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

The poster didn’t say a student loan took half the pay. They also quoted indemnity (which we HAVE to pay to be able to work) registration fees. CPD and courses take a huge chunk on salary, especially on the early years. Students are qualifying now with so much less experience and exposure to patients and procedures, this coupled with a highly litigious (especially the NHS cohort of patients) society often mean courses are 100% necessary. To put it into context text, I’ve just done a course that costs 20k. That’s not fancy high end dentistry, that’s oral surgery. Dental school really does teach the bare minimum now, some students qualify having done one root canal on a molar, no complete dentures etc. Furtther courses are a necessity, and exceptionally pricey.

Ours went private years ago. Im sure it was coincidence that all the nhs patients I know in our little town got letters to say they'd missed appointments that they hadn't made so were removed from the list. I got in for an emergency locum appointment and was given an appointment for 6 months. Great. Except they rang me an hour before to say I didn't and I wasnt on their list. Im currently having to stick my crown in with superglue.

Me, my parents and my now teen/young adult kids are with the same NHS dentist practice since my childhood. It has changed hands a few times and it is very noticeable that the latest team are x-raying all of us every time (so every 6 months). They don't even ask the late teens (who are now going by themselves), just pop it in their mouths without explanation and leave the room.

None of us have any dental issues we are aware of. We do not get to see the x rays.

I am concerned I have receding gums. No pain. No fillings for past 30 years at least. Would I be better going private as they just say 'nothing to be done' (but take lots of x-rays), 'you will probably lose the tooth at some stage'. I would pay private if I thought it could be prevented.

Thanks

Community is still going but chronically underfunded with recruitment problems. Locally to me they are working out of “temporary” units that they were promised years ago would be replaced.

They have unrealistic treatment targets when they work with patients who need a lot of time and resources and much of their core work like school dentistry and work with elderly no longer happens because of funding. Their recruitment is at rock bottom as is their morale.

It’s really socialist principles coming into fatal conflict with capitalism, isn’t it?

It’s not great. I needed work recently that cost £60 on NHS. Private it was 10x more. I can’t afford private and was made to feel crap my the dentist. It was horrible and will be my last visit to a dentis. Don’t think I’ve ever been so humiliated

No , it’s not being paid enough to cover surgery expenses.

An average payment (including patient fees) of £36 per year per patient treated is not going to go very far when all expenses to run a surgery have to be paid out of that and in a cheap area one room in a practice doing mostly NHS treatment costs upwards of £140 an hour to run.

Even worse when dental inflation ie the cost of materials etc runs at over 10% without the additional burden of NI increase and the profession is given a 3.5% increase in fees . Yet another pay cut for everyone.

I read a really interesting article about this about 10 years ago and the most shocking thing for me is that uk universities were churning out something like x10 the number of NHs density training contracts available. Not because contracts had been reduced- at that point they hadn’t, maybe they have now- but because universities can take that capacity, they keep churning them out. Knowing there is no job in the uk for the vast majority of them. I thought that really set the tone for how dentistry is treated.

Not quite.
In order to work in the NHS a dentist must , within 18 months of qualifying , do a year of compulsory Foundation training in a practice.

For many years there have not been enough training places and most times it is not a problem because of people failing final exams etc. A couple of years alternative hospital based training has taken up the slack.

Fewer and fewer practices want to do training because , as another poster alluded to , when new dentists qualify they need a lot more support and training. The time training is expanding , as are qualifications.

As a former Educational supervisor I had to attend annual training courses in education (taking a week off work) , and as well as training my trainee I had to give lectures to the other trainees . The tutorials and time supervising was at the expense of my own patients . I then had to fill out assessments and portfolio requirements . All of this for £12,000 a year and year on year the teaching requirements get more onerous as foundation year now teaches many of the clinical skills dental school used to.

There is always a job for a dentist, however for new graduates that may be anywhere in the country and it will be NHS because they don’t have the experience or skills for private work . Young dentists are the cannon fodder of NHS dentistry and are increasingly stressed and burnt out , leaving the profession early.

Thank you for this thread!
I have two crowns that have failed and there is decay under both.
My dentist says leave them as there is no pain and they would be tricky to fix.
They are next to my front teeth.
Is this the usual advice?
Thanks again!

Impossible to say but it is possible there is so little tooth left that they are irreparable and the alternative is to take the teeth out .

I’m very lucky to belong to a really good dental practice, all the staff, no matter what their role are all really lovely.

I mean nobody actually enjoys going to the dentist do they??

I find it slightly more bearable though as my dentist is pretty sexy and that helps 😂😂.

My son’s Orthodontist is in the same practice and he’s quite attractive too so I always make sure it’s me who takes him to his appointment and not my husband 🤣

Both men are always really caring towards my children too when they’re nervous during their appointments, and I’m a sucker for men who show their softer sides and nurturing traits when it comes to working with small children.

None of this is relevant to the actual post is it? 🤣

If anyone wants details of my dental practice with the gorgeous and kind dentists, who are taking on NHS patients, then please PM me 🤣

Does this even need asking?
Nobody in this country can be unaware of the crisis in NHS dentist even if they are wealthy enough to use a private dentist.

That said, I am happy to tell you my experience just yesterday.

I am lucky to have an NHS dentist. It was like winning the lottery when a local practice announced on fb that they had availability three years ago.

All places were filled within one hour of them posting and no places have opened up in my area since.

I broke a tooth and the dentist said my options were a root canal or removal.

The root canal would be such that I would need a referral to a specialist (the broken tooth had previously had a root canal many years ago but apparently I have very deep roots on my teeth so hence the replacement would be difficult) and the specialist will not do this at nhs prices so I would have to pay privately approx £1,300.

As I can’t afford this I had to have my perfectly saveable tooth removed.

Well as I say, I’m no economist, but not being paid enough to cover costs kind of exemplifies what I meant.

To my understanding, as heathcare is essential, in a competitive capitalist model it is expensive (see the US).
Under socialism, though, essential services should be as cheap as possible (ie good value, funded by the government by public money, on a not-for-profit basis). Yes dentists need to be paid a good wage, but it is evident that the government can't afford to do so. They cannot compete. So the dentists leave and NHS dentistry has all but disappeared. So it seems to me there is an incompatibility there.

Thanks for starting this thread. Do you mind sharing how many years experience you have and how much you earn?

My children were registered with an NHS dentist but they stopped offering regular checkups and would only agree to see them in an emergency, which they luckily haven’t experienced so far.

I found a private dentist who offers Denplan and registered them there, so thankfully they’re having regular checks and preventative care. It’s upsetting to think about the number of people who can’t access affordable dental care.

Growing up with parents who basically had no teeth in their heads by the time they were 30, I could see how much of a negative impact it had on them. Saying that, I haven’t been to a dentist myself for a number of years due to a horrible experience I had with a filling, during pregnancy 😬 I need to bite the bullet 😏 and get that sorted.

Qualified decades , many post grad courses , worked as an educational supervisor as well as mixed dentist NHS and private in very deprived area. Most I ever earned in a year was £56,000 before I retired a couple of years ago . The last year I worked fully NHS I earned £27,000. A colleague of mine who owns a NHS practice earned £17,000 before he gave up his contract.

This year two of my colleagues in seperate practices gave up their NHS contracts as both lost a 6 figure sum on them.

I’m a dental nurse. One of the frustrating things sometimes is the number of DNAs we can have in a single day; there have often been times that I’ve earned more than my dentist. If patients don’t bother to turn up for their appointments, I still get paid, my dentist doesn’t. It’s demoralising and unfair; my dentist was newly qualified, making a very long trip into work each day and wanting to do their very best for the patients they saw but ended up regretting going into NHS dentistry at all. There’s no money in it, and their time is taken for granted.

Absolutely this.
40% of new patient appointments are failed

The practice in Bristol where they had massive queues to get in for NHS treatment had 9 people fail to turn up on the first day alone.

Practice expenses still have to be paid , with no money coming in it's no wonder 78% of NHS practices can't meet their targets and get money clawed back each year.

Thanks for this! The reason I ask is because I had a crown fitted in July. It fell out last week and my dentist says they’re no longer covered under warranty and I either ‘live’ with no crown, pay again, or have the tooth out! But when he fitted it he told me it was under warranty for 12 months!

Thank you for starting this thread @Booyahh
I had an NHS dentist until last year. One by one the dentists left the practice (one moved to a different area, two retired early) and the owner could not recruit any new NHS dentists. I now see the practice owner as a private patient.

You’re right.

There’s not one single NHS dentist with an open list for adults in my COUNTY! It’s the fifth largest county in England and if you can’t pay then dental health is off the table for you.

My mum’s local provision, in another county, is terrible too. Whoever was in charge employed a dentist to provide NHS dentistry who turned out to not have any actual qualifications. None. It’s not only that he lied, they hadn’t even checked. He left people utterly butchered and needing more expensive care.

This is a scandal. A disgrace.

I don’t know the answer, but I am one salary away from not being able to afford it. And that scares me.

It is only guaranteed if it is exactly the same treatment or your don't need a post or different type of crown and it is the same dentist providing it , not just the same practice.

I only go to the dentis these days when I have a problem and need an extraction.

I'm only 46 and I have lost a number of top and bottom back teeth.

I went to the dentist a few years ago to have a wisdom tooth removed and once he gave me the injection i was asked to go to reception to pay.

Almost 400 quid it cost me, took him about a minute to get it out.

Why is it so expensive.

Thanks you for remaining an NHS Dentist.

It is! All of those things! It simply fell out! No additional treatment or anything!