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… 🤦‍♀️

I had this with my son. We had to also re register with the new dentist because the one who referred him for braces left. Took 3 months for that. She finally tried to take out the four teeth.. stopped at one because it took over an hour… said he had unique roots and referred him to the hospital. That took another 3 months just for them to tell us it was the wrong department and that they didn’t see children. So another 10 months (after I chased them repeatedly over this period, different numbers, departments and fobbing off) he finally got the removed, under the general.
if your son is registered with an NHS dentist, I don’t understand why they are making it so difficult. Definitely sounds like fobbing off to me.
You can contact the General Dental Council, hopefully you’ll get more of a response and answers.

The GDC can’t make a dentist do something they aren’t paid/commissioned for or is out of their competence. There is a lot to complain about around this issue but other than the staff member avoiding them by looking in the mirror nothing the GDC has any jurisdiction over.

As an update- I’m copied into the referral.
The covering email is correct (4 pre-molars to be removed) but the attached form requests his wisdom tooth is removed due to repeated infection

@LiveInSunshine words fail me.
If you look at the website of the hospital he has been referred to they usuallly have a referral criteria, I would have a look and see if they accept orthodontic extractions.

From the form, it’s clearly level 1:

Procedures/conditions to be performed or managed by a clinician commensurate with a level of competence as defined by the Curriculum for Dental Foundation Training or its equivalent. This is the minimum that a commissioner would expect to be delivered in a primary care contract.

Its such a fuck up.

I spoke to the orthodontist today about moving an appointment and they seemed very clearly angry over the situation. They asked for my permission to call and challenge them, because apparently this is an ongoing issue that is affecting them significantly. They seemed to guess the dentist before I confirmed it.

The form says about removing LR8 tooth. I genuinely think a significant part of the issue is the English competency of the receptionist who has done it is below the standard needed to understand the written technical language. The form is signed by the dentist who has left the practice some times ago.

I’ve spoken to them about a previous issue with a rude dentist. They can advise on what you can and can’t do and same with the dentist. Nothing to do with jurisdiction.

@WotsitsMadeIn1927 sorry I wasn’t clear, the GDC have jurisdiction over all behaviours of a dental professional you are correct but they can’t make a dentist do something, so if a dentist isn’t commissioned to do orthodontic extractions on the NHS it’s nothing to do with the GDC. If the dentist articulates they don’t feel confident in orthodontic extractions the GDC can’t make them do it.

If the dentist has accepted a contract where they should be confident to provide certain card but can’t that’s a professional issue the GDC can intervene on.

OP the referral should have been written by the dentist and that practice sounds awful, your orthodontist sounds totally fed up with them but they will be limited, even under the level 1 care that should be provided under an NHS contract if the dentist doesn’t feel confident they can’t be forced to provide a particular treatment.

I’m not trying to provide excuses for the practice or dentist which sound rubbish but just what can and can’t be done.

Update: he’s too young to be seen my the minor surgery service he was referred to.
He’s way way below the referral guidance for paediatric dentists at the hospital (plus it’s over a one year one wait). Argh!

The service and the orthodontist basically say it’s so routine the dentist should do it. The dentist refuse.

I’d definitely contact the General Dental Council and/ or the Dental Complaints Service. I know we had some issues but this is ridiculous

I plan to.
But it seems, considering they’ve weathered annoyed phone calls from both the orthodontist and IMOS it won’t make them actually do anything. Also- if they claim not to have the skills for it it’s a bit worrying forcing their hand to do it. Maybe they don’t 😬

My dd has been waiting 2 years 😬, she’s now 18. She needs wisdom teeth out before brace is fitted. Surgery delayed due to covid. She’s been in the system for 3 years, teeth were not clean enough to go ahead for the first year, I paid a fortune for hygienist and then got told there was a 18 month delay due to covid and now needs to go to a different orthodontist which is miles away. Dd has a huge over bite and struggles to eat, I wish I could afford to get her seen privately but she needs major surgery on her jaw after having a brace for a year. She’s given up all hope of getting it sorted.

I’m not saying to contact them with the idea of forcing them, it’s more to try and get information of who should be doing what, rather than either the dentist or orthodontist delaying the treatment any further. My son had his teeth taken out for the braces and I did when I was younger too, by our dentist. My son had his teeth taken out in the paediatric dentist part of the local hospital (after the original dentist failed) I’m just thinking there’s obviously a miscommunication or fobbing off somewhere between your dentist, the surgery service and orthodontist. Perhaps contacting higher up may help resolve this issue

We had our extractions at the hospital as they did it under GA . Ds needed 12 out and had to have 2 separate operations 3 years apart it might be worth asking for a referral to a hospital orthodontist

Ds is really straightforward. No particular issues. Needs 4 per-molars out due to overcrowding but no other problem apart from teeth squished into the wrong places. Pre-molars have single roots, he’s not nervous. He’s the really standard patient who just qualifies, mainly due to the front teeth protruding a lot from the crowding and a lower tooth behind another. Jaw shape is fine and molars bite fine.
I’d be surprised if he was accepted for other orthodontist, the one we have is fine with a good rep. If he was older they’d actually be able to do the teeth themselves, but their contract is 13+ with the nhs for minor oral surgery.
Its part the reason referrals are being bounced back, it’s routine.

Oh I see, then why do they seem to be having so much trouble just seeing him for a straightforward appointment?
my boy is 14 so had the remaining three of the four taken out in the child part of the hospital but was originally referred to the 16+ dept!!!
I remember the issues that delayed my sons treatment for over 18 months, that were all due to human errors and reading about yours/your sons brings it all back n makes me mad again!!!
really hope it is all resolved very soon 💪🏻💙

That’s terrible and really unfair for your DD 🙁

That’s terrible OP and so frustrating.
can you complain via CQC?

I can’t work it out what the fuss is.

Are you in England? In Wales we have PALS (patient advice and liaison service) who quickly sorted out a similarly ludicrous situation that we had with my GP giving my son his flu vaccination.

If you have a similar service I would definitely advise getting in touch with them. Be factual and objective. Explain how this delay is affecting your sons treatment. Keep emotion out of it.

good luck

My son just had 4 teeth out at my dentist ready for his brace, he's also 12. I'm on a plan because my teeth are terrible but my son isn't and they still took them out free of charge as a child. I thought children didn't pay whether it's an NHS dentist or not, because they are children. They had all 4 teeth out in two appointments a week apart and I think I had to wait 2 months from when I first rang up.

Are you not near any major towns or cities so you can ask around a bit more?

Why isn't this a major political issue? I know a lot of people who can't get anywhere near a dentist. Tooth decay is going to be rife in a few years at this rate and we'll be pulling each others teeth out with pliers and a swig of whiskey.

Ridiculous.

Major city?! London!
It’s depressing isn’t it. Fucking London.
There’s actually pretty more dental services commissioned for children. Actually zero for dental emergencies on a Sunday afternoon for children, I’d recommend not having a dental accident then.

I will complain, I’m just leaving it a week to be calmer and more rational. I’m a tangy emotional nut right now.

I’ve rung most the dentist’s I think in a significant radius of the house, tried social media etc.

I may sound useless right now, but I’ve been actively on this since July.

Bloody hell. I thought you were going to say you lived in the middle of Dartmoor.

@sagalooshoe

Why isn't this a major political issue? I know a lot of people who can't get anywhere near a dentist. Tooth decay is going to be rife in a few years at this rate and we'll be pulling each others teeth out with pliers and a swig of whiskey.

^
It is a major political issue, where have you been ?