to be confused about the dentist...

[funnysmells]

I have a tax credits exemption certificate, and have always had my dental treatment from free because of that, which is great as because I am a diabetic I have gum disease and it's a constant battle to keep it under control and requires quite frequent treatment / scaling etc. to keep it at bay.

Having moved to London, I was told that although my dental treatment is free, to have the cleaning / scaling and sometimes root planing treatment that I need, i need to visit the hygenist - and that this person is not covered by my NHS exemption certificate.

This treatment is very expensive. Was £300 last week for root planing, that was medically necessary.

AIBU to think it's a bit out of order for the dentist to not perform this treatment for me? it's confusing.

Also Mackerel

Yes I have parted with money. Over two years I have paid them over £800 for cleaning my teeth when I could have had someone else do it for free. I am het up because I am probably one of hundred of people they have done this to.

Over that two years I have probably questioned it with 4 different staff members and each time was lied to, so I feel their staff are trained to lie.

The conversation went like this:

"I am sorry, I am told on the NHS website that my treatment should be included...why are you charging me £100 per hours...this is an NHS dentist, I registered for that reason"

"No, the hygienist is private, you have to pay for that"

"but my NHS exemption certificate is meant to cover my periodontal treatment"

"Well you can go to the hospital (snort) but who knows what that would cost you"

"So is there an option not to use the hygienist?"

"Well, your condition is very serious, you can take risks if you want but to prevent permanent damage or tooth loss you need to see the hygienist for at least 4 sessions"

And this is how the convo would go.

I do feel they are behaving appallingly. Not only lying but trying to make me believe I was in danger if I tried another option.

I am not so worried for myself...but what about the little old lady who can't heat her flat because she was ripped off? Or the battered woman in a shelter who lets her teeth fall out because she is prioritising saving for rent?

I think we have to bear in mind those with exemption certificates are vulnerable. Our NHS dentists should not lie to them to make a bit of extra wonga.

Dentist is not paid by both you and the NHS. The NHS will deduct what you paid (£19) from what they pay him for the band 1. Unless I've misread what you've posted.

This is what I mean though.

I pay £19 and he gets extra on top of that paid by the NHS. so both me and the NHS have paid him, right?

for what?

Look in my mouth for 30 seconds and tell me I have to pay if I want actual treatment?

I had a good read on this today and found out that the following is what patients rights are:

<a class="break-all" href="http://webarchive.nationalarchives.gov.uk/20130107105354/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_115640.pdf" rel="nofollow" target="_blank">webarchive.nationalarchives.gov.uk/20130107105354/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_115640.pdf

Quoting here:

"What treatments should I expect to be provided under the NHS?

You will be able to have all treatment provided under the NHS that your dentist feels is clinically necessary in order to keep your mouth, teeth and gums healthy. If your dentist says that you need a particular type of treatment, you should not be asked to pay for it privately"

Also read this article, which was enlightening.

www.telegraph.co.uk/news/health/news/9295340/Dentists-forcing-500000-NHS-patients-to-pay-privately-report.html

Really surprised the dentists on here did not seem to know all of this...?

Errr hold on. Be fair. Read what I wrote in my first post. I did say that if it's clinically necessary you should get the treatment on the NHS. That if the treatment is now thought not to be clinically necessary you should ask why (ie has the situation changed or are they trying to get out of treatment, or have they even bothered to examine you properly to check)? I'M ON YOUR SIDE!!! I want to provide clinically necessary treatment on the NHS. I accept that the current system is pretty shit, and sometimes the patients lose out (like paying £19 for a check up + loads of X-rays and cleaning, or pay the same for a quick check up because that's all that's needed). And sometimes dentists lose out (being paid around £60 for many many hours of root canal treatment and fillings). Please don't tar us all with the same gold-digging brush. It's offensive.

I didn't mean you weren't on my side, or to say you were a gold digger. Not at all. I just meant it's odd that the most basic information isn't clear or that you didn't say to me that I should not have been asked to pay privately for treatment I was told was necessary.

I am not suggesting that you do this to your patients...but more concerned that it is so commonly accepted as "practice" that no one even seems to bat an eyelid.

There's 30 odd comments on this thread with some people saying maybe the dentists didn't have a hygienist and one person saying maybe their clinic was too small to cope with the work and one person saying maybe it varied by postcode and one person saying maybe my treatment wasn't necessary etc.

It should all be much clearer to patients.

An NHS dentist should not tell and NHS patient that treatment is clinically necessary and then demand from them that they pay privately for it under any circumstances

From what I have read, they are also supposed to provide you with a treatment plan (I never got) which you are meant to sign (which I never did) and if they recommend private treatment they have to give you those options and they cannot deny treatment that is covered by the NHS to you and need to provide it or refer you to someone who can.

My clinic is obviously grossly negligent - to the point of it being worrying, and I am just surprised at the response being "oh well maybe they did not think it was clinically necessary".

The contrary, I had their practice manager telling me my condition was so bad I had no choice but to pay for it.

I was misled over a couple of years over, and I am sure this dental practice probably misleads all their customers. A few hundred a year of each one probably adds up nicely.

I am sorry if dentists are not paid enough - I have utmost sympathy for the teachers, doctors and other people who serve our communities on salaries lower than they deserve BUT....but the solution is (without sounding harsh) for them to find a different job / strike and negotiate for higher pay ./go into private practice. Whatever works - but it's absolutely not okay to lie to patients, especially those with NHS exemption certificates and lead them to believe they have to pay extortionate prices or go into debt or allow their medical condition to worsen from fears of the costs.

Seems to be to be quite scary that people are not even aware of what should or should not be happening or that no one else on this thread find this "common practice" concerning.

According to that office of fair trading report on that article, they saw half a million complaints in a year from people like me over the same thing. Imagine how many other did not complain.

Scary!

I work for a specialist dental practice in London which is not NHS. My understanding was that general dentist can do the scaling but from more deeper cleaning a hygienist is always better as they have more time (NHS are very time restricted i understand?)
Op if you perio condition is that bad could your dentist not refer you to a periodontist? as they specialise in gum conditions. general dentists might be limited on the treatment they can offer? (please forgive me if I am wrong?!?!)

Rach it might be better...in the same way that getting your hair dyed in a salon is better than a home job; but my point is that my practice lied to me and told me this treatment was not available on the NHS.

they could have said exactly what you said above, but they didn't. they scared the living shit out of me, telling me my case was very serious and I immediately needed this very expensive treatment and that was my only option.

I have no problem with better solutions being offered privately, the same as they are medically - but you should not be told by the person charged with your care and trusted with your treatment that you have no choice but to pay them extra to get help.

Just as an example;

If I went into a hospital with gallstones, I am entitled to have my gallbladder surgery on the NHS but I might wait 6 weeks for it and have to share a room and have crappy food.

If I have the extra cash to do it privately, I might get a nicer room, and faster surgery which decreases my chances of complications and have lovely food and get spoiled.

But not everyone can afford that.

A person with an NHS exemption certificate has been deemed to have the lowest kind of income in the country. They get the certificate to tell their dentist / doctor / pharmacy that they and their children are entitled to free medical care / dentistry etc.

They can't afford £100 an hour to have their teeth cleaned. Even if it is medically necessary.

funny yes they should have explained it a lot better. I have heard of dental practices that don't offer cleanings as part of the nhs, maybe there is a loop hole?

I'm sorry your going through this

Thanks Rach, I am fine, just really concerned for all the people with gum disease who don't get treatment because of this. It seems awful they get away with this.

I am not sure if some practices do not offer cleaning as part of the NHS but from what I read today, if they don't they are obliged to refer you to someone who does and they cannot ask you to pay privately for any treatment that is necessary.

I think in my case, the simple point is that if they had been honest - I would have said "thanks, I will find another surgery who does do periodontal treatment on the NHS" and would have changed dentist and got the treatment I needed back last year instead of letting myself get ill and my condition worsen.

As it was, they told me the treatment was not covered on the NHS, and I believed them. Perhaps I was foolish, but it never occurred to me they would lie to me.

But visits to a hygienist are not available on the NHS? That's not a lie?

A scale and polish would be but is a quick clean. GDPs aren't paid to clean your teeth by NHS, if it's clinically necessary then we refer you to perio in a dental hospital?

I am a bit confused Judy as you say "we", do you mean you are a dentist?

If so then the NHS dental treatment included on the NHS is very clear:

www.nhs.uk/chq/Pages/nhs-dental-band-charges.aspx?CategoryID=74&SubCategoryID=742

Which includes amongst numerous other things:

Band 1

1. a scale and polish

Band 2

1. non-surgical treatment of periodontitis (a severe form of gum disease) – such as root planing (cleaning bacteria from the roots of your teeth) or deep scaling and a polish

So all treatment for gum disease, be it a "quick scale and polish" or much more in depth cleaning and scaling should be included on the NHS for every NHS patient.

If the "hygienist" is not "included" on the NHS, then you are presuming a hygienist has to do his work. there is nothing a hygienist does that a dentist can't do, and actually I was having successful gum disease treatment for many years done by my dentist.

I spoke with my new dentist today who is also an NHS dentist and he told me "If you are an NHS patient then all treatment other than 'cosmetic' stuff should be provided on the NHS. This is clearly stated on the dentist's NHS contract" - and this is exactly what I have read online too.

I have found countless stories online of people like me who have been put in the same situation. A great shame to read the way words are twisted...

I just read this story online which is very similar to what happened to me....

I popped into my local dentist and asked to register as an NHS patient. they said they had space for me and I went in for an initial consulation and checkup. The head dentist made me feel quite worried as he said my gums were inflamed and said I needed 2 hygienist treatments. I went back to reception and they horrified me with a bill for £93. I am a student! I don't have £93! I have no money! I'd much rather stick with inflamed gums

And no doubt this sort of thing is happening up and down the country with dentists getting away with it, and throwing out silly statements like "but a hygienist is not covered by the NHS".

How negligently misleading that statement is

To put that into context of an example:

Say you are in A&E needing 25 stitches and you get told you can't get plastic surgery on the NHS and you have to pay £1000 to have your stitches done, which you cannot afford, so you walk out and decide to leave the wound to heal at home because you do not have £1000 to pay them. Over time the wound worsens, becomes infected and you end up scarred for life.

You then later you find out any surgeon could have done your stitches - maybe not as beautifully as the specialist plastic surgeon would have, but certainly any surgeon on the NHS could have given you those stitches for free which would have been a vast improvement on you having nothing at all.

would you not consider this appalling? Because it is exactly the same thing.

It matters not a fig that the plastic surgeon is a private doctor not available on the NHS - the problem is that the patient was told they had no option and that stitches were not something the NHS did.

The fact that these stories are all over the internet is worrying to me.

Dunno if this helps, but rather than pay out the hundreds of £s OP already has, I know my (private) dentist's hygienists can now take on customers who are not with the practice's dentists - and their appointments are around £60. I have Denplan so for £20-odd a month, I get to see the dentist twice a year and for any treatment, as well as the hygienist every 3 months and that would be a cheaper option for OP than even using the NHS...

You could just find a private hygienist and pay less.

Not sure about the more medical side of it, planing etc. But certainly for regular hygiene appointments, a private hygienist might not be as dear as OP thinks.

Yes I'm a private Dentist. Thank god. Things seemed to have changed since I worked on the Nash. I didn't go to dental school to clean teeth.

NHS dentistry is crap. It's not sustainable with the funds available.

Perhaps speaking to your medical professional would help. If you need root surface debridement that much you need to consider whether your diabetes is being managed properly. I have plenty of patients with diabetes with pristine teeth I appreciate that you are more susceptible but surely you'd just brush more and watch your diet.

I agree with the above, find yourself a cheaper private practice and go see their hygienist instead of pouring over the NHS website feeling sorry for yourself

Definitely see a private hygienist if gum disease is so advanced. I don't imagine many NHS dentists have the time to spend on the cleaning you might need.

Bloody hell Judy that's a lovely attitude, You didn't go to dentist school to clean teeth?

I am sure most doctors did not attend medical school to comfort the elderly with chest pains that turn out to be indigestion, but they end up doing those things anyway as part of patient care and their bloody job as a healthcare professional.

And while I accept you might find it very difficult to comprehend the concept of all the people in your country who do not have £300 or £400 or £2000 a year to spend on dental treatment privately, I assure you they do exist. And that is why we have NHS dental services, for those who cannot afford it.

I have not been "pouring" (presume you meant "poring" but they did not teach that at dental school apparently) over NHS websites feeling sorry for myself. I have been investigating a situation where I was being ripped off.

Turns out that the Telegraph and The Office of Fair Trading agree with me in my outrage, so sorry if that does not fit with your narrow minded world view where all problems are so easily resolved by the poor just pulling their socks up and getting on with being shafted up the arse.

What a snobby character you are!

Marylou, as I have said several times, the dentist down the road offers extensive periodontal treatment on the NHS so the problem is resolved for future. Thank you

The correct term is "pouring" in that context, actually.

Best of luck with the new dentist.

No. It isn't.

"pouring" is what you do with milk over your cereal. "Poring" is the study of something.

grammarist.com/spelling/pore-over-pour-over/

www.vocabulary.com/articles/chooseyourwords/pore-pour/

www.merriam-webster.com/words-at-play/top-10-commonly-confused-words-vol-1/pore-pour

My dentist deals with any tartar during a check up. Normal check up price.

I have to see the hygienist for the scale and polish bit. It's £35. I might ask them why it's not being charged at band 1 prices as the dentist told me I needed to see the hygienist as I had early signs of gum disease, it's certainly not something I requested for cosmetic reasons. Hmm.

Interesting alltouchdout. I can totally understand if someone told me to pay £35 to get a much better clean and it was for benefit of my dental health etc. and I;d probably stretch to going without something to make that happen once every few months, but it's totally different at £100 an hour for several hours. That kind of expense will give me sleepless nights right now, which it did.

What bothers me is that the option / facts aren't being given to people like you and me. I understand dentists are not happy with their NHS contracts and do not have time or make enough money or whatever else is the problem - but the solution is not to do this to patients.