NHS dentist dropped DD part way through agreed treatment plan - any advice?

[MrsWhites]

My daughter is under an agreed NHS dental plan, she is currently awaiting surgery and then braces.

Her primary dentist is mentioned in the plan written by the dental hospital. However, as she is 19 (plan is still NHS funded as she was 13 when referred but Covid and surgery waiting lists have meant a ridiculous long wait), I have been advised by her primary dentist that she is no longer eligible for NhS treatment there. They say they no longer have a dedicated NHS dentist and the private dentists only have the capacity for children to be seen as NHS.

What can I do? It seems very unfair that after waiting all this time we will have to either find a new dentist (very unlikely in our area) or pay for the parts or the treatment to be covered by the primary dentist.

There is no such thing as registration for NHS dental patients in England and Wales , so the surgery is under no obligation to see your daughter and , indeed , if they have a child only contract can’t see her anyway.

She may be waiting for surgery and braces etc but that is nothing to do with the primary dentist and she is not part way through treatment with them .

Your options are to phone around , even out of area , for a NHS dentist or go private for her routine check ups and any other treatment necessary.

Thanks for replying. I understand that dentist registration doesn’t work like GP’s, however they are mentioned in the plan written by the dental hospital, there are a couple of points in the plan where they are directed to carry out work which obviously now they won’t do.

Finding another NHS dentist is impossible in our area, I think in this case I will have to refer back to the dental hospital and let them sort it out.

As I understand it the problem is NHS funding. Now she’s an adult, if the dentist carries out this work they won’t get paid for it at all. Not their fault and they’re not obliged to do free treatment.

The hospital will not be able to help, they have no authority to compel any dentist to do work , they have no power to find a dentist and no facilities to do it themselves . A particular dental surgery is named as they did the referral , there is no compunction that they will have to be the ones to do the work .

I presume the work is extractions or possible build ups of teeth, You will need to find a general practitioner NHS or private , not only to do the work but for your daughter to have regular check ups in the meantime .

I appreciate that the dental hospital can’t make the surgery do the work but can I ask why you think they wouldn’t be able to do the work themselves? They were going to do some of the treatment but then they decided to send it back to the initial orthodontist that referred her to them.

Surely they can’t come up with a funded plan and then half way through say ‘oh sorry there is no-one to do that part of the work so you’ll have to pay for that part’?

The NHS have agreed to fund her treatment despite her ageing out so to speak because she was on the waiting list for so long and because her issues aren’t cosmetic so the funding isn’t the issue. They have just lost their dedicated NHS dentist to physically do the work.
To be fair to them it wasn’t them that came up with the plan, it was the dental hospital as she was referred there because it’s a complex case.

That's disgusting, @MrsWhites . My adult child is still having treatment in similar circumstances. Is there a complaints procedure at the practice? I think I would contact my MP. It's just unethical to leave a course of treatment incomplete.

Explain what's happened and ask the hospital what to do, they may well be able to do the other work or if not point you in the right direction.

@bigboykitty i have emailed the practice to clarify the position but to be fair to them they didn’t come up with the plan so I assume they will say not their problem.

@BadgernTheGarden that’s my next step, she has an appointment there soon so I will discuss it with them then. The work is restorative mostly and looking at their website they do offer this by referral so hopefully they will be able to take over at that point.

DD2 16 - and was under when her brace treatment started - the orthodontist said she would likely be retiring before it was done but not to worry as once treatment had started - some dental/medical body we're in wales - would automtcially move us to another NHS orthodontist - which duely happened (the area some though waiting lists are years long).

So I think if they've agreed to fund it as she been on the waiting list before she was 18 - it should be someone responsibility to find a way forward - I'd start with the dental hospital service and see if they can direct you - if not maybe pals or local health board.

Though having said that Dad in England was left in shocking state when his NHS dentist dropped him and hopsital dental service would only do extrations - cause a lot of pain to housebound man at home and in hospital - caused by medciation side affect - that no-one wanted to take repsonblity to help with. He seemed to fall between services or couldn't directly access service there was supposed to be for people in his situation.

It's unfortunate but she's not a child so not covered for free/nhs dentistry anymore. That's the rules for everyone.
It's not the fault of the dentist that treated her as a child. He/she has no obligation to continue treating someone once they're an adult.
A treatment plan isn't some legally enforceable document, it's just a suggestion of what the person needs ideally for dental fitness.

If it is restorative and they have a restorative department then it’s possible that they may be able to do it. However the referral criteria for restorative departments make it clear that inability to pay is not a criteria for acceptance for treatment. If it is a teaching dental hospital there can be very long waits for treatment and there is a limit to what students are allowed to do. The consultants will only handle a very small amount of complex work that meets referral criteria.

This gap in care happens a lot eg when people have teeth missing part of a treatment plan may be to have implants, eventually , but unless you are missing 6 plus teeth that will have to be funded privately and , to be fair, hospitals will warn parents about this.

In my area the restorative budget is enough to cover the costs of rehabilitating two oral cancer patients a year . That is people who have had large parts of their jaw removed. There is no budget for anything else. This is a view of a typical restorative department criteria https://www.guysandstthomas.nhs.uk/our-services/restorative-dental

So it is possible that a large teaching hospital might be able to shift the referral criteria for your daughter to have the restorative part done there , but it is an outside chance at best .

As she is about to have very prolonged treatment she needs to have regular dental care anyway so she needs a general dentist . You don’t have to be in the same area , you can travel if it needs to be NHS , but she needs regular care on top of the hospital care.

Thank you, it is a large dental hospital so hopefully they can help. They’ve already been involved quite a bit as they didn’t agree with the orthodontists initial plan to remove healthy teeth just to improve symmetry. They then decided that she would be better with having the baby tooth removed and in the absence of an adult tooth to create space with the brace for a bridge with a view to having an implant when she is older (which we know we will have to pay for).

I don’t have an issue paying for her general check ups with the dentist privately, to be honest it’s not that much more than an nhs check up. It was more the bridge work that we are concerned about as with the gap they have created it is now necessary and when discussing this with the dentist yesterday they said it can be expensive.

Thanks for your help!