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

Thank you for taking the time to reply with all the details.

It is, as I assumed that NHS dentists are not well paid for their services and no wonder so many leave NHS care.
The system is to blame here and dentists should be paid appropriately to compensate for their time and skill. No wonder so many opt to leave the NHS.

Thank you for sticking with it,

I’ve been lucky from what I’m reading here in that for the last 15 or so years I’ve had an NHS dentist, and that’s having lived in two different areas of the country during that period. I last moved about four years ago and decided to start looking for a Dentist in the new area fully expecting to have to go private. I set out one day to go and visit a couple of dentists in the town on foot to see who was taking new patients on to their lists (again assuming private) and on the way back home, I literally walked past one that wasn’t on my radar but which had a massive sign up outside saying it was accepting new NHS patients. I went in and they told me that they had just opened the list earlier that week for a limited period. I got myself and my partner registered there. It’s in a large building where there is a mixture of private and NHS treatment. I pay privately to have more frequent hygienist appointments and those cost me more than double what I pay for my NHS check up. The dentist who does my NHS checkup is excellent and I never feel short changed. There is a separate waiting room on one floor for purely private patients and it has more pot plants and is a little bit more luxe than the other waiting rooms, but I’m not bothered about that. I have recently moved out of the area again and I’m sticking with my Dentist for as long as I possibly can.

I had a great dentist for years. Then the practice was bought by a new owner, my dentist left. Now I see a different dentist every time, appointments are far more rushed like @maddiemookins16mum's 4 minute experience, and they now have a 'policy' of only doing an x-ray every two years. Is that allowed? Surely x-rays should be based on medical necessity/history, not one size fits all?

The inconsistent, far worse care (they're catching cavities much later) means that I'm changing practice (thankfully there is another available). I was too scared to go for 7 years, so it's all quite daunting.

Unless you are at high risk of developing cavities or have active gum disease bitewing x rays should be at two year intervals and other x rays as clinically necessary.

I had a lovely NHS dentist for years, I also had private treatment using the same dentist for implants. The dental surgery got taken over and I got a phone call saying I either had to have him as a private dentist or go completely NHS. I saw the NHS dentist last checkup and they barely looked in my mouth. She probably took about 2 minutes to look at my teeth, I’m trying to find my previous dentist even if I have to pay privately.

I am indeed at risk of developing cavities and have had quite a few. I had a small one caught early by the good dentist that he gave me Duraphat 5000ppm fluoride toothpaste for (i.e. still reversible, no filling required yet). So surely they should be checking on its progress more than every 2 years?

Difficult to say. The rules are a s/p are provided if clinically necessary. It depends on circumstances unfortunately. Are you seeing the hygienist privately or on the nhs? And if nhs, is it a scale or a perio appointment do you know?

It’s very sad isn’t it! As an FD practice and also I being a clinical tutor at a dental hospital, it’s hard to be positive sometimes. The world is getting tougher. We need nhs dentists but the more the younger ones come into it, the harder it is for them

I can’t comment sadly as I haven’t had an NHS dentist for over 15 years now.
My NHS-trained but now private dentist is lovely though.

(SERIOUSLY: why does the NHS not stipulate that if you train using public money, then you work for the NHS? If you want to wrk privately, you train privately.)

Yes there are some dentists out there, nhs or private, who sadly do no offer the appropriate care. As far as I am aware, these are in the minority. However I’m sure that doesn’t put you at ease. Always seek a second opinion if you are not sure. Also, be aware that some dentists over prescribe as well as under prescribe

If you have had no new cavities for a while than two years or longer is appropriate.
Annual x rays are only appropriate while you are still developing new cavities . When the rate of decay goes down then the gap inbetween x rays increases .
With U.K. radiation regulations there has to be good clinical reasons to justify each and every x Ray.

They are looking into this! Currently if you train in the uk you get your final year at uni funded by the nhs and then your training year (FD) but after that’s you're not obligated to continue working in the nhs. I got sent a questionnaire last year asking if I felt that graduate dentists should do time in the nhs and if so, how long for (I believe most of not all dentists got this). So it is something there looking into. But I wholeheartedly agree with you. If the nhs funds your placement, you should spend time paying them back by working for them

Exactly this. Guidelines state we need to follow ALARA and also NICE guidelines. Low risk patients get routine X-rays every 2 years. It goes up from that or youre medium or high risk. Or if you of course attend with an issue

Yeah X-rays are routine every 2 years unless otherwise needed so depends on your circumstance. However a 4 minute experience isn’t good

why is the same question not asked of vets or architects ? The average dental student graduates with over £80,000 of debt . They will be paying student loans and interest off for years . The majority work in the NHS for years until the gain experience and skills to work privately .

As in link above most NHS work results in a loss for the practice , it is only private work that subsidises and keeps NHS afloat.

When I qualified over 95% of all dental work in the U.K. was provided on the NHS . Now it is around 50% . If you want dentists to work on the NHS pay enough to run the practice and pay a decent living. NHS dentistry is the only branch of healthcare where practitioners pay for people’s treatment out of their own pockets. https://www.bda.org/media-centre/nhs-dentistry-treasury-now-no1-roadblock-to-saving-service/

May I ask a question please?
I've had an abscess for a little over a year. I got antibiotics for it at first (from my NHS dentist) but I've never been back. Partly through fear and partly through fear of treatment cost. I just don't have any spare money at the moment but I'm starting to get pains around it and on that side of my jaw. If I go and can't afford treatment what will happen? (I know it won't be good medical wise but I mean can the dentist offer any help?)

You’re welcome and thank you for your understanding. Unfortunately, whilst I know the nhs is underfunded in general, I feel that nhs dentistry is massively underfunded. They’re cutting contracts and availability constantly. My practice has actually massively over compensated this year and asked for an extra 6000 udas which could accomodate anywhere between 500-6000 people! However since April, it’s been shoved to one side. We’re fighting for this! It’s not always our fault :( one of our nhs dentists has had to leave because the nhs couldn’t give him a contract this year!!

I’m afraid if you pay for NHS dental treatment nothing can be done unless you pay.
If things are that tight have you looked to see if you are entitled to help with dental costs https://www.nhsbsa.nhs.uk/check-if-youre-eligible-help

The only places that may offer free dental treatment are dental hospitals where you are treated by students . However not all dental hospitals will take on new patients, there may be a long wait for those that do and if you are nervous it may not be the best place for you.

NHS patient. I had injections without adrenaline. They didn't work to numb me enough so my dentist said to make an appointment to return and have the injections with adrenaline. The first available appointment was almost 6 months away. They're still taking on new NHS patients. Is this the norm nowadays?

I haven’t seen a dentist for 2 years, finally got an appointment for October but the price for check up is so high I think they may have switched me to private. DH has had to go to a private dentist after 5 years waiting for an NHS dentist because his dentist left during Covid. We can’t afford private dentists.

Of course you can ask a question and I’m sorry you’re in this position. Are you still registered with you nhs dentist? If you’ve not been back in a year, you may want to check that. It’s very strict at the minute. They may see you for an emergency where you can get more antibiotics. There will however be a charge of £27.40. Sadly there’s not much else you can do as if you ring an emergency line, they will not accept you if you’re registered with a dentist already. Taking the nerve out of the tooth, or taking the tooth out is also usually a band 1a (emergency fee) of £27.40. However it depends the last time you saw th dentist and your recommenced recall. If you were advised to attend every 3-6 months then that won’t stand you’ll need to pay the band 2 charge of £75.30.

if you cannot afford that and are happy to have to tooth removed, you can request a referral to secondary care. However please be aware, this could be rejected

Many contracts now have the stipulation you have to take on so many new patients during the year , as access is the politicians priority . The problem is that there is no more capacity so all that happens is those who need treatment are waiting longer and longer . Not the dentists fault , the fault of the government who will put no more money into NHS dentistry , just want more and more done on a decreasing amount of money.

I wasn’t aware vets and architects are public sector professions?

Educational Psychologists have to work in the public sector for a few years after training, which I completely agree with (although I think it should be for longer).

Inability to pay a fee is not a valid reason for referral to secondary care . It actually states this on most referral systems and the referral will, automatically , be rejected.

There’s a 12 month warranty on nhs crowns