NHS not providing bridges or anything beyond the bare minimum

[SadSadSaaaaad]

I have shit genetics when it comes to my teeth.

I have/had atleast 4 'baby' teeth remaining when I reached adulthood with no adult tooth beneath them. Over time those teeth have worn away and crumbled, 2 are completely gone now leaving large gaps and 2 are still there albeit very small (less than half the size of the adult teeth next to them)

I believe its called Hypodontia. It's all genetics and nothing I've done. I brush and floss as I should.

I've spoken to multiple dentists over the years and have been told they will not provide bridges on the NHS despite it being listed as a band 2 NHS treatment. I could never afford private dentistry.

I mostly keep my head down when I'm talking to people or just avoid socialising much at all.

It's not even all about cosmetics, I have pain and gum damage around those teeth and they bleed every time I brush them (only ever in those areas)

I'm only 30.

AIBU to think it doesn't feel fair?

What is their explanation for not providing the bridge?

OP I had to get a tooth fixed when I could afford it and the dentist provided an interest free finance plan. Is that something you could consider, tackle one at a time?

I agree it’s terrible that it’s so difficult to access affordable dentistry - particularly given its importance to our overall health.

Get a referral to a dental hospital
Or a restorative dental specialist in a hospital
Unit.
You would qualify for treatment if you have hypodontia of 4 teeth, they can build up the Microdonts to look like permanent dentition. Many wouldn't extract them if the root is ok they would just build them up.

You ANBU I'm NHS a band 1 is supposed to include a scale & polish (basic hygiene clean) if needed which was always given.
Some years ago the practice was sold the new dentist will always say that you need to see a hygienist which costs an extra £70 on top of the basic band 1 tariff.

My daughter has hypodontia, and after a battle she is now under a specialist centre for this - Evelina hospital in London. Despite being only 8 she will start orthodontics treatment later this year to move her teeth into positions where bridges will be a viable option. We have been told that this may not work and whether she can have bridges will depend on her compliance with the orthodontics and the condition of her teeth, and that bridges may damage her remaining teeth and lead to her loosing more teeth so leaving her in a worse position. This is all covered on nhs. However, we have been advised that the better option would be implants which are very expensive as not coveted by nhs and can't be done until she is 18, estimated cost of what she may need is around £15,000. So we have openned a savings account and putting as much as we can afford each month for next 10 years into this so she can hopefully get these if she chooses.

Obviously I don't know your exact situation, but following the extensive discussions we have had with specialists, the reasons for not doing the bridges may not be them being awkward, but concern that this may further damage your existing teeth and leave you worse off, or you didn't have the correct orthodontics at a young age to make this work.

I would suggest getting a 2nd opinion, to conform whether there is agreement that bridges won't work for you, asking for referral to a specialist hypodontia centre if there is such a thing for adults

Thank you for the replies.

The only explanation I've been given for refusing bridges is that they do not provide that service on the NHS anymore 🙁 (I've been asking for years so it isn't a new thing in my experience)

I was under the care of the oral surgery department in a main hospital because of pretty severe TMD which may or may not be related (they don't think so)

When I asked them if they could help with bridges I was told that they only remove teeth there and don't put any in. They have discharged me now and I just have to live with the TMD aswell.

I'm not sure where else I could go. Maxifacial perhaps?

Regarding finance, I did raise it with my current dentist and he said I would *not meet the criteria because I'm on too low an income (carer to my disabled child)

It's all a bit shit isn't it? I could understand not wanting to provide pricey treatments for people who don't look after their teeth but I always have.

Edited due to spelling error.

I have this exact same problem. It had one bridge put in on the NHS about five years ago. I've since changed to a different dental practice. I lost another baby tooth and asked my new dentist for a bridge but he said no because he couldn't attach it to the next tooth due to a fractured root canal (that isn't causing any issues!) He told me to get used to the gap and accept it.

I went to one of his colleagues who said he couldn't do a bridge either but he recommended I see one of his other colleagues who could do me a removable tooth which I wasn't happy about but agreed to go to the appointment.

I finally saw this last dentist and he said no need for that, I can give you a bridge! Turns out he specialises in cosmetic dentistry. He offered me the bridge on the NHS. This was a couple of weeks ago! So unless things are different in different parts of the country, you definitely can still get it on the NHS. I would highly recommend seeing a different dentist. Doesn't have to be at a different practice, just get an appointment with someone else there.

Thank you for sharing this. I'm so pleased your daughter will be getting her treatment. It doesn't feel right that you would need to fight for it, but well done for persevering. I really hope it all goes well for her.

£15,000 though - wow! Worth every penny I'm sure but that sum is completely out of reach for lots of people. The savings account is a great idea.

I think I will raise it with my dentist again and ask he refers me on, I'm wondering if maxifacial or however its spelt would be worth a shot.

Ah I'm sorry you have the same thing, but very encouraged to know you've been able to get a bridge on the NHS!

Why do you think some/most dentists turn us away for them? Is it solely the cost? I could definitely scrape together the NHS band 2 cost, which is still up on the wall being advertised in the surgeries.

Unlikely I know but if you're in London could you point me in his direction? 😁

It is extremely unlikely you would be accepted for a restorative referral for multiple bridges, maxillofacial do not deal with bridges , you would need to see a restorative specialist for assesment. Most dental hospitals will not accept referrals for bridges and to be accepted for treatment for hypodontia you have to be missing at least 6 teeth in most health areas. Even then the emphasis is on retaining the baby teeth for as long as possible.

NHS general dentistry is there to secure dental health in the simplest way possible. If you have multiple teeth missing that will be with a denture.

In order to secure back teeth on a bridge you have to drill down the teeth either side to hold the bridge on. When you do that you run a 25% chance of killing off the nerve . If you are missing two teeth either side that is four healthy teeth that will need drilling down with a danger that you may lose healthy teeth. That is why dentists will not provide multiple bridges and the gold standard is implants. Unfortunately it is virtually impossible to get implants on the NHS and most people are advised to start saving for their child's treatment at an early stage.

Can't you get a plate instead?

My friend is 50 and has the same problem. She had bridges/ crowns on the NHS but her son is not entitled and she'll need to pay for each crown herself (this will cost a fortune). It's down to cost and probably lack of dentists.

@SadSadSaaaaad "Why do you think some/most dentists turn us away for them? Is it solely the cost? I could definitely scrape together the NHS band 2 cost, which is still up on the wall being advertised in the surgeries.
Unlikely I know but if you're in London could you point me in his direction? 😁"

I have no idea why they won't do it, in my experience I think the two dentists I saw initially perhaps weren't confident enough to do it due to the fractured root canal they'd have to join it to. I'm not in London, sorry, I'm about 80 miles away. But if you're willing to travel I'd PM you his details so you could see if you could get on his NHS list.

As explained above for each bridge you would have to cut down two teeth, so potentially eight teeth to be damaged with a 25% chance of needing a root canal and potentially being lost.

You are only 30 , a bridge will last , if looked after really well, on average 10 to 15 years before it needs replacing. Each time it's replaced more tooth is taken away , so bridges will need replacing multiple times in your lifetime and will eventually result in loss of teeth.

This is why dentists try to keep the baby teeth as long as possible and where you have multiple gaps will suggest implants, leaving the gap or a part denture.

Then there is the vexed question of NHS dentist. A bridge is band three not band two. You might get a dentist to agree to a bridge if you were just missing a single tooth. They would be doing you a great favour as the fee paid won't even cover the cost of the laboratory fee for a three unit bridge (one bridge) so essentially they are paying for you to have the bridge and lose money.

If you have multiple teeth missing there is no way they will do a dubious treatment cutting down many teeth on a young patient with the risks to the teeth and their career with the very litigious state of U.K. dentistry whilst making a loss of many hundreds/thousands of pounds when a part denture is a simpler treatment with no damage leaving you the option of implants in the future if your financial circumstances change.

Thank you for the helpful replies and explanations.

I'm not against a partial denture which is a lot better than nothing, unfortunately it has never been given to me as an option.

I assume I have to ask for one specifically?

There may be reasons you have not been offered a denture , eg what the health of your other teeth and gums are like , what your bite is like etc.

A denture is not an easy option it takes a fair bit of adjustment and practice to be able to wear one. However there is nothing to stop you asking the dentist next time you are there is a denture is a possibility , particularly if you need more teeth out .