What's the answer to the loss of NHS dentistry in the UK

[Thottey]

600 practices have withdrawn completely from NHS dentistry in ten years.
My DC, both adults were told their dentist wasn't going to treat them any more unless they went private. They have registered as private patients elsewhere.
Private dentistry is hugely profitable but it used to be focused on cosmetic dentistry and serving the wealthy. Now their patients are from all walks of life.

NHS work doesn't pay and there needs to be an alternative.
Perhaps clinics where the dentists are directly employed by the NHS. Recruitment would be difficult at first but I think the vast majority of the population would abandon private dentists and use the NHS if they had chance. I'm aware there are a few of these already. The waiting list for the one in my area is four years.
So gradually the private firms would lose patients and there would be more dentists to recruit.

All the dentists I know are very wealthy too.

Strange , the only very wealthy dentist I know made their money from property developing , not dentistry .

None of my colleagues I know well enough to know their finances would even remotely be described as wealthy , 78% of dentists do not own their practices .

Even so , with a newly qualified dentist graduating with over £100,000 in debt , plus the costs of specialising training and equipment and the years of training , I do not begrudge any colleague who earns well, they will have worked damned hard to get there and there are far easier ways to earn a good living.

It’s impossible to get a good living purely on NHS work as most practices will lose money on it , it’s the private side that subsidises NHS and keeps the lights on in the practice . https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

For most NHS work a dentist would lose less money giving you £20 to go elsewhere.

There are more dentists on the dental register than there have ever been . They just can’t afford to work on the NHS at a loss and flogging themselves to death whilst doing so .

The NHS doesn’t employ many dentists (it’s much cheaper to contract out to practices in the community ) private practices who contract services with the NHS have arrangements with self employed dentists to provide NHS services . The point is if what the NHS pays isn’t even enough to cover the practice expenses how are these dentists expected to earn a living?

I don't think anyone disagrees that the current model doesn't work. Not is there the political will to invest more money.
I guess people aren't dying of bad teeth so it will never become a priority.
Insurance seems a good idea but then if you suggest any kind of semi privatisation of health services it's taboo.

A couple of my DCs friends went into dentistry. From what I can tell they got jobs in practices that do NHS work and had to do that for a couple of years but are now allowed to do private practice which involves as much expensive cosmetic dentistry as possible and they are doing very well financially.
Yes to huge student loans but no different to doctors, teachers.

I recently had some problems. My NHS dentist would only consider extraction. I am high risk due to drugs I take so went to an endodontist. I'm £1000 lighter for a root canal. I appreciate I'm lucky to still have an NHS dentist though fully expect them to stop any time.

People can and do die from bad teeth. Bad teeth can affect your heart.
I have seen posts on Reddit and on here where someone has had a family member that has just pushed through recurrent infections, then died from them. Not from sepsis either, but from the cardiac effects. Having a constant low level infection can do a real number on you.

I have an NHS dentist, but he literally looks in my mouth for all of 60 seconds and says I don't need anything doing... when I know I do. I swear it is because I am on UC and do not have to pay anything at all.

Much higher loans than teachers as much longer course and at the end the dentists are not employed , they are self employed so have to earn at least 30% more to have equivalent benefits eg holiday pay, sick pay , pension etc .

Your endodontist would have done further training to get qualified in endodontics , probably around another £50,000 plus the cost of equipment eg operating microscope £20,000 plus cost of consumables and disposables eg one vial of specialist cement for one patient £90 . Plus the hourly cost of running the room which will be a minimum of £200 in a cheap practice , plus the costs of continuing professional education to keep their endodontic knowledge up to date which will be a few thousand per year , plus the increased indemnity insurance (malpractice insurance ) for being an endodontic specialist and you are more likely to be sued in the U.K. than anywhere else in the world.

You can earn a relatively good living as a dentist but it is very hard work, extremely stressful and there are much easier ways for the very bright and able students who get into dentistry to earn more money .

You cannot earn a good living just doing NHS dentistry. Very often you can’t even cover practice expenses , let alone be paid anything yourself.

I know someone who went to Turkey for numerous implants. Said the hotel was full of British people getting the same. The reason for the implants was to do with long standing problems with their teeth so there was a cosmetic element in terms of the appearance of their teeth being improved but the primary motivation was related to tooth health.

No you get exactly the same amount of money if a patient pays a contribution or if the patient gets free dental treatment . There is no difference financially to the dentist or practice.

My DC’s friend is studying dentistry. Is a clever enough kid but not particularly outstanding.

I don’t meant to be rude but there is often a vibe of “if they weren’t doing this they would of course be earning millions as a top corporate lawyer” when medical/health graduates are discussed and no, mostly they are going to earn way more in the health career they have chosen than hypothetical alternatives.

Seems a fair price TBH

I have been to two different NHS practices and found the same thing.

Time to take responsibility for your oral health

I think the era of being looked after unconditionally by the government is coming to an end.

I think the government needs to be honest about that then and just make ir clear that NHS dentistry doesn’t exist, everyone needs to pay insurance premiums and those who are on the lowest incomes will be have theirs paid for them. Just as long as it doesn’t go the way of vet bills.

They are outstanding as this year around 5% of applicants got a place to study dentistry . The CV with volunteering and other useful life experiences , UCAT score and interview are equally vital as the As and A*s expected at A level.

I heard that too.

I don't mind paying private as can't get into an NHS dentist and want to grow old with them intact.

Recently paid £300 for a filling, then someone moaned to me they had to pay £80ish for an NHS filling. Such a vast difference and if they had needed more than one filling that cost would have covered it.

If they had needed more than one filling the charge to them wouldn’t change and neither what the dental practice earns . You are paid the same for one or ten fillings and it’s why NHS work loses the practice money . The only thing paying the electricity bills is the subsidy from private work. https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

Well yes, no one gets implants with a full set of healthy teeth? The whole point is to replace rotten teeth. Thats like going to a prosthetic leg clinic and saying the primary reason people were there was missing legs

Perhaps you dont need any qualifiable NHS work done then? The money patients pay goes to the government, and the government pays the practice for the amount of work they do, the practice in turn pays the dentist. Whether you pay or not is irrelevant to how much the dentist makes

Easy to say if you don't have genetic conditions that cause bad teeth, medication that affects teeth... even pregnancy can fuck your teeth up.

Scottish process is a bit different in terms of grades. I never understand why if medical jobs are felt to be so stressful and poorly paid that the demand for places is so high.

I would like to think that. But I have severe erosion on my back teeth, several cracked teeth, and one that has a hole in (dentist says it is just broken and not a cavity... said I can have it pulled when it hurts).
I have missing teeth in my smile line. It is "cosmetic" and I was told I will have to see a private dentist to get that sorted. Makes no sense to me as my pensioner DF had loads of teeth removed on the NHS, and was being fitted for dentures. But he was paying NHS rates. I pay nothing. And I am not alone in this. I know several people on UC who get fobbed off with extraction or nothing.
And this is the second practice I have experienced this with.
The first one, she said what I needed doing. I went to arrange next appointment and they saw I was on UC. Appointment after that... I don't need anything doing.

It’s a sad state of affairs when there are hotels in Turkey full of British people getting clinically necessary dental treatment.