To think this must be making dentists life difficult?

[denimflowers]

Just a caveat that I'm sure this is all covid and it's crap for everyone. I know I am BU really. Just very miserable at the moment

Dentist check ups were all stood down over covid and then I've had 3 cancelled due to dentist cancelled / I had covid / covid in the house etc etc. All rebooked but pushed back later and later. Cancel in February rebooked to July - nothing sooner. The only option is routine check up or severe pain / emergency appt with whoever free in the practice.

Obviously I've now entered a dental disaster period. Out of nowhere I've got 4 teeth that are hurting. Went for emergency appt, had to have an extraction. Appointment lasted over an hour as complicated then needed 4 more emergency appointment due to complications (stitches / infection / dry socket etc) - I guess this could have been possibly been avoided with a sooner check up.

Every time I've seen a different dentist there they've all said the same - you need a good check up / full X-rays so we can get a full plan of what's going on and needed. But there aren't any appointments. All I can have is a patch up job as emergency and wait for July - and hope that isn't cancelled too.

Surely every time I go in for an emergency it's more work (especially as I'm the sort that nothing ever goes smoothly for). I don't even know how they fit in routine treatment after a check up as that doesn't seem to be an option. I'm on a waiting list for a cancellation check up but my work in a hospital means I can't just drop and run easily.

I'm exhausted with the mental load of this. How I'm going to get the next problem sorted, how will I manage work, how am I going to eat at the moment as it's all uncomfortable. I'm not sleeping and losing weight.

I know it's shit for dentists too though. They can't like working like this either.

For everyone who doesn't have an NHS dentist as no access or kicked off their list - what do you do? Have you gone private?

My Dad ended up at dental hospital as he needed treatment -he got extractions - was referred to other dentists all who refused to take him on - he still hasn't got one.

Mum at a different dentist is hanging on as NHS but keeps expecting to be told they're now private IL are similar - hygienists at their practises are now private and that's what happened first with Dad's. I think my siblings are like us paying for private monthly.

DH and I haven't been NHS since we moved here years before covid - no NHS dentists and a reluctance to admit that by local services. We pay monthly for us https://www.denplan.co.uk/patients.html and considered ourselves luckly they took the kids on as NHS and there still NHS orthodontistry in the area though waiting lists were years pre covid and have just got worse since.

We've had check ups though - roughly one a year insead of six months but they have happend for us and our NHS children and rest of my family have also had them since covid started.

DM is signed up to an NHS dental practice, but hasn’t had a checkup since before Covid; every time we phoned we were told they were only seeing people in pain. The NHS dentist has now left the practice and we don’t know where she stands.

You're not wrong, OP. It must be frustating for dentists who want to treat patients well, but even worse for patients who have minor issues become major due to lack of treatment. My (NHS) dentist said there was a 3 month waiting list for a checkup, but if I wanted to pay for private treatment, I could see the same dentist the same week...it's a miracle how these slots mysteriously open up...

Isn't the point though that 'everyone else pays' is a flippant way of saying - there is no dentistry unless you're comfortable financially? What about the 78000 people on NHS waiting lists who can't afford 'to pay' - what do dentists think will happen to those people? (I'm not suggesting that is their fault, just I'm curious what they think should happen to people who have no money)

I've currently got a temporary filling while I sit on the waiting list for a replacement. But was told if it breaks in the meantime to let them know and they will redo it. Does not seem the most efficient of systems if multiple appointments may be required!

A dentist is a self employed person, think of them like a plumber.
Privately they decide how much to charge for their services taking everything into account such as overheads and staffing. You don’t quibble when your plumber bills you £50 for mending your tap, although you may get a few quotes (you can do this with dentistry too)!

The dental nurse is paid £10-15 per hour, same for reception. A dentist needs to earn £250 an hour maybe, bearing mind their other costs such as rent, materials, overheads, indemnity etc. The actual dentist will usually see 40% of that, before tax. Bear in mind they go to University for 5 years- it shouldn’t be a poorly paid job. A filling may take half an hour, so expect to pay £120 for it privately.

Under the NHS the dentist is paid x amount for doing so many “units”. The dentist is only allowed to do so many units a year. When they are all done then wait until next year. Any extra the dentist does for free. The dentist gets 3 units for one filling or if that patient needs 10 fillings they still get 3 units. So if the patient needs lots of fillings the dentist does some of them for free. It’s a totally messed up contract and one many dentists are reluctant to work under.

Dentists, like everyone else go to work to make a living. They are caring professionals and want the best for their individual patients. The bigger picture-the NHS contract and where that leaves patients who can’t get in and can’t afford to pay - is politics not Dentistry. Talk to your MP about this, not your dentist!

I'm an NHS dentist and it constantly feels like we're firefighting, we spend 18 months working with requirements to ventilate and use enhanced PPE all of which drastically reduced our ability to see our usual number of people. Our check ups have been delayed, when we do see people they need more treatment so we haven't been able to accept new patients.
Locally several colleagues have handed back their NHS contracts, which puts even more pressure on those left. They've left because the NHS Dental Contract is a mess.
I'm booked up for months, something has to give. The Government are not showing any desire to sort NHS Dentistry out. there were access issues in many areas before Covid, now they are everywhere. It's shaeful that they don't support NHS Dentistry, dentistry is something we all need.

But this system puts the patient in the middle. Never have I felt so much of a burden to the dentist for being poor, for feeling that needing NHS care is synonymous with lack of money / respect for dentists making a living / judgement / annoyance. Which obviously perpetuates fear of dentists.

I guess with plumbers replacing taps / hairdressers cutting hair / decorators / car mechanics - you can either have a go yourself using YouTube or just not bother (or get your landlord to pay - the people who have money to run a house). It doesn't cause clinical harm.

That's quite sweet that you're worried about the dentists when a lot of people are angry they can't get an appointment with the overpaid buggers.

You have just summed up why I feel the contract is totally unethical. It’s wrong for a healthcare model to make it detrimental to the provider to do the right thing for the patient.
At least privately I diagnose a problem (bear in mind I didn’t cause the problem and some but not all dental problems are self inflicted!), recommend treatment, carry it out and get paid appropriately. On the NHS there’s an incentive to either not diagnose or not treat appropriately as it actually costs the dentist money!

I go privately, and the Dentist openly admitted her frustration at only really being able to do check ups. They can only do 2 "treatments" ie fillings a day as they have to leave the room empty for 1 hour afterwards. I had to have a filling as like a PP I had decay that was picked up on xray, and had to wait nearly 3 months to get the appointment.

I personally think it's been complete overkill in terms of Covid hysteria.

I remember my previous dentist saying I needed a hygienist clean and it cost £60. I said I just couldn't afford it - it's more than a weekly shop for me. He was so disapproving that I couldn't prioritise it. I just remember feeling so much shame. I don't know how much dentists earn actually but I guess he would have an extra £60 if he needed it. Many of us don't.

I wonder if it 10 years time we'll see posts on here saying I can't find an NHS hospital to take me on. I think I've had a stroke / fits / heart attack and I can't afford to pay.

denimflowers I agree it's not fair, NHS Dentistry was failing before Covid and Covid was the nail in the coffin.
The profession has been hit like everything else with rising costs and currently it's almost impossible to recruit dental nurses and dentists. I have never seen so many adverts in my career. Most of the vacancies are for NHS jobs, which is not helping the access issue.
Dentists like our patients, we want to help them, we are just struggling to run practices with the uncertainty of the NHS contract. For example they set us targets for January to March 2022, 75% of us didn't reach this so they moved the target.They moved it-after we hadn't reached it and were facing massive financial clawback. That's the issue; unatainable targets coupled with financial insecurity.

My dentist already deep cleaned his room between patients. As I said earlier, they didn't have to make a lot of changes to procedures because of Covid.

Plus of course people trying to access a service that the government only ever contracted for 50% of the population.

@Bickles you probably don't mean to, but you sound quite bitter, almost judgmental of patients? I work in the hospital and it never occurs to be to think of whether the issues we are dealing with is self inflicted or caused by staff(??)- they are people who are suffering and we want to help - just a really odd thing to put in your post.

I get really frustrated with people moaning about dentists and making out they are causing the access problem when in fact it is the useless NHS contract.
Obviously decay is caused by sugar so it is self inflicted to some extent!
On an individual level you would never judge a patient for their problems, dentists are very caring healthcare professionals. Relieving pain and rebuilding a dentition is immensely satisfying.

Obviously decay is caused by sugar so it is self inflicted to some extent!

I just don't see what you keep bringing it up though. It's quite judgemental and holds no place in healthcare. Every person who walks the earth will make some unwise decisions about their health in some way - it's what keeps healthcare workers in business or else there would be no need for any of us. Just feels quite lacking in compassion and lack of understanding about why people make certain decisions. And perpetuates fear of dentists.

@denimflowers

Another dentist 👋.
Not judgemental at all.

There are a large amount of patients who really do think the dentist has somehow put the dental decay/gum disease there and it's nothing to do with them.
You won't have come across it as you work in a different healthcare setting.

@Linnet

"I’m in Scotland. Our dentist opened up in the June or July after the first lockdown as my children and I were seen for check ups in the August of 2020 for a routine check up where they did X-rays as well. I then had various appointments for teeth cleaning and a filling, then a broken tooth was fixed in December 2020. Then we were back in February 2021 for a check up, where I was told I needed my teeth cleaned again 🤔 and another filling. I’ve never had my teeth cleaned so often as this dentist did them!

The dentist we were seeing has now left, but they have taken on two new dentists so I think they’re are now 3 dentists in the surgery, and we had a check up booked in for April. This has been moved to August as it’s only routine and they’d rather wait so they can see more urgent cases. Fair enough, but we got an email last week saying that if you were booked in for a routine check up and felt you had no pressing need to see a dentist to please contact them to move your appointment so they can see the urgent cases.

I don’t understand what is going on, we were seen frequently when they first opened up for almost a year and now suddenly there are so many urgent cases normal routine check ups can’t take place"

If you read my comment from yesterday, Scotland have a massive recruitment crisis. They didn't let any of the final year dental students in Aberdeen, Glasgow or Dundee graduate in July 2021. There were a lot of folk who took early retirement as well, so our man power has vastly reduced this year.

That, coupled with Covid self isolation/lack of staff, and a Covid lockdown backlog, are the main contributing factors to the recent cumulative effect you are seeing

@WithANameLikeDaniCalifornia
That's quite sweet that you're worried about the dentists when a lot of people are angry they can't get an appointment with the overpaid buggers

Please don't give me that. We study for 6 years, plus post graduate training, accumulating a lot of debt in the process.

I have a business twice as large as my mortgage, that I had to put in hold for a year during Covid, that I have absolutely no means of paying back in full. I will sell up at some point soon and I'll be lucky if I break even.

You have NO idea 😒

We're in Cumbria.

Our only local NHS dentist closed last month as they couldn't find any dentists to come and work there. So we only have one private practise now (which is full) and all the nearest NHS dentists are also full - I believe the nearest one taking on patients is a 90 minute drive away.

I am very fortunate that I'm with DenPlan and registered with a private dentist, but even that practise is a 45 minute drive each way!

The state of dental care in this country is shocking.

I appreciate that I am fortunate in having an NHS dentist who it's not been difficult to get routine or emergency appoitments with (other than when they were completely closed in the first bit of lockdown).
In Feb I needed to have a tooth extracted - right at the back, a filling had shorn off (when bloody flossing my teeth on the advice of said dentist), emergency appointment for temp filling arranged same day, a saturday.
I'm a nervous patient at the best of times, and when I went back I'd fallen and had a bruised coxyx - impossible to sit still and 'relax'. Dentist referred me to a dental hospital instead, as they provide more in the way of knock out drugs.
I left it for a couple of months, then called on Friday; they'd just scheduled an appointment, but for when I'm going to be away - so I was offered a next working day appointment instead.

Have you asked your dentist about the possibility of a Dental Hospital appointment?

I've been ruminating over this all day - I'm really struggling with the various niggles / pains / lack of eating / mental load. I just want to get it sorted.

I've been looking at my dentists website. They have something called DPAS dental plan which seems to cover all check ups / X-rays / treatments and costs FROM £16. This is private right? Can you enter into something like this with known problems or is it only for people who have already got all their problems sorted and paid for?

I guess they charge different amounts for how crap your teeth are likely to be - what's the worst case scenario for someone hideous like me who everything goes wrong when you do 1 thing and I think I need a checkup, cleans and a good few fillings? And just had a complicated extraction.

I'm wondering if I could ask for a private check up and assessment for the work needed and whether I could be considered for this plan and what the cost would be. I feel sick at the thought of the money I don't have (it'll have to be a loan from somewhere) and giving up NHS place - but it doesn't look like it's going to help me long term.

Has anyone had any experience of this?

I replied earlier saying I switched to private due to dental anxiety but the thing that spurred me to consider private was a broken tooth. The only option offered to me due to my anxiety was extraction however privately (not at the same practice) they were prepared to try other treatments first with the aid of anxiety treatments which have worked fortunately. So it was seeking a second opinion that made me consider it then the support with my anxiety which has made me stay. I'm also on a low income and while paying for treatment can be a challenge they're very helpful and try hard to make it work for me.

I wouldn't just look at the private options available at your current dentist but shop around at others nearby that might also suit. Check out their websites, hopefully they're transparent with pricing and payment options (mine do zero interest payment plans and denplan) and if you book in for a check up ask more questions then. It's possible they won't accept a denplan style thing until any known issues are dealt with but they could probably answer this over the phone.

In your position I'd get a private check up done either at your normal dentist or else where then get a priced up treatment plan with available payment options, at least you know what you're dealing with but I am coming at this from the viewpoint of a very anxious patient.