Dentistry - what’s going on?

[JohnPrescottsPyjamas]

Just interested in others experiences.

For more than 20 years I had been with the same dentist practice and inevitably seen quite a few changes of staff over the years. I subscribed to Denplan which covered all my oral needs except crowns, implants and anything considered cosmetic. Since Covid, my check ups have consisted of a vague one minute waft of a mirror around my mouth and a question if everything was all right, despite my premiums increasing, and being told everything was fine.

Unfortunately, in the last 4 years I have had two molars collapse and each time I have been patched up with a lump of self curing composite packed in by the dentist, which have been rough to say the least and haven’t lasted more than a few months. When I asked if a crown was possible, I was told no, extraction and an implant was the only alternative.

Eventually, I sought a second opinion from another practice, the difference with this one being I pay for treatment as and when required, but I’ve taken the view that the amount I’ve shelled out for Denplan and not received any benefit probably equates to around the same. The new dentist x rayed my mouth and produced a 3 D scan which clearly shows - and as I suspected - I have quite a few missed issues. They have also been able to crown the teeth more than satisfactorily, despite being told it wasn’t possible and my oral health is definitely improving.

What concerns me is I have clearly been paying for a substandard service and therefore, is dentistry becoming like getting your car serviced; you need to shop around and always get a second opinion - almost caveat emptor - or, because the industry is virtually all private, there are no minimum standards?

I feel the same about Denplan actually.

For ten years, I will go four times a year to the dentist.And each time had a scale and polish.

I'm now only getting that on fifty percent of the visits.

That sounds awful. I've paid for denplan since I was 18 (no NHS dentists in my area and I hadn't had an appointment since I was 11!) and I'm always very happy with the service. Check ups can be very quick but the dentist checks all the gums, every tooth, as well as my bite and feels for any lumps in the jaw. He also always asks if I have any problems and mentions anything to keep an eye on. It's sometimes less than 10 minutes but feels thorough. I also get an xray every couple of years included and I only have the basic plan.
Are there any reviews of your practice available? Have you considered talking to them about it? The practice might not be aware that they have a rubbish dentist.

I think on the basic plan a clean and polish is only every 6 months?

“What concerns me is I have clearly been paying for a substandard service and therefore, is dentistry becoming like getting your car serviced; you need to shop around and always get a second opinion”

Yes - of course you do. Isn’t that obvious? Do your research.

Denplan is notorious for “supervised neglect” by certain types of dentist. And I say this as a dentist. Just like NHS/Pay as you go private - there are always some dentists who are better than others.
There are absolutely “minimum standards”. What I would say is- there is more than one way to skin a cat, and you will quite frequently get different treatment plans from different dentists. This may depend on their skill level and what they are happy providing, a very broken down molar may need root canal prior to crowning or be very complex and need other additional skills to crown it. Also, the UK is very litigious and a lot of dentists, especially the more recently qualified aren’t comfortable carrying out certain treatments so will offer a referral to a specialist.
I’d like to think that all of my colleagues do try their best to diagnose and treat patients. If you’ve been unhappy with the service - I’d firstly speak to the practice. There may be a simple explanation that as a new patient you’ve had more/different X-rays taken than you would have as a regular patient and sometimes there can be “incidental” findings like chronic infections at the roots of teeth that have otherwise caused no issues.

But my point being; something health related shouldn’t be like shopping around.

Thank you - a very useful and comprehensive answer.

I think my concern also stems from the fact that over the years, there’s been a definite decline in the thoroughness of my check ups, but you’ve also explained why the possible reluctance by my former dentist to offer the crowns - which I hadn’t appreciated.

I'm feeling the same as you @JohnPrescottsPyjamas

Since my dentist retired and sold the business (denplan) I've been less than impressed with the service and had to argue discuss the finer points of my contract regarding a scale and polish (which they said wasn't included in my plan, yes, it was, I had it there in black and white).

Next issue came when one of my molars broke. No pain so they tried the path of least resistance by building it up (fair enough) but that didn't work. I asked about the cost of a crown (as it clearly states in my contract crowns aren't covered), only to be told that they won't/can't do that as it would be considered cosmetic (due to no pain or infection). So they've removed a huge portion of completely healthy tooth to replace it with a massive filling instead - if this fails, I'll be in pain because they've gone into the nerve to anchor the filling and made a big song and dance about getting the right colour match.

Sorry for the moan!

Yours.
Another Dissatisfied Customer

Thanks for that. Maybe I have been a little too harsh then.

100%.

When I add up all the premiums I’ve paid to Denplan over the years and the actual treatment I’ve received, it’s quite revealing. I appreciate this might be the case with standard insurance, but Denplan advertises as a way of spreading the cost of treatment, not just the insurance. If you’re not actually receiving that treatment, and still coughing up each month, they’re quids in!

Those quick fix 'chewing gum' type fillings are what I would expect on the NHS. Not with an insurance plan.
I'm glad I don't have denplan. I was considering it but my dentist said they don't do it as it's not very good.

That’s exactly it, and great description - exactly how it felt in my mouth. It was left to harden (not light cured) and felt rough and uneven, despite a half hearted attempt to smooth it with a drill. It trapped food and snagged when I tried to floss, but apparently it was “satisfactory” The whole procedure, each time I had it, was less than 5 minutes.

I wasn’t even paying for the basic Denplan, it was the middle tier, so I would have expected a slightly more enhanced service!

@Boglets yes! "supervised neglect" is exactly the phrase I've been trying to find!

Could never put my finger on it but, my previous dentist spotted (eg) cavities that weren't yet causing me problems and dealt with them (a surface filling, no drilling needed) to prevent infection and a bigger problem later on. Current dentist just told me about my recent cavity (possibly old filling failed now and fallen off) but, because it wasn't causing problems or pain, won't do anything with it.

I am starting to wonder what I'm actually paying my monthly fees for

@15minutesaday unfortunately denplan defo encourages this with certain types of dentist. I obviously can’t comment on your specific case - but I think pay as you go or just simple plans that include examination and hygiene with payment for any treatment required ontop are better and discourage this sort of behaviour. It’s terrible that it happens and unfortunately there are a few colleagues around that do do this.
And I’ll just edit to add - they shouldn’t be waiting until it causes pain or problems to fix it! Denplan or not, the point of attending the dentist regularly is to nip these things in the bud! I’d tell them you’d like them to discuss with you the options for dealing with the issue!

Unfortunately, because Denplan is a payment plan rather than an insurance, I guess it is open to abuse by unscrupulous operators as I assume they receive the money whether treatment is administered or not?

Incidentally, my old practice has been taken over by a large conglomerate in the last three years too, so I wonder if it has become more profit focused?

I have Denplan, but my dentist only offers the essentials plan, so it only covers check-ups and hygienist visits. Treatment is out of pocket. I do find the check-ups thorough - I assume they are incentivised to find any issues, as the treatment costs are outwith the plan.

I think with any health insurance it's possible that the insurer will want to spend less on a treatment than you would yourself, and they will normally incentivise the practitioner to try cheaper options before the more expensive options.

You might want to bear this experience in mind next time you see someone calling for total privatisation of the NHS.

Absolutley. They get paid whether or not they treat your cavity. If they do fill it - they’re using time out of their dairy and not getting paid any extra for it, is how some will unfortunately see it. I’d stress there aren’t too many dentists out there like this though.
Yes, if a practice has become a corporate, they often have targets also. That doesn’t mean they’re all money focused though. Dentistry is a difficult business and if you find a dentist you like- stick with them!

Different country, different dental system but there’s definitely a difference between good dentists and those that you wonder how they managed to graduate because they’re pretty shit.

There’s some limited public dental care available for those on low incomes but the majority of dental care is private. Private health insurance can help cover the costs with a big range of what’s covered and how much they’ll pay.

My family had been going to one dentist for over a decade but then we noticed that she was no longer attentive to details and seemed to be having age-related cognitive decline. Tried another 4 dentists. Two were good, one was okay and one was bloody terrible. DH put in a complaint about him to the practice.

Fifth dentist has seemed to be the right one so far. He’s great. He’s been thorough, gentle, very detail oriented, knowledgeable, and doing preventive treatment along with needed right now treatment. He refers us on when it’s beyond his ability, like assessing whether a root canal tooth is worth putting a crown on or if it’s too far gone and would be a waste of money. For that he referred DH to an endodontist. DH now needs to see a dental surgeon. He sent me to get an OPG before he’d do a crown on one of my teeth that has been root canalled.

We chose top dental cover as part of the private health insurance policy. We knew that DH’s teeth needed it.

I’d be pissed off with a one minute check up. Get in there, check each tooth by touching it or blowing air on it, ask about if I’m having any issues, x-rays as needed, discussion of any fillings etc that might be needed, then scale, clean and polish, and finish off with fluoride treatment. At least 20 mins for all of that all done by the dentist. This dentist also uses a probe thing to take photos of any teeth that need treatment so we can actually see what he’s talking about and so he has a record to compare to at the next check up if we decide to watch and wait instead of treat. He puts the photos and x-rays up on a screen so we can see them.

I’ve never heard of a chewing gum-like filling administered by a dentist. I’d expect that as something I could maybe buy from a pharmacy while waiting for a dental appointment.

If teeth have had a root canal then they need a crown to keep them strong and undamaged. Previous dentist didn’t bother with DH and we had no idea because we trusted her. That’s three teeth he needs removed now.

Thank you.

My new dentist practice is absolutely lovely. Not cheap, but I don’t actually mind paying for something if it’s good quality and thorough. I asked around locally for recommendations and they were consistently highly thought of.
They run their own scheme where a monthly payment covers 4 annual check ups, 2 hygienist visits and 10% off all additional treatments, for a third of the price of my Denplan scheme I’m happy with that because I know exactly what I’m paying for.

Yeah, it's crap isn't it? And a world away from the lovely composites I got from my private dentist.

Definitely quit the Denplan!

Same here. Presumably, because I’m now paying directly for it, my new dentist has spent half an hour carefully cleaning away all the damaged/decayed tooth and building up layers of light cured composite resin, which is so much more comfortable, looks more discreet and feels very solid and secure.

I had a bad (and expensive) experience with misdiagnosis and mismanagement of a painful dental problem, which was with a private dentist and not on a plan. I agree that it's worth shopping around for a decent dentist, but have been happy with treatment given while on a plan with my current dentist.

Though I'm on a plan directly with the dentist, rather than Denplan.

Glad you've got them sorted now! No more chewing gum! X