Child tooth extraction for braces

[LiveInSunshine]

Aibu to have expected this at the dentist?

Im having a nightmare trying to get DS’s teeth extracted so he can have braces.

He was accepted for braces at the end of July and got an appointment to have them fitted in august. First though he needs 4 teeth extracted.

I’ve been trying to make appointments since. My own dentist has given us the run out, every week it’s ‘next week we’ll have an NHS dentist again, book then’. I think they actually have one but for whatever reason they want to filter children to someone not yet qualified? It’s unclear tbh. Since the end of July I’ve been calling every 1-2 weeks. In September we got an appt, turned up ready and it turned out they have booked it with someone unqualified to remove teeth (a therapist). Wasted journey. I’d given them the letters, discussed…

After this I was promised a call to rebook. 3 weeks in they haven’t. So I ring today to be told they don’t remove children’s teeth and he needs a hospital referral.

If this is the case they could have done it in July! It’s months more waiting.

Aibu to have expected it to be at the surgery? He’s 12, it’s pre molars, no medical or Sen history or fear of the procedure.

I’ve tried so many places instead of the usual dentist, but no one is taking on patients. I though the orthodontist would be the tricky bit, but we have that. I’ve had to rearrange the appointment 3 times now due to not being able to remove the teeth to start treatment.

Have others had this at the dentist? Or is this more fob off? Initially today they refused to book the extraction because he’d had an appointment in September and children aren’t entitled to appointments less than 6 months apart… the unnecessary appointment with the non-dentist… 🤦‍♀️

That's dreadful. I would be having stern words with the practice manager. Not being able to see kids less than 6 months apart is bull - what if they

Posted too soon. What if they had toothache? They wouldn't be expected to wait 6 months. It isn't a check up you are after it's treatment. My son has had 6 teeth out for braces at our surgery with no issue

If they don’t have dentist there isn’t much they can do. They can’t magic up
appointments
Access to dentists is so shit at the moment.

I would go into the dentists and ask to speak to the manager. If it's milk teeth that need extracting they come out really easily so don't know why the surgery wouldn't do this.

Could’nt you just go as a paying customer instead of looking for an nhs dentist?

If they're NHS braces, get the orthodontist to intervene on your behalf.

If it's private, bite the bullet and go to any private dentist that your orthodontist recommends

Yanbu. Is this an NHS orthodontist referral?

For DS's extractions the NHS orthodontist wrote to the dentist and the dentist contacted us to make the appointment. All NHS and peak covid 20/21 winter too. Was about 2 months between seeing the orthodontist and teeth coming out.

That's appalling. My DS needed a tooth out before starting braces. Our normal NHS dentist rang me to arrange the appointment the day they received the request from the NHS hospital where he's having the braces.

It’s NHS orthodontist yes. The dentist made the initial referral last year.

Teeth to be removed are adult pre molars.
I have been in 3 times, called many times…

I guess payment may magically make things happen, but I really don’t have hundreds to spare. It should be free, and I’m already paying for private hygienist and extra guards, special tooth cleaning bits etc that will run into hundreds.

Firstly you wouldn't find an unqualified dentist in a dental practice. You know how hard it is for them to get their NHS number?

Secondly children are entitled to an appt before 6m.. whoever is giving you this information I'd be wary about.

I get your frustration and your practice sounds shite. You need to email the practice manager.

There are dental therapists now who do basic check ups. Assume it’s them who can’t do extractions.

My DD2 is nearly 15 and waiting for hospital extractions of completely impacted teeth before she can have braces, I sympathise!

dental therapists. They do children’s check ups/ basic fillings etc. They are not qualified to remove adult teeth.

If I’m honest with this particular receptionist, not the others, I think her English is the barrier rather than policy. I have to paraphrase and re-explain a lot and her responses are in broken English. It makes communication really really hard. For example I’ll say
‘I’ve been trying to book an appointment for extractions for my son. You already have the letter from the orthodontist for this, he needs 4 teeth removed before they will fit braces’ and she’ll respond
‘check up for children cannot be 1 month after last. He came in September. He saw dental therapist’
i’ll say
‘I’m not trying to book a check up. He needs teeth removed. This is part of his treatment plan. It’s in the letter from the orthodontist they sent you on august the 3rd.’
she’ll say
’you want referral to orthodontist? He need check up first’.
’He is already accepted by the orthodontist’
’Nhs say children appointments are not less than six month apart’

It’s hard to stay calm and clear in these circular conversations. She’s either will fully ignoring me or doesn’t understand, and from her tone I’m never sure which.

My 12 yo DS had assessment appointment and approved for braces on 7th Sept, has to have 4 premolars removed for space, appointment booked with our regular dentist and an extra appointment in case they can't get 4 in one go, and the brace fitting appointment at the orthodontist in November. This is what I would expect.
Can you speak to another reception? Ask for the dentist? Go in and stand until it's sorted, that is what I would do, also let orthodontist know they might be able to help

That’s rubbish of course dentists take out childrens teeth both adult and baby teeth.

Will your son sit to have the teeth out with an injection? That might be what they are worried about? He won’t get a general anaesthetic to have erupted sound pre-molars out so why they have sent to the hospital is beyond me? Also the dentist should not be referring anywhere without seeing your child as you would need to agree/consent. That referral is likely to be sent back to the dentist as being inappropriate. Anyway for the sake of getting his braces started I would consider paying (would not be giving this practice your money though!)

Just Google high street oral surgery practice in your area and you should find one somewhere near enough. I’d expect extraction of premolars to coast £80-£120 per tooth but that depends on where you are.

NHS dentistry is on the way out which is just not right.

Anyway

And asking the orthodontist to intervene, that just won’t happen the dentist and orthodontist are independent contracts (although with NHS contracts) the orthodontist has no authority or right or even professional responsibility to insist a dentist does anything.

Hope it gets sorted!

He is a mature child who goes into the room alone and has communicated , without me present, he would like them removed at the dentist. I have confirmed this in a chat post appointment I’m happy for this. Absolutely no reason for him to be referred. Teeth aren’t in a funny position or anything odd with. I can complete imagine the referral being bounced back. He’s not a nervous patient.

I guess paying May be the only route out. But yes, not this lot! They’d already wiped ALL adults off their nhs list in a blanket policy last year.

I may ask them if it’s part of their practice, they seem decent and do more than just braces.

@LiveInSunshine yes definitely ask the ortho practice if they either do extractions or can recommend another practice. Your son sounds like a model patient!

In a very similar situation we have ended up paying. I know how you feel, it wasn’t pocket change to us either, but in the end I felt like there was no other option.

As a dentist I would guess they don't currently have a dentist that is carrying out NHS work. There are recruitment problems for NHS dentistry with lots of vacancies. A therapist can't extract adult teeth.
I would suggest an e-mail to the practice manager asking what the problem is. If they don't have an NHS Dentist it may well be a case of paying privately and calling round for quotes. In my region the NHS managers are trying to negotiate tapering off contracts to practices handing back their contracts to finish off things like orthodontic extractions where kids have been on waiting lists.

Well privately it’s £700 😩

Ive rung the dentist again, she does now have an nhs contract (they didn’t tell me as promised). I’ve booked a review face to face appointment with her tomorrow to actually see what’s going on. Not removal, but at least something. The referral wasn’t put in as promised… unsurprisingly

I think the thing that annoys me most is the run around.
8 calls since the end of July
-First 5 saying they expected the NHS contact ‘in a week’
ok- that’s hard

-then an appointment with the wrong person

-then saying a referral has been made, they can’t do it

-now another call, no referral, but they finally have the contract but you’ll need to see the dentist to see if they’ll do it or refer. I don’t even see why we must go again. They have x-rays from the orthodontist, he saw the dentist 5 months ago and the therapist this month. I can’t guess what they expect to get out of seeing us to review again. They have x-rays, they know his character from ten years of appointments

I went today, as asked, and the dentist refused to see us. Despite us having an appointment made.
The practice manager said see wouldn’t as wouldn’t get paid for seeing him as the therapist has seen him recently and the NHS wouldn’t pay.
She said the referral was ‘in hand’, but admitted it wasn’t done. She also said their email was blocked by the NHS (??)) and they couldn’t do it until that was sorted. She said ‘by the end of the month’ and said ‘I’ll do it myself. She’d already claimed she’d done it last time we spoke!
I (pretty calmly!) explained we were told something new each time, they could have referred months ago at the end of July.
I asked to put this in writing, she said I couldn’t as they had no email.
I asked for alternative contact details, she offered to get them then left us in the waiting room.

This bit will sound unbelievable:

She left us and his in the office. She didn’t realise there was a mirror and her voice carried due to the lay out. She kept peeking her head round the door and saying to someone else ‘no, she’s still here’, ‘she’ll go soon’. I gave up and left and left a note to contact me.

It was like a Fawlty Towers episode, complete with the receptionist arguing with someone else in broken English. Fucking surreal.

Good grief, how shambolic.
Reading between the lines, the new dentist is not yet set up with an NHS e-mail therefore cannot use the e-mail referral system. My concern would be if the extractions are straightforward and your ds compliant the referral will be rejected so this is pointless.
The comment about not being paid is wrong, but if the therapist has opened a course of treatment and it has not yet been completed they would not get paid for today's visit. There is no limit on how many times someone is seen in a time period but if you have too many reattendeances you show up as an outlier. Either they have been pulled up on this or are trying to avoid this.
I'm at a loss as what to suggest, this should be simple to sort out. You said earlier that your orthodontic practice does more than orthodontics. Do they have a contract for NHS Dentistry? Worth a chat with their receptionist to tell them the trouble you're having.

I spoke to the orthodontist, they can only offer private at £700. It’s double what I was hoping to squeeze. I annoyingly nearly moved dentist in august, but they had an nhs waiting list until October to see ds. This one said by the end of august, so I didn’t. I’d have been seen by now. They are no longer taking people on.

The NHS email is the name of the previous dentist, who left some time ago. I’d been thinking it was weird they still use it- but reading your reply it maybe it’s been picked up? It is first [email protected], she is no longer at the practice and hasn’t been for a while- I know because she was my dentist and I had to see someone else over a year ago.

The practice manager said to me today that the extractions were ‘complicated’. I don’t believe her. The orthodontist saw them and said the dentist could do them, and I can see enough to see they have one root and they aren’t in contact with other teeth. I said directly I wanted the dentist to confirm this, I asked-since we had an appointment, if she could at least pop her head round the door and confirm this. She refused. She wasn’t with anyone else, I saw her in the mirror in the hallway. I do think if the dentist would look it could be resolved, but she won’t. I think they are just saying to make me go away, they didn’t do a referral before.

The therapist appointment was a check up. Coated teeth, checked clean. I spoke to him . He said at the time he couldn’t remove the teeth and a dentist had to. So it seems unbelievable he’s suddenly making a referral himself, as is claimed. He would have said so when I spoke to him. He said all he can do is check ups.