I’m an NHS dentist…

[Booyahh]

First time posting… AIBU to think that NHS dentistry is absolutely on its arse? I’ve been in the industry since 2011 and it’s getting so much worse. I’m constantly hearing bad things about dentists or the ability to see a dentist, which makes me so sad. (I’ve started this thread on the back of another post recently just to hear some views)
I’d love to hear people feedback. Also, happy to answer any questions anyone may have

It absolutely is - Welsh Government have just scrapped a new plan for central appointments, it was all over the news yesterday. I haven't been to the dentist since I lived in the Falkland Islands because it was much easier to get an appointment there! (And the cat I was baby-sitting gave me one too many love bumps when I was brushing my teeth and chipped one!) I don't know what the answer is sadly - there used to be a notion of having these primary care hubs that would have GPs, pharmacies, dentists, all in the same place. But I think that idea died a death because (a) there weren't enough qualified people to go around and (b) people argued about the best locations for these hubs. At this point in time I am just waiting until I sell my novel, get fabulously wealthy and buy a set of veneers - not Turkey ones!

Of course it is. The government want to run it into the ground and make it unworkable, it’s too expensive to fund. You must know this OP?
Add to this the litigation culture now, poor remuneration, attitudes of some of the general public, utter contempt and devaluing of the NHS dentist (repeat FTAs) …it’s no suprise we’re leaving the NHS in droves.
It’s a sad state of affairs and I really feel for those patients who genuinely can’t afford private care and have valued the NHS service. NHS dentistry will be a core service only on the next ten years. It just can’t survive.

Thank you for being a dentist. It always seems a bit thankless so there you go.

My three year old loves his dentist and is always asking to go see him. He also helped us out by putting him on the NHS waiting list even though we were told their waiting list was full, so full gratitude here.

Dentists are appreciated, though some people only remember this when they have tooth ache.

Really disappointing to hear so many people are struggling.

With regards to me knowing this… we understand it to a certain extent. However we are getting updates regularly from the NHS on how they’re improving the system. Perhaps it’s a facade. However my practice is taking on 6 new patients a week and I myself see 5 emergency NHS patients a week for the primary care trust. So perhaps where I am, it doesn’t seem to be as much of an issue, this is why I wan wanting opinions from
a wider field

Thank you for starting this thread.

Please could you explain what the minimum level 1 dental exam for an adult should consist of?

Going to the dentist is one of my least favourite things in the world. I’d rather the pain of giving birth. Terrifies me lol

I'm so grateful that we still have an NHS dentist. When we moved a few years ago there were no dentists taking on NHS patients. We've had to stay with the same dentist 10 miles away.

However the dentist we have had for over 10 years has recently left and gone to a private practice. I don't blame him but since then a whole new team has taken over the practice and they seem to be concentrating more on cosmetic procedures than previously.

Is root canal not taught very well or isn't it worth performing, payment wise in the NHS? Our practice were unable to perform this and I had to go privately.

During covid I went to a local private practise sometimes too, because they were seeing patients and the NHS practice wasn't. The NHS practice also struck patients off who hadn't been seen for a year or two, but it seemed a bit unfair because they weren't sending appointments and would only see people who were having problems.

Overall though I am just glad I and DC have an NHS dentist!

Are 2s and 3s ok for gums at 38?

Thank you! It can be very exhausting at times. I’ve taken on many new NHS patients over the past 2 years. However, we are limited to the funding we get and I am at my max every month

Thank you for remaining an NHS dentist you are few and far between now!

Our dentist switched to private in the summer, and was constantly trying to get me to take extra private treatments, I’m not sure if they are actually needed!
luckily they’ve switched us to another NHS dentist at the same practice. But they are overworked and overbooked!

But I know I’m very fortunate to even have an NHS dentist.
So thank you OP for still being dedicated to providing NHS dental care when the system is making it increasingly hard for people to access affordable dentistry.

A question - how much less are NHS dentists rewarded for their time and services compared to private treatments? Is this why dentists are leaving the NHS?

Nearest dentist actually taking nhs patients near me is over a 3 1/2 hour round trip.
havent been able to register with a dentist in over 6 years. (Luckily they will take children so both dc do have an nhs dentist)
The nhs find a dentist website makes the situation look a lot better than it is, as all local dentists come up as accepting nhs adults ‘when availability allows’ (which is never!) but it’s a clever way of fobbing off the system so it looks like there is availability when actually they haven’t taken on new nhs patients for years and years. So it’s hard to find which nhs dentist near you actually will let you register.
Its hopeless and my once lovely teeth are now deteriorating and it makes me worried and depressed.

Can’t remember when I had an NHS dentist! I’m on denplan care which covers most stuff except lab fees

my dentist tried to refer me to hospital to have a wisdom tooth out and it was a 3 year wait. I took a loan out and paid an oral surgeon at another practice who whipped it out - if anyone in the NW is terrified and has money to throw at it, I can recommend that practice as incredible

Band 1 should exist of a full examination of hard and soft tissues (so teeth, gums and an oral cancer screening)
Also any X-rays that are needed plus a scale (now known as pmpr) only if clinically required.
For children or high risk adults, this can also include fluoride varnish, fissure sealants (sealing teeth to prevent decay) and smoothing sharp teeth or adjusting fillings

I hear this all the time! And I fully sympathise! 8/10 people (according to statistics) are scared of the dentist. I always do my best to reassure patients and usually get a decent outcome. I cannot speak for everyone though.

I will be honest, I hear ‘I hate the dentist’ probably 5-10 times a day and it really takes its toll. There’s not many other professions you deal with where someone tells you they actively hate you! Haha.

I’m a dentist who worked in NHS ( ethically and voluntarily) for 30+yrs. But the last 15 yrs of my NHS career nearly killed me.

I took early retirement and my NHS pension 2 yrs ago and now just do one day a week privately. Part of me wishes I had gone private years ago but I’ve always believed that everyone deserves NHS dentistry even if it is just a core service. I would not advise seeing an NHS dentist nowadays.

The astronomical costs of running an NHS service and still being able to make a half decent living are impossible if you want to maintain any standard. I’m much happier working in the private sector where I have the time to provide the treatment patients need using quality materials and technology.

When I sold my practice and started working for someone else I felt pressurised to comply with time restrictions and was not happy with the materials supplied for NHS work.

As the owner I was happy to subsidise the system, take a lower income in exchange for peace of mind that I was still working ethically, but 6 yrs on the overheads have doubled and the NHS fees have not. Most of our NHS work is now subsidised by private work, we would go out of business otherwise.

I’ve been a dental nurse for 37 so I’ve seen a lot of changes. The UDA system is absolutely ludicrous!! We’re quite fortunate at the practice I work in as it’s in a nice area with not too many high needs patients. Our patients are also happy to and can afford to pay for private fillings and crowns so we can make it work. I just don’t know how dentists in deprived areas manage!

I am lucky enough to have an NHS dentist. For my last three 6 monthly check ups, I have set the stopwatch on my phone as soon as my name is called over the Tannoy.

Each appointment from getting out of my seat in the waiting room until getting back to the desk to pay has been under 6 minutes, the worst being last Friday - 4 mins and 19 seconds. I kid you not. I had my mouth open for all of 9 seconds. No prodding the gums and doing that number thing, no little mirror thing used. It was so quick there is no way that was a proper check up. I’m pretty certain years ago we even got a bit of a clean and polish at a check up. No X Rays taken in 18 months.

As I was paying, they told me the dentist I’d just seen was going private and I’m being changed to another.

When our patients say “I hate coming here” I usually respond with “yeah, me too” 😂
Ive been at the same practice for 31 years so they know me well enough to know it’s a joke.

I have a question. I went to see the hygienist last week for airflow cleaning. It was really unpleasant. I could barely breathe for the acrid dust and I was getting a layer of dust sludge in my throat. My mouth and tongue were so dry. Afterwards the corner of my lips was so sore and eventually scabbed over, it felt like it had been sandpapered. The inside of my cheeks and gums were raw and felt ulcerated, again as if sandpapered. Is this normal or was it messed up?
It's just over a week later and it's just about back to normal.

With root canal, it depends on the tooth. The complexity of it is what we have to address, also we have to look at if the tooth is ‘strategic’. We also can’t work out of our competency. So for example, a front tooth would be considered available on the nhs, unless it has complex anatomy and the dentist felt like they couldn’t do a good enough job to save it. Or if it was heavily filled or crowned. A wisdom tooth or a second molar isn’t usually available on the nhs as it’s not seen as strategic (meaning it’s not necessary for function )

There’s no black and white answer unfortunately. Lower front teeth for example can often have multiple anatomical difficulties which a general dentist cannot manage so an endodontist is require for a successful outcome. Unfortunately, nhs endodontists are gold dust and usually private is required. Hope this helps

Do you have a bad back as a result of your career?

Could I possibly ask you a question regarding warranties on NHS crowns?!

Thank you for responding and it’s great to hear your input! I’m an associate, not a principal but definitely good to get an unbiased opinion. I feel more and more like I’m letting people down each day. I went on a course 5 years ago and I remember clearly saying how much I loved the nhs and working for them and feeling like I was adding something to society, I don’t feel like that now and it’s heartbreaking. The NHS is amazing when it works well. For dentistry though, I feel like it’s not working.

I try and look after my NHS patients as well as anyone, however I have some come to me after some terrible NHS dentistry and it makes me mad and sad. E.g. you have a gum problem, see a hygienist. Then they come to me and I find an UR6 needs rct for this recurrent ‘gum problem’. The bad apples give the good ones a bad name. Sorry for the rant

2 is ok, it means there is tartare present (generally)
3 means there’s a sign of gum disease. However it’s a screening tool, not diagnostic. So without X-rays, and perhaps a pocket chart, a diagnosis cannot be determined

I haven't been to the dentist since before covid, my dentist went private and when I tried to register with a new one none of them were taking on NHS patients. I'm still on a waiting list for a new surgery but I've been told minimum 18 months to 3 years. Thankfully my DC are registered! I'm oral hygiene obsessed now because we just can't afford private. I floss 3 times a day, use an electric brush, corsodyl toothpaste with the interdental brushes as well as the slim interspace brushes morning and night. Thankfully haven't had any issues so far 🤞
Thank you for staying with the NHS and doing what you can.