Am I being a CF?

[DerelictWreck]

About 6 weeks ago I registered with a new dentist and asked for an urgent appointment as a bottom front tooth looked chipped it had become sensitive.

Dentist couldn't see me for a week (not urgent but if they're busy, they're busy). At my appointment she said my tooth wasn't chipped, it was just scale and needed a scale and polish. She told me to book in two appointments for treatment - one with her to replace a filling that was loose, and one with the hygienist for the scale and polish to deal with the issue.

I have had to wait 5 weeks for availability for these appointments, which I am sat in the waiting room for now. Receptionist has just told me that the hygentist appointment is £50 which no one mentioned before.

At my old dentist scale and polish was always included in the treatment and a quick look at the nhs guidelines says that this is how it should be. I have asked the receptionist t to clarify with the dentist why I have to see the hygienist and pay extra for this service, and instead she has cancelled my appointment (slight language barrier I think).

Am I being a CF here or am I right to be pissed that I'm being held to ransom a bit over an urgent piece of treatment as an nhs patient?

I think its your responsibility to ask about cost. I have always paid for urgent appointments. You still saw a Dentist within a week which is a lot quicker than the scheduled 5. In your case it could have been a lot more expensive.

You said there may have been a language barrier or crossed wires regarding your cancelled appointment, so you can't really call it being held to ransom.

By there shouldn't have been any costs? It's a piece of treatment which nhs patients are entitled to for free?

I know 'held to ransom' was a little emotive but that's how it feels!

I just joined a new NHS dentist and was disappointed to find they didn't do any polishing at all, unlike my last one. I only joined to get a hygienist appointment anyway, but I would expect some basic effort from the dentist. I think some dentists are just a bit crap or cutting corners, so personally I'm just looking for a new dentist instead.

I might be being a bit dim here, but I thought everyone paid for dental treatment?
I'm with a private dentist and always pay, but I thought free treatment was only for under 18s...

Yes Iam thats right, but you pay in 'bands' so band 1 is supposed to cover your appointment and any basic work like scale and polish. But they want me to pay my band 1 price and £50 for the scale and polish

Dental Hygienist here.

If a scale and polish is not deamed “clinically necessary” by the dentist at the check up she / he may decide not to carry out the procedure. The presence of scale alone does not necessarily mean you have to have a scale and polish. This is open to interpretation by the dentist mind you so some will and some won’t. Bear in mind also that a scale and polish is almost never an emergency procedure and won’t be treated as such unless the presence of gross plaque deposits are a contributing factor to say acute painful gum disease.

You can be refered to a hygienist for a scale and polish privately and many people take up this option ( I’m flat out busy and booked up months in advance).

If in your case a scale and polish was clinically necessary to treat existing gum disease that was threatening to cause tooth loss then it could be carried out As part of your treatment plan at no extra cost. Dentists are therefore unlikely to carry out scaling and polishing on the NHS unless it is to treat aggressive gum disease.

If it’s not to late ask what your BPE scores are. If they are 4’s ( sometimes 3’s qualify) you are probably justified in insisting on a scale and polish within your NHS treatment plan.

If all you need is some calculus removed to improve “gingivitis” then its perfectly reasonable for the dentist to ask you if you would like to see the hygienist.

BUT ...... she / needs to inform you that the treatment is private and give you a treatment plan and price at time of booking.

Before anyone flames me for this answer , I don’t like the system . I used to work within the NHS providing treatment for all gum disease before the payment system changed in the 90’s .

And the system is open to interpretation as to what is deemed “clinically necessary”.

the above pp has pretty much covered it, but it's the same at ours - NHS treatment all covered but hygiene appt unless necessary not included. I could really do with one, but I can never seem to justify £50.

I'm just lucky to be with a good NHS dentist at all really I guess, they're rarer than hen's teeth!

My hygienest costs £65 so £50 is a bargain - misses point of the thread!

Imagine this scenario.

You go to Costa for a coffee and a cake.
As you are already buying the coffee, Costa has to give you the cake for free.

In this scenario the “coffee” is really the dental check up and the “cake”is the scale and polish.

Mad eh.

@Whatjusthappenedthere

That is completely nonsensical. Doesn't apply to this at all.

I googled the NHS bands, and the band 1 fee includes the treatment PLUS a scale and polish if required. So, according to that, it should be free. But it seems that the sticking point is when is it required; according to the dental hygienist upthread, it's rare that it is actually necessary so therefore is elective. But since this isn't explained on the NHS guidelines for the public, it's easy to be confused.

At my dentist. You get a scale Polish included if you have any gum disease, but once that's cleared up you have to pay. Ours are £40, I've booked one for next time but luckily I have free insurance from work so this and my appointment cost (NHS) will be refunded. We get upto £60 per year for dentist and the same for eyetest so it covers the basic yearly checks.

I'd say the Costa analogy is more like if you already bought the coffee and then they charged you for a spoon to stir it with.

Thanks all - had my appointment and the dentist conceded that I was right - basic scale and polish is ALWAYS included in your band 1 price if it's needed.

They were being cheeky by telling me I needed a hygienist appointment who charges because they do the scale and polish with airflow instead so it counts as an 'upgrade'.

So the good news is I didn't have to pay and I apologised to the reception staff if I had been a bit rude (I was nervous!) so it all ended well.

By the extra thanks to whatjusthappened for taking the time to explain how it works! A little more confused now as no one has mentioned gum disease or gingivitis but I still got the basic scaling included.

Either way, don't be afraid to ask and double check people!

I last saw my dentist 3 years ago.
So when i recently needed work done my dentist took an x-ray for my treatment plan and then suggested i see the dental hygienist before treatment commenced which makes sense.
i pay £25 for the dental hygienist so £50 sounds extortionate to me.

i'm in Scotland so maybe that makes a difference?

Wow. I didn’t think anyone got free dental treatment anymore (apart from kids and pregnancy etc)

But Costa have already charged you for the spoon to stir your coffee. It’s covered in the price of the coffee. The time it takes to do a proper scale and polish is not covered within the banding system as there is almost never a value placed on the time taken to carry this procedure out properly.

I got a check up, xrays and scale and polish all in one appointment - I think o paid about 20 quid so i assume Scotland is a bit different?

I've always had to pay for hygienists appointments. They have never (afaik) been available on the NHS. They should have told you though but probably assumed you knew. The dentist for over 20 years has never given me a scale and polish. They do it sometimes for the children.

I think forty punds is about average. It is sixty now in my practice to see the hygienist (SE). Obviously depends where you live. Ywent five in Scotland!! What a bargain.

I think the point is getting missed -it's not that hygenists should be free, it's that you're seeing a hygenist for something the Dentist can include in your normal appointment at no extra cost.

Obviously this doesn't apply when you're choosing to have a scale and polish just because.

This was my first every time at a new practice. At my old practice the dentist did the scale and polish every single time at no extra charge. Seems like some practices bend the rules/do things differently.

Worth paying hygienist if you can afford it. We alternate, checkup, treatment and nhs scale, next checkup and see hygienist.
Dentists are robbers tho

Wow. I didn’t think anyone got free dental treatment anymore (apart from kids and pregnancy etc)

Or if you are claiming certain benefits.

For everyone else NHS treatment cost money, but that money is in bands.
Band 1: £21.60
Covers an examination, diagnosis and advice. If necessary, it also includes X-rays, a scale and polish, and planning for further treatment.
Band 2: £59.10
Covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).
Band 3: £256.50
Covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.
www.nhs.uk/common-health-questions/dental-health/how-much-will-i-pay-for-nhs-dental-treatment/

As I understand it you pay once in 12 months. So if you paid band 2 in January it wouldn’t cost you any more to have a filling in November.

Pretty sure we pay the same looking at what visitor has posted - it would be the £21.60 I paid but this included the scale and polish. At a previous dentist they didn’t do the scale, you went to the hygienist but iirc the check up was free and you paid the 20 quid after the scale and polish.

What I posted there was for England, not sure about the rest of the UK.