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?

That is but a drop in the ocean and there is no new funding for these extra appointments , it is out of existing funding .

A close relative is a tube driver. They have always earned more than myself , a highly qualified dentist who also taught. In one of my dental groups someone there has just retrained as a train driver . Many dentists are desperate to get out of a highly stressful, litigious job .

For many treatments including those involving a lab-made crown or denture, an NHS dentist will often be in negative equity, not merely paid "too low". Would you pay to work?

Yep
I know loads of people who have had dentistry abroad mainly Turkey & Croatia

when faced with cost of 15 -20 25 k even more here and maybe 4 -8k in Turkey it’s obvious why people go abroad

Im on a few dentist pages for dentistry abroad and I think as long as you do the proper research then it’s a valid option

I am lucky I have healthy pretty much perfect teeth but whenever I go abroad I generally get my teeth deep cleaned as it’s much cheaper but I do see my own uk dentist once a year for a check up and a deep clean

i have one tooth that I had removed several years ago My uk dentist wanted over 4k for an implant - 1 implant

I could probably get a whole mouth of crowns in Turkey and a holiday for that amount

My poor DD damaged a tooth as a teenager and is now facing a bill of £3,800 for an implant, she hasn’t had an NHS dentist since 2011, and struggled to find a private one that was taking on patients.

My DS has spent almost £1,500 as well in the last six months and it has cost me around almost £1,000 since September as I had some fillings needing replacing as well as hygienist visits. There is not a single NHS dentist with places in the whole county since I moved here two years ago.

Yep, it's absolutely horrendous. I can't get my child an NHS dentist at all. She has poor oral hygiene due to sexual abuse trauma and she can not stand having a toothbrush in her mouth. She is also autistic. No NHS dentist will accept her or help me. I can't get her referred to a specialist because she needs to go to the dentist to get a refferal.

I'm now looking at trying to find a private dentist who will actually be able to help. I can't afford it, I'm cutting back on food shopping so I can put money away. And god knows if I'll be able to actually get her there.

To train and equip a practice to place implants will cost over £250,000. The minute you start to,place implants your indemnity (malpractice insurance ) rockets up some implantologists I know are paying over £20,000 a year . The laboratory fees and consumables are hideously expensive .

The problem is not with going for dentistry abroad it is with dental tourism as people who go to eg Turkey as dental tourists end up with much more destructive and extensive dentistry than would normally be provided. Eg as a dentist who saw the same cohort of patients for decades I have never cumulatively or otherwise placed 20 plus crowns on a patient .

However 20 plus crowns or all on 4 or 6 on young patients in their 20s and 30s is not at all unusual . It is heartbreaking to see someone have 20 plus teeth hacked to pieces just to make them white and even. Even more heartbreaking when they realise their teeth are ruined for life , they are doomed to a repeat cycle of replacing crowns until the teeth are lost and often they cannot afford remedial treatment and do not realise the NHS will not pick up the pieces from failed dental tourism.

I worked in a setting where people lost their jobs because they had failed dental tourism and could not afford to get it rectified and the constant pain and infections meant they could not be sent abroad which was part of their job.

In some areas you can self refer for community dental service .

If not speak to gp and they may be able to refer to community dental service. There will be long waits .

in extreme cases a general anaesthetic may be necessary for treatment but community dentists are well used to treating those with difficulties accepting dental,treatment.

My dentist was saying he won’t treat anyone who’s been abroad for dental treatment (I’ve known him 27 years and he talks AT me to keep me distracted as I’m a nervous patient!)
He gives me 2 topics to choose from and I picked dental tourism last time

The gist of it I got was if I went and had veneers abroad, I wouldn’t be able to be seen by him
There was a lot more ranting in it about filters, celebrities, Instagram, unrealistic expectations of natural teeth when all we see are white veneers…

I live in a poor area. It has actually got easier to get an NHS dentist here in the last six months, I have no idea why. I had no dentist for a few years, but now have an excellent one.
And to the person saying people will happily pay for a £50 haircut but not dentistry - like many people I know, I cut my own hair.
After covid my NHS dentist said they were only taking private patients. As did many dentists. But the trend is slightly reversing here.

Absolutely good and bad in both sides, even at the practice I go to there are some that are great and some that aren’t nice at all.
The one my husband went to, it was a private practice that did offer NHS, but it was time-sensitive so the only time we’ve done private. The only excellent dentist was NHS for the 5 years DH went to him with the exception of the very last visit(s).

Sorry you had a bad experience, I’ve been there too many times and it’s just mortifying isn’t it. Dentist visits are scary! I wish more dentists understood how much it takes to even get up the nerve to go

What the fuck is this race to the bottom attitude?? Yes we'll live like cave men, bring it on!!!

I’m in Australia and we have never had free dental care as part of our healthcare system, yet the population doesn’t walk around with stinky breath, so unsure why it would be a problem in Britain?

Not sure of exact timeframe but think maybe 15 years ago, our government did introduce a dental voucher system for kids under 16yo whose parents were below a certain income level. I think it equates to 2x cleans and polish a year and possibly simple extraction if required. Doesn’t cover any orthodontic work. Also, not ever dentist practice will accept the vouchers, they are all private practices so it’s up to them and many don’t as it doesn’t make sense for them to. Apart from this we all pay, and dentistry, even basic is not cheap. Having said that, nearly 55% of our population also has private health. Most private health covers 2x cleans/polish per year and a few extractions but anything above this they just chip in a bit and you have a large gap you need to pay. Even for basic clean/polish there is a gap with my dentist (although there would not be with many for clean/polish) but I prefer to see them rather someone else and have no gap. Irrespective, more than that you are looking at large out of pocket gaps no matter where you go really. But again, not a nation with our breaths stinking out supermarket lines🤷‍♀️.

Yes they are just copying and pasting the Tory plan... golden hello's etc all of which hasn't worked.

People don't need "emergency appointments" they need a course of treatment, in order to get their teeth up to a decent standard.

Atm these emergency appointments offer a filling or an extraction.

Labour, did nothing about the lack of NHS Dentistry when they were last in, they'll do SFA about it now.... & one reason, among many, they've lost my vote

I don’t think expecting dentist to paid less will help at all. They will all just go overseas and then it will be even worse!

This is depressing to read.

I tend to agree with this. I pay a couple of hundred quid every couple of years for nice glasses frames, so why not on teeth? Also, where is the BDA in all of this? Where's the professional voice?

Our dental surgery now uses a dental therapist for routine checkups. I was initially skeptical but it works really well, and means my children are seen every 6 months rather than every 9 months. The therapist can also do adult fillings and then refers any more serious issues on to the dentist. I have also seen a lot of orthodontic practices using orthodontic technicians under one orthodontist, which is actually really efficient and has good outcomes.

BDA and Eddie Crouch are very active , he appears on TV very regularly and BDA is constantly campaigning , giving evidence to parliamentary committees etc eg https://www.bda.org/news-and-opinion/news/welfare-reform-has-pushed-millions-away-from-nhs-dentistry/

https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

https://www.bda.org/media-centre/dentists-handed-pay-cut-after-record-
breaking-delay/

https://committees.parliament.uk/writtenevidence/136052/pdf/

the problem is that press releases about not enough money budgeted to keep NHS dentistry alive is not as sexy as a picture of Mr Bloggs with the 6 teeth he extracted in his shed with a pair of pliers .

The problem with using therapists in NHS practice is that many of them refuse to work for what is paid to , particularly , young dentists in the system (rightly so in my opinion). In my area it is cheaper for a dentist to do NHS work because they can do all treatment , than use a therapist to do restricted treatments and split the derisory fees between dentist and therapist . This is because most dentists are paid on piecework and most therapists are employed.

Probably drugs

Report by a Commons committee on the "Dentistry rescue plan" introduced by the Tories has totally failed, resulting in more dentists leaving the NHS and less treatments.

Labour are continuing with a version of this "plan" so.....

All the people where I live have those big shiny white teeth. There's a waiting list for whitening procedures at dentists where I live. I think much dentistry has become cosmetic, rather than a health issue.

Among the better off.... of which there are many.

Yes, you're right. Invisalign, whitening etc, all very popular. Our dentist has expanded and taken on 2 new dentists because of this demand.