Ripped off by nhs dentist?

[moodycore]

So I've got a baby who is 4 months old. I have nhs exemption and currently registered under the nhs with a nhs practice.

When I was pregnant, my dentist had to keep giving me fillings on my back tooth.

After dd was born I became in agony, antibiotics etc. the dentist said she will redo the filling, if it doesn't help, then the cavity is too deep and will need an extraction.
Fast forward 4 weeks ago. I'm the the worse pain of my life. Swollen cheeks, jaw pain the lot.
After being robbed off for 2.5 weeks with antibiotics I finally begged the dentist to see me as an emergency she said she would have no lunch break and see me if I'm so desperate

She saw me and said she will clean my tooth out again and try to numb the nerve and put a temporary filling on and basically i need root canal but it will be private and cost £800. I said I cannot afford it and then would rather have an extraction and then get a bridge.
She laughed and said she will not remove the tooth as it can be saved and she doesn't feel comfortable doing the root canal so I need a referral to an endodontist that will do root canal over 2/3 appointments then I can come back and she will do the crown on the nhs

I took out a payday loan because I simply could not deal with the pain and the private clinic she referred me to literally rang me the same day and said I could come 2 days later.

I had my root canal today and honestly I'm in more pain if that's even possible. Just one appointment over 2.5 hours and I have some shield over the tooth until my dentist fits a crown (it's going to take a couple of weeks)

I just feel so ripped off. My friend said considering my treatment started under the nhs and I'm on exemption that I should have been referred to a nhs endodontist and not had to pay so much.

Aibu? Is this normal? Any dentist on here to explain why this happens?

Lovetoridemybicycle the NHS charge for root canal treatment without a crown is £65.80. The practice will get a small additional payment on top of this.
That is never going to fund practice investment in specialist equipment and training.

I had similar - root canal needed on a premolar that has 3 twisted roots instead of one straight one. Dentist said he wouldn’t/couldn’t do it, he could refer me for NHS treatment but I would probably never get to the top of the list, or he could refer me privately.

I went private (£600 10 years ago) and the work was amazing - no pain at all and it’s lasted well. The NHS dentist did the crown (badly) which has since broken off leaving me with a gap that I’d tried to avoid in the first place.

I’m sure there are some good NHS dentists but I’ve not found one. I’d definitely pay for private treatment for big things like that in the future (if I could afford it).

If all dentists could do every root canal there'd be no such thing as specialists.

Some teeth are just anatomically more challenging, require microscopes, expensive equipment and training. The chance of success in a general dentists hands is very low, the dentist isn't doing this to make a profit, there's no financial gain in referring to a specialist. It is not the dentist getting the £800 it's the specialist practice. A tooth that has reached the point of root canal is already a pretty compromised tooth, and if it's a complex root canal with a low chance of success it's not always justified on the NHS. As with any procedure with a really poor success rate.

@MillyMollyMardy

Graphista your comment about dentists being able to do all treatment is the equivalent of expecting your GP to take out your appendix.

Root canal treatment can be really complex. Specialist endodontists complete an additional 3 years of training and have fancy microscopes and equipment. Dentistry has sub-specialities just like Medicine. If I'm going to self fund a three year MSC in specialist training and then spend thousands of pounds on my kit I wouldn't then be carrying out a complex root canal that takes me 2 1/2 hours to complete and be paid in total about £75 that has to also pay the nurse, receptionist, equipment costs, utilities, CQC, GDC fees, indemnity for that time too. The maths don't work.

NHS Dentistry hasn't been free from charges in the last 70 years. In most areas of England the Local Area teams have not commissioned specialist services such as endodontics. In those that have the criteria to meet them are really strict.

I'm in the South West we have a Dental Hospital nearby, they won't take referrals and there is no second tier referral service for difficult teeth so those with blocked canals, curved roots, resorption its a specilaist privately or extraction.

OP I hope you are in less pain now, I would hope your dentist was acting in your best interests, it is always better to save a tooth that can be treated. NHS guidelines would say a bridge has to be clinically necessary, in the back of your mouth this is rarely the case.

Mummyoply unfortunately you can't reclaim private charges.

*

Thank you for this explanation!

It made me feel at peace and understand it all now!

@Pinkbonbon

I've had route canal on the NHS. Just because she couldn't do the route canal, I'd be surprised if no one could have. Unless it's some sort of particularly difficult tooth.

Route canals take up to 3 weeks to stop hurting in my experience (though they may tell you it'll be less). But the worst of the pain should pass in four days or so.

Root, not route

@MillyMollyMardy I'm sorry but I disagree - barring very obvious complexities like oral malformations that the patient would already be more than aware of, then no in my experience I've not come across a decently trained experienced dentist (which frankly this one sounds FAR from being and I even wonder if they have had adequate training at all!) who can't manage something that is as frequently required/done as a root canal!

The maths don't work. well truth will out! This is what it REALLY comes down to - money!

Which nhs PATIENTS are not responsible for, have no power over and shouldn't be penalise and left suffering as a result!

NHS Dentistry hasn't been free from charges in the last 70 years.

THIS Kind of dentistry certainly was in the 80's and 90's - I know because I had it!

Even now medically necessary dental treatment is STILL supposed to be free

Dentists should be advocating for patients as well as themselves

It really SHOULDN'T be the case that nhs dentistry is so poorly funded and provides such poor quality treatment to patients

there's no financial gain in referring to a specialist.

No "gain" as such but the avoidance of monetary loss - at the expense of patients in pain and suffering

In this case the op actually REQUESTED extraction which seems a perfectly acceptable option to me under the circumstances and the dentist refused. On what basis? I see no clinical sound reasoning for this - but plenty of monetary ones!

At the VERY least the op should have been referred to a dentist who COULD do the job of the root canal and it should STILL have been done for free

It is NOT patients fault that the govt don't pay dentists enough or don't fund them properly to do the work necessary.

Dentists as I said should be advocating and agitating for better funding and helping patients rather than leaving them in pain!

It's a DISGRACEFUL away for ANY hcp to behave towards a patient EVER

Dentists as I said should be advocating and agitating for better funding

So should patients - by not consistently voting for a party that has prompted the crisis in NHS dentistry and by petitioning their MPs. One of my parents has been an NHS dentist for almost 40 years and they completely despair at what the contract has done to dentistry. And dentists are leaving in their droves.

Graphista in answer to you many points.

I'd say I'm decently trained and experienced but I can't do all root canal treatments. Maybe my dental school and all the CPD I've done have been inferior to all the decently trained and experienced dentists you've come across.

There are exemptions from NHS charges for Dentistry for certain groups of people such as children, pregnant and nursing mothers but it's not been free since 1952. I'm also not sure what the medically necessary free dental treatment you refer to is.

I'd love to refer people to a free NHS endodontist in my area. The LA have chosen not to contract these services, so it's not an option. I have sat on many committees over the decades where they talked about doing it, but they never have, I've spoken to my MP, I've spoken to PALS, I have spoken to Healthwatch.
NHS England have said there is no more money for Dentistry. They are spending less on it than 10 years ago. Don't believe the non recurrent 50 Million they have offered this has to be spent by the end of this month and the clawback they will get from practices far exceeds this.
This is why the maths doesn't work because successive governments don't prioritise Dentistry. Labour brought in our contract, it hasn't worked in 16 years, there is a new one coming; our best guess is it's worse.

I'm assuming you are aware that all Dental practices are privately opened and are subcontracted to carry out NHS services. The practices pay for their own equipment, they pay their staff, the Dentists pay for their own postgraduate training. We don't work like GP practices, nothing is paid for us. We receive a sum to carry out a certain number of units of activity, if we don't hit targets money is taken back.
I'm estimating that we are about to have 30% of our last quarters' target taken off us. We will have to leave the NHS if this happens, my team need paying, our bills need paying but I'm sure I'm just being greedy for needing to balance the books.

Why do you not think that dentists have the patients' best interests at heart, that we don't advocate for them? I have spent nearly 30 years working for the NHS and I am finally broken, I can't make it work but please twist that around and tell me we are selfish, greedy and wrong.

Graphista you are clearly enjoying being outraged. Ridiculously over dramatic language and argumentative for the sake of it.
MillyMollyMardy talks a lot of sense. And does so without accidentally pressing her caps lock on and off.

I'm also not sure what the medically necessary free dental treatment you refer to is.

That's supposedly how the current contract stands for nhs patients

I've lived all over the country and had a lot of different dentists as a result (army brat then army wife then full civilian)

I also have a dd with dental problems due to her disability (this includes a slight jaw malformation)

And I've NEVER come across a dentist that can't do a root canal even on dd.

I'm 50 this year and left home at 17. At that point it was MUCH easier to

1 find an nhs dentist

2 get on their list

3 get free treatment and in a reasonable time

Over the years - ime it REALLY started going downhill late 90's-early noughties. At that point it was even regularly in the national news about patients being unable to get registered with an nhs dentist.

I know this was at least partly due to the then govt not treating nhs dentists - and by extension the patients - fairly wrt both recruiting/training enough dentists and wrt the way the funding structure worked to cover the cost of treatments. A lot of what some more experienced dentists then considered to be unnecessary extractions were happening as a result especially in children. Because extraction was cheaper than other treatments and these were families who absolutely couldn't afford to go private.

Since then I don't think matters have improved it's just no longer deemed newsworthy

Thank you for all YOU have done wrt speaking to Mp etc but I'm sure you'll acknowledge not all dentists do, and that actually a group action (via union or professional registration group or similar) by dentists would be far more effective, though yes of course patients need to do their bit too - this is one of the things I regularly discuss with my Mp, msp and gp mainly as dd has had so many issues and finding a dentist ABLE to treat her has been murder at times! And yes by voting for a govt that supports the nhs fully too.

I'm assuming you are aware that all Dental practices are privately opened and are subcontracted to carry out NHS services

I do

Personally - as with gps - I think that should never have been allowed to continue. We should have had nhs trained, funded and operating dentists. I have always said that nhs services should all be fully under the nhs umbrella not one foot in and profits an issue etc

Balancing the books is one thing but I've certainly come across/been made aware of dentists that take nhs patients but in a very limited way that doesn't really serve the patients and their focus and best service (and I don't just mean in a monetary sense but I'm talking in terms of attitude and personal treatment of nhs/private patients) is absolutely targeted at the private patients to the point nhs patients feel ashamed of being so. And where such dentists keep trying to "upsell" to nhs patients and even scare them into treatments/options they don't really need and can't really afford - don't tell me they don't exist cos I've met them! One such dentist was for a very brief time at my current local dental surgery, a while back and this was essentially why he was let go/moved on - because patients were complaining about his attitude and behaviour towards nhs patients which in this area is most patients as it's a deprived area. There's no need for that. I even had one dentist like this try and charge me for the extra anaesthesia I require (I metabolise it very quickly unfortunately and it usually needs "topping up") when I went to my current dentist and discussed this with him he was outraged and said that there absolutely was no need to charge extra for this and that wasn't supposed to happen.

There are dodgy people in all professions.

@graphista no one has said the dentist can't do any root canals, they have said some root canals are beyond the capability of general dentists because they are more challenging for various reasons. For example sclerosed canals, curved roots, accessory canals. And actually you will always get a better success rate with an endodontist as opposed to an NHS dentist no matter what the skill level due to the equipment and time available.

Unless you have a dental degree and have seen OPs tooth and Xray then you aren't qualified to comment. Yes in this case an extraction should have been offered, but it doesn't mean all dentists are money hungry. And yes of course there are dodgy people in all professions, but the majority of dentists try to do the right thing for their patients.

Putting various words in capitals doesn't make your point any more valid. I think that @MillyMollyMardy is well aware of the politics behind NHS dentistry. The majority of dentists have been campaigning for years to change the NHS contract, including big groups such as the BDA. A group of dentists coming together would do fuck all

Well said @Carrotten.

@Graphista, fancy doing molar endodontics yourself? Feel free to qualify as a dentist and work in the nhs. The profession is screaming out for people who are willing to get themselves trained up and offer everything.

Our NHS dentist did two lots of root canal work on two of his teeth and put in two crowns on the NHS last year. It was about - not 10% sure even though I paid - I think about £250 each time? - NHS charges for 3 sessions on each tooth - initial examination, then the root canal main work, then back after a few weeks for the permanent gold crown.

Update guys.

I'm so upset I wasn't aware I would have to pay for a white crown, otherwise it be metal. She said my exemption doesn't cover a white crown only a metal one.
She can do the crown but as her schedule is all booked up and she's away on holidays. I'm getting the impressions done in 3 weeks.. and the crown fitted in 8 weeks??!?? For a price of £560????

I haven't paid/booked anything but I have no clue what's going on.

I feel more ripped off that one tooth is going to cost a total of 1360.

Wouldn't it have been cheaper to have a free extraction then get an implant?

Also been told as I've got a thin glue thing covering the tooth. Until the crowns fitted..I can't put any pressure on my left side of my mouth or my tooth might crack :/

My son had gold NHS crowns (they are at the back so cannot be seen ) and they are better than white ones as they last for life which I believe white ones do not. His NHS cost I thought was about £250 per tooth, nothing like £1200 but I don't know if the root canal work and crowns would be the same for my son compared with apple93.

I've just had a quote for an implant @apple93, £3000, double what I was told about 6 months ago

It definitely sounds like everything should have been explained to you more clearly. When I had a crown fitted I was given a breakdown of the different options and prices.
They are right though than typically white crowns aren’t offered on the nhs, same with fillings and although you have a maternity exemption that it only for nhs treatment.

I don’t know if a removal and implant would be cheaper, I think likely not although I’m sure that doesn’t really make you feel much better. You would have had to wait significantly longer for an implant to be fitted vs the 8 weeks for the crown though.

I had a root canal a few months ago and the tooth has never been the same since. Just a constant pressure whenever I bite down which has slowly turned into throbbing pain. I’m just going to ask for the tooth extracting, seems easier.

I think your dentist sounds crap, all dentists should be capable of a root canal.

I was in this exact situation after years ago.

My dentist first attempted the root canal herself but she couldn't do it. The reason she explained was that the equipment that the NHS is provided with is much much lower quality than the state of the art things the private hospitals have. Essentially the rods she had were not thin or fine enough and she didn't have the machine that allows them to magnify to see deep inside.
My private dentist did the root canal and cost me about what you paid, a little less but it was 8 years ago now!
I was referred back to the NHS and had a gold crown placed free of charge. If its a front tooth you will get a white one.

It hurt really bad for a few weeks, I didn't wake up one day feeling better it just slowly disappeared over the course of a few months til I stopped noticing it.

I had an appointment very recently with a highly skilled cosmetic dentist for something unrelated. After seeing my xrays she asked if my root canal ever hurt. I said no but did ask why and she said something was left inside to prevent infection. Not too sure how that works but I could see it below the tooth on the xray.

You will feel better soon.

Oh and the NHS does offer white crowns, I’m having two done next week so not sure why people on here said otherwise- nonsense.

I'll just add. The white zirconia crowns only last a few years before they eventually crumble but gold will last indefinitely. If you grind your teeth at all gold is much safer as well as its softer.

If its not a front tooth gold will be fine you won't notice it.

@SartresSoul

Oh and the NHS does offer white crowns, I’m having two done next week so not sure why people on here said otherwise- nonsense.

Of course the nhs can do a white crown, but nhs dentistry offers the minimum clinically necessary and as metal crowns and fillings are stronger these are almost always the option covered by the nhs unless it is a front tooth.

Try to ask for a white filling or crown on a back tooth in 99% of dentists without paying privately and let me know how you get on.

There is so much misinformation and anecdotal stories on this thread.

OP NHS dentistry is very limited at present. There are backlogs due to the pandemic, and dentistry is still very restrictive.

There are slightly different NHS contracts in different parts of the country, so what you will have been told, and what has been offered will vary depending on where you live.

For those suggesting referral to an NHS endodontist, I suspect there will be more chance of hell freezing over than for you to successfully manage that. There are exceptions of course, but usually for very unusual and exceptional cases.

Implants start at @£2.5-£3k.
Anything less than that, unlikely to be implants.

The pain might take a few days or weeks to settle fully post op.

In Scotland you cannot get white crowns on back teeth on the NHS.

In the case of the OP, you probably should have just had the tooth out. Sounds like the treatment was complicated. Most likely a private referral in order to have the most successful outcome. Even then, don't get your hopes up.