The state of UK dentistry

[FirstSheIsWise]

I know how difficult people find it to see an NHS dentist, plus there are the costs of treatments etc on top for most people. I really do think this is having a dreadful effect of us as a population.

I notice when I'm out and about that so many more people than I've ever noticed before have terrible breath. I'm talking 'standing in the same aisle in a shop a few metres apart and I can smell your breath' terrible. And it happens a lot. It's got me paranoid about my own breath too, and my sinuses in case these smells are coming from me... but they aren't as confirmed by my dentist and hygienist.

What's going to happen to all these people with likely gum disease? Especially if they can't afford or can't get to see a dentist. The links between gum disease and dementia and other diseases is also concerning. It's going to cost more down the line to treat all of these consequences than it would to provide a proper service focused on prevention now, not to mention the human costs in terms of emotions and relationships (who wants to kiss or have sex with someone with rancid breath? Is the ensuing rejection yet another driver into incel-dom for young men?)

However, I know there have been other threads about a general decline in hygiene standards, and I do agree there has. Is this just part of that? Have people's sense of smells been so affected by COVID that they don't notice it? And what, if anything, could we do as individuals and as a society to improve things?

My teens are 16 and 17. I just had to pay £98 in advance for a 10 min check up for them (same appt).

Is that what they were costing the NHS before the dentist (same practice) went private?

In my area (SW) you can't even get a private dentist.

Every dentist under 45 will have at least part-funded their degree. It’s been decades since people received full grants to study.

There was a thread on here a while back about that. Someone was hiring and had a candidate that ticked all the boxes except he had a tooth missing.
There were very mixed responses.

Dentists qualify with £80000 to £100000 debt . That has been the case since 1998 when students started paying for their courses.

If the government won’t pay for people, including children , to have dentistry is it right that dentists should go into debt to pay for people’s treatment? Even at NHS prices dentists lose money on all treatment and check ups.

No. A check up, X-rays, scale and polish , referral letters and anything else involved in a NHS check up would earn the practice , in total, around £28. That would have lost the practice, on average £7.69. In other words the practice paid to see your children on the NHS. https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

I had no idea. What's the answer .. go abroad?

I think a lot of people also don’t realise how thorough you often have to be with your teeth
Yes some people get away with it but for example I have to
brush twice a day with biomin f toothpaste or duraphat using an electric brush
floss
tepe brush
small pointy brush for around wisdom teeth
xylitol rinses
flourigard mouthwash at lunch time

if you haven’t had a dentist and don’t know this stuff or look it up online, you wouldn’t know

NHS dental care is a "right" same as getting AE treatment or a GP appointment.

Would you be happy to pay '000s to have a broken bone treated? or pay for private maternity care?

Where does it stop?

A crown and a couple of fillings will easily be more than a holiday.

@luna25 do you buy xylitol rinse or do you make it and when in the day do you use it. I have bought total sweet and add it to my coffee. Please tell me more.

I am off to Google the toothpaste you mention. Thankyou

It's a huge problem. My dentist has suddenly gone private and is trying to convince everyone £26 pm is a good deal (rather then having to pay that twice a year on the NHS).....the annoying thing is they are doing this by stealth so people have to pay or risk having no dentist and relying on the walk in in an emergency. I am having to just look after my teeth myself (they are in good shape) but not sure if/ when I will get another NHS dentist.

Honestly I just chuck a teaspoon of the xylitol in my mouth, crunch it up, swish it round for as long as I can then spit it out
or use the gum

@Lollygaggle everyone is now leaving uni thousands of pounds in debt, but they’re not all expecting to walk into 100k a year + jobs within the first few years.

There are plenty of purely private ‘older’ Dentists who received funding, happy to turn their back on NHS patients and go fully private, despite children no longer being able to register with an NHS dentist without travelling for miles. It shows profit is king for these people.

Luckily my practice are very good and offer private while still maintaining some NHS coverage.

Haven’t labour pledged to create something like 200,000 more appointments ( don’t quote me on figures) but I know it’s definitely been identified as an area of the NHS that needs improvement.

After suffering badly with chronic and very sudden toothache last year I was told I’d be on a waiting list of up to 9 months to have a problematic wisdom tooth removed. Thankfully I was able to go private but if people don’t have the money for that I have no idea how they’re meant to cope with emergencies like that. It is scandalous when you think how quickly things like that can deteriorate and become very serious.

Can’t say I’ve noticed the bad breath thing you mentioned. But definitely think that waiting times for emergencies and extractions need to be looked at.

I said on this thread I had just found an NHS dentist. I had my first appointment today.
The dentist was really nice and tried to make me feel comfortable. I have an old filling that has decay around it. I have a dental mirror at home and can see it. I can also feel it with my tongue. I have 2 teeth that I can't bite on as they hurt.
Dentist said my teeth were "fine" and to come back in 6 months.
I think I was dismissed as I am exempt from paying.

The state of UK everything btw….budding dentists might be better advised to take up a career driving trains as they’d probably get paid more by the Labour government.

There was a radio 4 talk about this recently, a dentist was on and ran through what the NHS reimburse them for treatments, and they are working at a loss. NHS dentists have to be looked at as charity workers. It's a tragedy that people are willing to pay for hair/fillers/eyelashes but feel that a highly trained dental surgeon is ripping them off.

And I've never noticed awful teeth anywhere consistently other than Bradford. I don't think I saw a white person with front teeth there, it was very shocking. I didn't see this trend in the Asian people.

This was my worry as someone paying for NHS, I felt they wouldn't do what was needed as not financially worth it 🙁

NHS dentistry is also not of the same quality as private, as the fee simply doesn't allow it. Many people think they are the same. My DS is a dental student and said he would never go to an NHS dentist, the standards are so much lower.

I think there needs to be better provision for people with anxiety as I know a lot of people who don’t go as they are terrified. I understand sedation and anaesthesia are expensive and not ‘necessary’ but if it was easier to access as an option more people would get dental issues sorted. I know for me, the main reason I left one of my molars for almost a year to become more and more painful as it rotted in my mouth was anxiety and shame -it would have been salvageable had I not left it until bits were crumbling off. I was mortified.

Alsoore consistent NHS dentists that don’t shame people with mental health issues! I had the nicest dentist pull the tooth I mentioned previously, he was so understanding and kind. For my last checkup he wasn’t available and l had a horrid dentist who shamed me for the state of my gums (I have issues with skin picking on my gums in particular which causes me dental issues). I know it’s bad, I need my teeth checking not a bollocking like I’m a child! Haven’t been back since as left in tears.

My husband had the BEST dentist ever. His teeth aren’t great due to his lifestyle when he was young and this man saved teeth other dentists had said would need pulling, even when it meant going back 3 times in one week to have the filling replaced and different techniques tried to make it work. He never made my husband feel shitty or embarrassed about his situation- we moved from practice to practice to stick with him.

He moved a couple of years ago to another country and we were so gutted, we wanted to get one of DH’s teeth issues sorted by him before he moved and this dentist made sure we were booked in two days in a row including his last day working in the UK. This was at a private practice (had previously had all treatment by him on the NHS) but we agreed it was worth the money to see him before he moved, and at the end of 2 days of extensive treatment, x-rays and a complicated root canal we got to the front desk to pay the £550-odd cost of the treatment and the dentist had done the work entirely for FREE.

Our son was only a couple of months old and he said he was so grateful for our loyalty and trust that he’d done the work for nothing and told us to put the money towards a nice first Christmas for our son. I felt like I had to tell this story because it’s one of the most wonderfully generous things anyone has ever done for us. It made such a difference and the dental work had held up amazingly.

If all dentists were this kind, understanding and empathetic more people would probably go to the dentist. I personally am avoiding it until a problem crops up as my last experience was so bad. That coupled with the costs of treatment, I don’t get haircuts or nails etc so it’s not like I’m prioritising the wrong things, it’s just a load of money in one go if you need treatment and it’s not always affordable for people.

@LaTristesseDureraToujours
The NHS dentist I saw today did make me feel comfortable.
I saw a private one about 14 months ago, and he make me feel terrible. I was panicking in the chair, and he just kept repeating "what is wrong?" over and over. He called in 2 colleagues to just do the same.

Not a choice for a lot of us though.
I have a cavity that needs filling. My NHS dentist ignored it. I am sure I will be back as an emergency when I have an abscess.

Ours costs a fortune. Fillings are £200. Check up around £100. Root canal and crown around £1800. They don't do Denplan once you're older and your teeth start to deteriorate. I work in a fairly low paid sector. Lots of us are missing teeth. Dentures and implants are thousands. This has been going on ten years or more really, it's not new. So I don't see how Labour are meant to fix it overnight. It will take years to undo the damage that's been done.

Only dentists who left more than 27 years ago received any funding and , in general, they are the ones propping up NHS dentistry. The average practitioner in my area is in their 50s and is still working NHS because of the pension. As this cohort retires then there is no one to replace them, particularly as if you add the massive cost of buying a practice the already difficult economics of NHS practice become impossible.

The fact is most NHS work makes a loss . I have two close friends who gave up their NHS contracts this year after both losing a 6 figure sum on it the previous year. Banks, utilities , suppliers all need paying and when even a check up loses the practice money the fact is a practice providing mostly NHS treatment is walking a financial tightrope. Oasis closed 85 practice because they couldn’t make the sums add up.

Is it really reasonable to expect a dentist to pay £7.69 to see a child on the NHS? Because that is how much, on average , the loss is https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/.

For many NHS treatments a dentist would be better off giving a patient £20 to go away and see someone else. It’s not that profit is king but that you can’t pay your bills, let alone yourself on NHS rates and bankruptcy follows.

The majority of dentists , young or old, will never earn £100,000 plus at any time in their careers.

Dentists have been propping up the NHS with private treatment for years , their good will kept things going even as income plummeted and fee rises have been less than inflation for years and that is no longer sustainable . Save your anger for successive governments which have stripped funding from dentistry for decades , resulting in fee cut after fee cut and the collapse of the service which dentists can no longer afford to,run .