NHS Dentistry takes the piss

[gobbin]

AIBU to wonder why the Receptionist at my dental surgery gets pissy when I haven’t been for 2.5 years (because my teeth aren’t giving me any bother, I just thought I’d have a check up) and arsily suggests that ‘I’ll have to ask the dentist if he’s prepared to put you back on his books’.

Fuck me, my hospital consultant only sees me once a year for my well-managed, life-threatening chronic illness, my tits and fanny get seen every 3 years...what the fuck is so different about teeth that the dentist NEEDS to see a patient every six months. Apart from the kerching they get from the NHS, that is. Christ, if we all went to the GP every six months for a check up the system would be beyond breaking point.

The difference between dentists and hospitals is that dental surgeries are not part of the NHS. They are private practices and have no obligation to treat you. Many will have a contract to dispense NHS services but they don't have to have one and they can choose whether to let patients enrol with them I doubt they make much if any money out of someone who arrives for a check up every three years so like any business they may decide they don't want your custom.

I only go about once a year and just pay privately. It doesn't cost much more than the NHS and the check up is more pleasant and much less hurried. Noone has ever suggested that I go more often. People spend loads on getting their hair cut and loads of other things so unless they are on the breadline or their teeth/gums are in poor shape I don't get why people seem so desperate for an NHS dentist.

I went to the same dentist for 40 years. Then I didn't go for a year because I was having chemotherapy and wasn't allowed. During that time my dentist retired and they took me off the books 😐 I was very very lucky to find a dentist just down the road taking on nhs patients! I had a whole course of treatment to put everything right and it only cost me £45! The dentist explained that it wouldn't cost any more no matter how much work I had done. I was amazed how cheap it was!

NHS dentistry is shit, they get their £30 or whatever it is for a kids check-up and spend about 2 minutes checking because they dgaf, it's just to get the money.

Our lovely NHS dentist sees both my children every 3 months, as they are autistic, and she wants to build up a good rapport with them. She gives them longer appointments so they don't feel rushed and has made amazing progress with them - they've gone from hiding under the chair to sitting in the chair and allowing her to check their teeth and take xrays of their teeth. If she was just after a quick and easy dental check up, she could have off-rolled us two years ago, but she has put in loads of time and energy easing my children into coping with dental care. I am immensely grateful to her for this.

I hate going to the dentist after a traumatic experience as a child. Was really flaky with it for years, didn't go often. Now I have children, I don't want to pass my anxieties on to them, so I wanted to make sure we go to the dentist regularly. Took me a year to find an NHS dentist to register with. Then took months to get an appointment. Finally, we're on the right track.
Yes, I think dentists and opticians should be included in the full nhs funding, but it's a historical thing that they're not. Incidentally, GP surgeries are also privately owned and contracted to do NHS work. Given how lacking the nhs is when it comes to money, that isn't going to change any time soon. So we'll just have to find the money for our 6 monthly check ups and hope the preventative treatment is enough to maintain our dental health.

I'm at the "firefighting" stage of dentistry now. I've always been regularly but a combination of various things - the main one I suspect being smoking - has left my teeth in terrible order. But I only get a reminder every 12 months and NHS dentists have worked miracles on my teeth.

Also we moved away for a decade but they let us come straight back onto their books

Only nhs dentist near us only take on children or those on benefits so 100% freebies. They won’t take on paying nhs clients.

The reason you have to go regularly with NHS dentistry is because there are very limited NHS resources. We only have x amount of UDAs per year, and any work above that we and the practice don't get paid and will lose money. So we have to know roughly how many patients we are getting every six months and how many UDAs we are likely to use that year. If you are on our books and don't use the service then you are taking up space that could be used by a patient that will come regularly, taking up NHS resources.

The other reason is because obviously with the NHS we get paid the same whether we do one filling or 30 fillings, if you come every 2.5 years there's a much greater chance that you are going to need more than 1 or 2 fillings. Which isn't really fair to us, or the practice. We would make a loss. And it's not fair on you because instead of a small filling you could end up needing a root filling or losing a tooth.

The third reason is obviously prevention, for example with regular scale and polishes to prevent things like gum disease, give you regular advice. Also think what percentage of the population will need a filling compared to the population who will have other health conditions. It's for your own benefit.

If we lose money we will eventually shut, and those UDAs won't get redistributed. Ergo less NHS dentistry. NHS dentistry doesn't make an aweful lot of money. I don't get paid 20 for a check up I get paid 8(1 UDA), if you need a filling I will make 24 (3 UDAs) but that could be for several hours work if you need multiple appointments or a root filling. If you need a denture I will make 100, but then there's probably around 60ish in lab costs bare minimum, could easily creep up to 100 and that's 4 or 5 appointments. A lot of the time I am working for free.

The rest of the money goes to practice running costs, which are high. There's obviously nurses to pay, material costs. Most of it is to ensure your safety as a patient. I think it's about 300 an hour to run one dental surgery.

If you don't want check ups and just want to go when you have a problem then you don't want NHS dentistry. You want private dentistry, that service isn't what the NHS offers. If you want NHS dentistry you need to use it regularly.

We also realistically don't know if you are ever coming back so will allocate your space to someone else who needs it.

Sorry bluecornishpixie, what is UDA?

To add to the discussion, Bluecornishpixie has, IMO, explained very well why NHS dentists ask their patients to attend regularly and I think they are reasonable points.

I didn't used to attend regularly and then needed a lot of work. I do attend regularly now (plus 6 monthly hygienist).

I had the same issue I hadn't been for three and half years. I rung up and they said I had been removed from their books.went a a different dentist all was okay however he still recommended I come back in six months.

It annoyed me more when 4 months after my last check up I’m getting reminders telling me I’m overdue and if I don’t have it they will remove me from their treatment list. My check ups not due for 2 months!!

There is always at least a 3/4week waiting list for mine. I get what people are saying, about catching problems early and therefore saving time. However in reality if every client my dentist has suddenly wanted to be seen every 6 months I cannot imagine the waiting list!! Not that I worry, my dentist surgery doesn’t take card payment and there is no computer. Everything is in files behind the counter so none of the money is getting spent there!

Love my dentist by the way, he is a wonderful man and definitely not greedy.

A UDA is a unit of dental activity, the practice gets allocated a certain number per year and each treatment is worth a certain number.
So a check up is 1
Most other treatment is 3 (and this is for the whole course of treatment including the check up)

Then lab stuff is 12 (again everything n that treatment plan including all the fillings, the check up, could be multiple crowns or dentures would come to 12)

So you have to be quite careful about how you use them because otherwise you could get to the end of the year and either have use way too many in which case you won't get any money, or you could have not done enough in which case you've waisted time, you have to pay the NHS money and those udas will never get used. So that's valuable nhs dentistry time that hasn't been used.

You'rr welcome to come as often as you like, but if you don't want to comply with the NHS recalls (could be 3/6 or 12 depending on your risk levels) then it's not fair on the practice or everyone else who wants to visit an NHS dentist but cant for you to be NHS and you would be more suited to private dentistry.

As a dentist, thread is so depressing.
I wouldn’t do Dentistry if I had my time over again. It’s too stressful.

I’m going to start a chat thread on the Healthcare board if any dentists want a moan

Valley- fellow dentist here, I can't agree more!

Ex dentist here, not a single regret except maybe taking too long to leave the profession. Fuck this shit!

I’ve found a big difference between nhs and private dentistry. NHS dentists aren’t really paid enough per unit so all of the ‘kerching’ stuff is rubbish really as they have to be speedy to make any sort of money and I’m sure can’t always offer the service they might otherwise want to.

I just paid £52 privately for the hygienist and I go every 6 months. Having a 30 min appointment and a proper scale and polish is quite different to what I had on the nhs (which was a quick scrape). There is a lot more scope for education re prevention and improving brushing technique or flossing etc.

Nhs dentists have a contract with the government to carry out x amount of Units of Dental Activity every year. If they don't fulfil that contract they have to pay money back to the NHS at the end of the year hence why they will want patients who will stick to the recommended 6 months to 1 year appointments (This recommendation comes also because of the idea of preventative dentistry rather than restorative I.e prevention is better than cure). What's more if they treat over the x amount of the nhs contract they actually do not get paid for it the patient still gets free treatment but the dentist gets nothing for it whilst still having outlay costs coming out of their Paycheck. At the same time the Government are handing out less and less nhs contracts which is why NHS places are like goldust...they simply don't exist. It's not always greed on behalf of the dentist. I don't think many people would gladly work for free.

I had the same dentist for the first 40 years of my life, until he went and retired. Never even had a locum in that time. So I was a bit nervous about getting a new dentist, but I like her, and her maternity replacement. My appointments don't take too long, even with x-rays, but I have never felt they're not looking at everything. Seems good service for what I pay each time.

Well the pissy receptionist has prompted me to find another NHS dentist - three week wait for an appointment for two of us in the family, instead of “well I’ll have to ask the dentist if he will continue to see you and his next appointments aren’t til mid April.” Well fuck that.

Its like running a car into the ground then wondering why a mechanic is charging £s to fix it instead of regular servicing.

Its like running a car into the ground then wondering why a mechanic is charging £s to fix it instead of regular servicing

You misunderstand (in my case, specifically) as my teeth are in a stable condition. Very little has needed to be done over many years apart from replacing some large ancient fillings and a broken tooth caused by hard food. Had a scale and polish maybe every three years or so and never seen a hygienist.

I suspect there are many like me who can’t get my head around the idea of being penalised for NOT using a service unnecessarily. The arguments above about attending and UDAs are based on financial considerations not patient need. Bonkers.