did what they could.

^what they said - in NHS emergency appointments all you can do is as quickly as possible get ‘something’ on to stabilise the situation. If you had gone back to the NHS place they would probably have booked in a longer appointment to finish polishing / shaping and taking x-rays once everything has settled

Thank you everyone.

To clarify, I was extremely grateful that our dentist squeezed us in. We arrived at lunchtime and was told to return a couple of hours later for an emergency appointment. If the repair was a temporary measure, I would not have thought twice about the quality. I would have happily come back at a later date, paid for a better cosmetic job etc. However, when I said I was disappointed with the outcome, I was told that this was the best they could do and that was that. I asked about when we should come back and they said we should just wait till our next scheduled appointment. When I said that wasn’t for 6 months, he huffed as though I was being unreasonable and said “I suppose you could bring it forward to 3 months”.

I fully appreciate that NHS dentists are squeezed dry and as I say, I was very grateful they saw us so promptly. I think I am most upset that they didn’t numb the gum before injecting. It took barely anytime to work and made the whole job so much calmer second time round. I have taken my children to the dentist since they were babies to avoid creating anxiety and this has completely undone all of that work 😔.