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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To think our NHS dentist should provide the care DP requires!!!

85 replies

lilylu22 · 04/02/2010 17:17

Instead of trying to refer him to a private hygienist!!

DP has a severe gum infection... Tried and tried and tried to resolved it at home with almost obsessive brushing and mouthwashing, but to no avail.

Went to see our NHS dentist who told us he required 'deep cleaning'. However that he would only offer one standard NHS clean but DP should 'for the sake of his own health' visit the private hygienist for a deep clean.

Funnily enough, there is NHS literature in his waiting room that states, 'if your dentist says that you need a particular type of treatment, you should not be asked to pay for it privately'.

I just feel his is taking the P and that this is exactly the type of care the NHS is supposed to provide. I was with DP so I triple checked with the dentist the care he was suggesting we seek was 'clinically necessary' (what the NHS says it will provide) - and he was very rude and made out like I was thick, "that's what I just said". I asked that refer us to a NHS hygienist so we could have the treatment done, but he said such a thing doesn't exist.

Have rang our local primary care trust that suggest we go to have the NHS 'brief clean' he is offering then consult a new NHS dentist to see if he has resolved the problem entirely. If not, they will deal with him - for breach of his contact to provide all necessary services to NHS patients..

BUT - it seems unfair we have to go thought consulting a second dentist etc when he himself admits DP will need more than one clean. Imagine how many more people this dentist is exploiting but getting them to privately pay to what they are entitled to under the NHS..

Rant over - AIBU??

OP posts:

differentnameforthis · 04/02/2010 21:11

NHS no longer offer the treatment your dp needs. If he needs a deep clean, he will get a basic one on the NHS & that's it! This would not help your dp much & his gums will not improve.

Don't blame the dentist....it is set by the government.

differentnameforthis · 04/02/2010 21:18

'But he is NOT offering a solution' YES, he is! He is offering a standard NHS procedure, and he has admitted that it will not be enough to fix your dps problems.

You can have him do it, but your dp will still have gingivitis. This will not get fixed via NHS care.

differentnameforthis · 04/02/2010 21:22

Imsonot...

the NHS has fees fixed by the government, whereas private dentists are free to charge what they feel their time/work is worth.

The NHS dentist probably had 5 minutes, whereas the private dentist would have had more time.

Again, this is not the dentists fault, they are working in limited time, with limited funds that barely cover the cost of running that surgery.

Earlybird · 04/02/2010 21:35

How often does your dp have his teeth cleaned?

Is it possible this problem occurred because his teeth are not cleaned often enough? Might going more frequently stop the problem happening in future?

In your shoes, I'd pay for the deep clean privately and then in future ensure your dp has his teeth cleaned as often as the dentist will allow.

LouIsOnAHighwayToHell · 04/02/2010 21:43

Is there anywhere that lists that services that an NHS dentist MUST provide? I needed to have a wisdom tooth out and my dentist said that he did not do extractions so I had to pay someone else privately (same surgery though). I would have thought I could be referred elsewhere.
So is there a list???

JaneS · 04/02/2010 21:49

That is very iffy, imo. He shouldn't be telling you to go for private services for 'health' reasons.

That said ... I have just had to have some nasty dental treatment and (I feel a bit ashamed to admit), I went private. I've had horrible experiences previously with inadequate NHS dentists. The private dentist was so, so much better - he did a root canal that didn't hurt at all, for example. I'm really angry/shocked that care is so much better privately, but it really is.

differentnameforthis · 04/02/2010 21:55

Littlered, it is for health reasons though! Dental health & physical health!

NHS offers very basic cleaning, which in this case, sounds like it will not be enough to eradicate the problem.

Therefore, dentist has recommended that ops dp gets some more intensive cleaning done, to improve his dental health & his overall health. Having gum disease affects the rest of the body too, he will be swallowing all sorts of bacteria when he eats, which can cause stomach aches etc.

differentnameforthis · 04/02/2010 21:56

Littlered, it is for health reasons though! Dental health & physical health!

NHS offers very basic cleaning, which in this case, sounds like it will not be enough to eradicate the problem.

Original poster

lilylu22 · 04/02/2010 22:33

I understand what all of the above posts have been referring to in regards to there being limits to what the NHS will offer.

HOWEVER, the NHS people themselves (other than the dentist) - the DHS direct consultants (I've spoken to 4) and also our local Primary Care Trust ALL agree that my DH should be able to have his problem SOLVED by the NHS dentist and should NOT be referred on... That is, they should provide the deep clean.

As I said in my original post, the NHS literature I found in the waiting room of the dentist states very clearly that if you need treatment that is 'clinically necessary' to solve a problem - the dentist should provide it, not refer you to a private service.

The dentist simply isn't doing what he is obliged to do, I feel.

OP posts:

Original poster

lilylu22 · 04/02/2010 22:35

Lou - this is EXACTLY my point, NHS dentists seem to be a law unto themselves. My DP had his wisdom teeth removed on the NHS, so obviously it IS possible

OP posts:

Original poster

lilylu22 · 04/02/2010 22:42

On the NHS website,

All necessary care and treatment, including dentures, is available on the NHS. If you want, or your dentist suggests, treatment that is purely cosmetic (for example, tooth whitening, large white fillings or white crowns on back teeth), you can only have this treatment done privately. Ask your dentist how much this will cost in addition to charges for NHS treatment.

I feel that this really clarifies the situation. ALL treatment is supposed to be available to fix the problem. So because he needs a deep clean, the dentist stated this was clinically necessary, it should be provided.

OP posts:

unavailable · 04/02/2010 22:43

Lily - does your dp smoke? I was told I couldnt have a deep clean on the NHS as a smoker as it would not be effective. They would do it once I had quit smoking - that seemed fair enough to me.

Original poster

lilylu22 · 04/02/2010 22:45

No - he doesn't smoke..

What mixed messages we all get.

OP posts:

Becles · 04/02/2010 22:49

Your trust are being very woolly.

The dentist has claerly stated that it's clinically neccessary and has stated that there are facilities in the practice to sort this out.

Rather than faffing about, I suggest you have the hygienist clean and afterwards offer to pay the NHS Band 2 treatment cost which covers a deep clean (about £45). If they make a fuss, you then need to go directly to the PALS or complaints team at the Trust and insist that the dental contracts manager investigate why the practice is refusing to carry out a basic procedure on the NHS that is clinically neccessary and they have demonstrated they have the clinical skills / expertise within the practice.

The dentist is having it both ways by picking off cheap quick things on the NHS and making patients go private for other work. If they can do it privately on premises, and they've said it's neccessary, they MUSt provide it - no excuses or grey wording in the contract. The trust being lazy in performance managing the contract and should respond with a gentle prod.

unavailable · 04/02/2010 22:49

Yes - it seems like another postcode lottery

Original poster

lilylu22 · 04/02/2010 22:59

Becles - the trusts has no dental manager atm - which is why they have suggested he have the basic clean the consult ANOTHER nhs dentist.

If they find that there is more treatment necessary (that was not offered under the nhs at the first dentist), then it will be easier for someone lower than a manager to discipline the first dentist.

That part of the palava is a pain too... but obvs just bad timing on the manager position being unassigned at the moment

OP posts:

JaneS · 04/02/2010 23:25

Sorry, yes, I understand it's for health reasons. I meant to explain that I think it is unacceptable for him to refer you on those grounds.

However - as a separate issue from what your dentist says, I have to admit that I've found complex procedures to be hellish on the NHS, and very good privately (which they damn well should be given the amount you pay!). I'm just sad that the standard of care is so different with NHS and private.

differentnameforthis · 05/02/2010 00:26

I don't see how they can say that without seeing his mouth, lily!

I think you will (probably) find when the second dentist assesses him, he will agree, if your dps gum disease is that bad!

differentnameforthis · 05/02/2010 00:27

And actually, it is VERY unprofessional to tell you that it can be done under NHS when they haven't even assessed his condition!

Original poster

lilylu22 · 05/02/2010 00:48

I just don't understand how it can NOT be dealt with under the nhs. He has a medical condition. He is an NHS patient. It needs to be resolved. They need to make the treatment available at NHS rates. That's it.

OP posts:

ButterPie · 05/02/2010 01:13

I had two wisdom teeth out under sedation on the nhs and i think I paid a fiver for the first consultation and nothing more. Had to get referred to an obscure village dentist that was nigh on impossible to get to, but it did the job.

Personally I think it all should be free, as should opticians/glasses, for everyone. And private should be banned. But that's a WHOLE other debate

Earlybird · 05/02/2010 03:58

OP - please can you answer my questions?

How often does your dp have his teeth cleaned, and prior to this, when did he last go to the dentist?

Is it possible this problem developed because his teeth are not cleaned often enough?

I've asked because I wonder if your dp's dentist cannot (or will not) deal with a condition created by infrequent visits to the dentist to have his teeth cleaned.

differentnameforthis · 05/02/2010 04:03

NHS treatment will let him have a basic scale & polish. They will (or used to) also let him have another visit. Approx 15min appt.

In that time, no treatment is going to repair gum disease. Fact!

Gum disease CAN NOT be cured in one scale & polish.

But there is a treatment is there, your dentist has offered it. It will help to remove some, maybe most of the hardened plaque that is living under his gums. This will, hopefully, let the gums start to heal. But that takes time. It needs to regrow & re-fuse to the periodontal bone (that holds the teeth in place). Depending on how severe it is, he may have lost bone already.

Depending how long the appointment is, will depend on how much cleaning they get to do. BUT he will need maintenance. This isn't available on the NHS. Only 'maintenance' used to be every 6 months. And you can't maintain a mouth recovering from gingivitis with visits every 6 months.

If he has gingivitis, it will take several longer appointment to cure & build up a maintenance programme.

differentnameforthis · 05/02/2010 04:05

"They need to make the treatment available at NHS rates. That's it."

They are the government, you know that don't you? Your dentist isn't making the rules. He is abiding by them.

differentnameforthis · 05/02/2010 04:07

If he has gingivitis, it will take several longer appointment to cure & build up a maintenance programme....

The NHS DO NOT offer this. FACT!

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