Is my dentist afraid to do a root canal?

[firsttimejoj]

Hi everyone,

I've recently changed NHS dentist and they've told me I need a root canal.

They are encouraging me to go privately as they say that root canals done by NHS dentists only have 50% success rate.

I've had root canal on the NHS before and been fine, so it's making me loose confidence in this dentist. The only thing I can think is that the dentists at the practice are v young, so maybe they aren't experienced enough.

So my Qs to you is, AIBU to question the ability of these new dentists or should I just agree and spend the extra to have it done privately? (£650 vs the NHS price)

Thank you!

It is based on cost. The NHS only allows band 2 charge £60+ for ordinary filling and root canal filling. The root canal takes much longer. I would have the NHS root canal. I don't know whether an NHS dentist is allowed to refuse to do root canal on the NHS

It's more likely to work if done by a specialist. They're probably worried about being sued if it doesn't work.

I've had experience of both NHS and private dentistry. Have literally just had a root canal completed this morning by my private dentist. My private dentist took MUCH more time over the work than my old NHS dentist. She's a perfectionist.

Did your dentist say that it was a particularly tricky tooth to work on? Are they recommending you see an endodontist as they are experts and have much more advanced equipment?

Thank you everyone for being so understanding. @Upsidedownfrown, yes he said it was a back tooth with 4 nerves in it.

I would go private, I think if you go with the NHS you'll end up with failed fillings pain and infection and eventually losing a tooth

It's bloody lot of money though☹️ I feel your pain 🤦🏼‍♀️

As a pp said, they can't really refuse to do the work that's needed so I think you have 3 options;

1. Insist it's done on NHS even though they're not too confident about it but be prepared for it to fail in the future (this is what I did. It was fine for 2 years then bam! Huge abscess draining gunk) had it redone by endo and been fine since but cost a fortune)

1. Have it pulled (probs not recommended)

1. Take the loss and pay out for an expert but again, know that there's always a chance it could still fail down the line

I had an NHS dentist who started on my root canal, but ended up sending me to a private specialist. The specialist had not just the expertise, but much better equipment. The x-rays at the specialist showed so much more of what was causing problems than the NHS dentist could see. I wish I'd got a referral straight away rather than starting with the NHS. I think it is possible to get NHS specialists, but you might have to wait longer for treatment.

It seems as if NHS dentistry is like Tesco basics compared to Waitrose finest (is there such a thing? I'm too poor for Waitrose 😕) if you go private?
actually the discrepancy is probably way bigger than that but you certainly don't get the cutting edge of dental science ☹️

i'm a retired dentist, a back tooth with 4 canals is tricky at the best of times it can be very difficult without working with magnigfication a private dentist may well have a type of microscope to do them which will not be available in NHS
The success rate for root canal (RCT)drops the more canals there are and sometimes canals divide like a delta
occasionally just removing part of the nerve works and once sealed the rest dies off without a problem however it could easily flare up again and then need extraction, obviously having neither seen tooth or xray I'm guessing but I think your dentist feels that unless the root treatment is done under magnification it is likely to fail ( ie a standard RCT will not work because of complexity of nerve network) so you could end up with needing extraction later
the NHS rules do say that the replacement or re-doing of failed treatment for free does not apply if dentist warned it may not work so in this case if he tried RCT and it didn't work on NHS you would need to pay again for extraction

I think this boils down to the fact that on the NHS the best option is extraction but if you really want to try and save tooth you need a private RCT as an ordinary RCT is unlikely to work longterm and perhaps not even short term

it's really good of you to give such a detailed and helpful explanation Teacup😊

It seems as if NHS dentistry is like Tesco basics compared to Waitrose finest (is there such a thing? I'm too poor for Waitrose

I think Waitrose thinks its products are intrinsically 'finest', unless they're 'essential', which is the range for poorer customers , like me!

The NHS/private specialist difference was more Tesco basics compared to Harrods Food Hall

Root canal treatment is very very skilled work. My husband is a dentist and he went to a specialist root canal dentist for his own treatment. Root canals done by non specialists have a much higher failure rate

I think your dentist just doesn't want to do a time consuming procedure for crap pay. The NHS underpays dentists for this kind of work. He may well be hoping to sell his own private treatment, a lot of NHS dentists turned to doing that, and misleading patients about the NHS treatments to do that.

If it's a back tooth I would have it out

I'm guessing there's a reason not to? I know in general we're much more keen for people to keep teeth to support the face structure now

all dentistry needs to work but it is like brand new cars all must confirm to safety standards brakes etc but a £7000 dacia is not a 40K Jaguar but both are safe on the road and drive legally the dacia manufacturer / mechanic is not a maker of unsafe or substandard cars but neither do they provide Jaguar spec for dacia prices nor can they reasonably be expected to; however it is perfectly reasonable to expect Dacia cars to be safe and work
ie if you need a white filling on a front tooth whether NHS or private all the decay should be removed it should be a suitable shape and the filling should stay in, on the NHS it will be one of about 4-5 shades of white and whole filling will be that shade when finished it should be polished so no rough edges and not interfering or catching the bite, however a private white filling will probably be one of about 10 -15 shades, possibly using stainers to mimic the shade differences with adjacent tooth, it may have finer particles that give a better shine so the light bounces better giving a more realistic look etc it may well be 3D contoured with grooves etc to mimic natural tooth and it may last longer

If it's a back tooth I would have it out
I understand why people would make that decision and perhaps it doesn't seem like too much of a big deal but, my concern would be that over the long-term it affects the bone density of the jaw etc?
Teacup
I feel as if what you describe there is what we ought to be able to expect from NHS vs private treatment but mostly can't because of lack of funding in the NHS section?

I've had root canals done by my NHS dentist, but they've also referred me to private specialists for root canals on back teeth.

I googled at the time and learned that root canals are a specialist job that not all dentist can do well, especially when it comes to back teeth with multiple curly roots. The first guy I was referred to showed me an X-ray (that was far more detailed and clear than anything I'd seen at NHS dentist) that showed multiple roots including one with a corkscrew shape.

I was practising in Scotland which still runs on an item of service fee ( every treatment has a fee patient pays 80% unless exempt upto a maximum of £384) rather than banding so root treatment on a molar with 2 xrays and a large filling would be would be about £115 patient charge,
high street dentists work as self employed businesses so expenditure must be less than costs in order to pay themselves and staff etc
it is simply not possible to provide a molar RCT for £60 as all the metal files are legally single use only they cost about £15-25 per set for just basic files so in the banding system it means you need a few patients that need just 1 simple filling to cross subsidise any one that needs RCT
it doesn't seem fair to me that three patients pay £60 for treatment that would cost about £25-30 in Scotland in order that the molar root treatment can also be done for £60 instead of 3 people paying £25 -30 and one person paying £115; it might work out the same in the end for the dentist but then it might not
we should not be relying on the swings and roundabouts methods for healthcare

I'm an NHS patient at my dentist but they also have private patients. I'm still given excellent care, I'm obviously lucky! She root canalled two of my teeth. One needed further work and she referred me but to the NHS dental hospital.

I had a root canal done successfully by a UK NHS dentist, but he insisted I didn't need a crown on top of it. For the next couple of years the tooth felt like it was going to fall apart any minute.

Then I moved to the US and my dentist put a crown on it (standard practice here) and it's been fine ever since - it's now 14 years since I had the root canal and 12 years since the crown.

I got referred to a specialist for root canal treatment on one of my front teeth because my dentist said although he could do it, the specialist was more likely to get it spot on without requiring further treatment. I paid almost £700 which was insane but worth every penny. I didn't feel a thing and the equipment the specialist had was clearly superior even though my dentist is actually private too.

My dentist, who did my root canal on the NHS, told me that the amount the NHS paid him for it only covered the consumables used. In other words, an NHS dentist doing a root canal is well out of pocket. So that might be the reason.

They are being honest in saying they don't feel confident in doing it well so I would either find another nhs dentist to do it or go private. I had to have one redone at huge expense with a specialist even after having it done privately.