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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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:
fanjoforthemammaries7850 · 05/02/2010 06:09

well, i am bemused by that, as i work for 2 NHS dentists and they regularly see people for several 20 min appts for periodontal treatment, i.e. a 'deep clean'

izzybiz · 05/02/2010 07:04

At the NHS dentist I used to go to a Hygenist appointment was £42 for a half hour appointment.

I have just started to see a private dentist and have discovered I have gum disease, I need to see the hygenist to have my teeth cleaned right down under the gum line.

I have had a one hour appointment that cost me £120, and I need a couple more.

This deep clean is not a quick thing, its quite painful, so I was numbed first, and it takes time. I will be getting this sorted out and keeping regular Hygenist appointments in the future, I don't want to lose my teeth!

MmeBlueberry · 05/02/2010 07:20

The dentist is in a no-win situation. In order to fulfil his NHS contract, he has to push patients through his surgery as fast as he can. He doesn't have the time to spend ages with each patient. If he does that, which is the right thing to do as a caring professional, he won't meet his NHS targets and will be penalised the following year.

He doesn't have the time to spend over an hour doing a proper root plane (you can't do it in 20 minutes), and then the follow-up. It is better for all concerned to go to a hygienist, who has both the time and the specialised equipment.

My private dentist does all my hygiene work. I go four times a year and spend 45 minutes in the chair each time. You get what you pay for, tbh.

CaptainUnderpants · 05/02/2010 07:23

Unfortunately some people cant afford to pay for private dental care. So I think the comment ' you get what you pay for ' maybe a bit unfair .

MmeBlueberry · 05/02/2010 07:28

It's not a case of being unfair (that's a different debate).

It is a case of being true.

differentnameforthis · 05/02/2010 08:27

Fanjo, 'several' meaning 3? That is all that was given when I was in NHS dentistry & when I spoke to a friend not too long ago (to keep on top of dentistry for when I return.

3x20 minute appointments will NOT clear up gingivitis! 1st appointment is normally and in depth assessment & CPITN. Then maybe, if possible you get a few minutes to clean. 2nd, cleaning. 3rd, cleaning & not forgetting going over the oral hygiene routine, which takes time.

You simply cannot treat, eradicate & maintain gingivitis in an hour. And if your practice does, it sounds to me like they are lacking somewhere!

MrsGokWantsatidyhouse · 05/02/2010 08:52

There are no NHS spaces in our town. I would have to go to the city 30 miles away, which means bus, train and taxi to get to. Which costs a fortune. I can not afford to go to a private dentist in the town, so haven't been for donkey's years.

My DH has just signed up to a NHS dentist near his work, he hasn't been in 15 years. They have started the work but have run out of money untill April, so he will have to wait until then to continue his treatment.

ImSoNotTelling · 05/02/2010 09:29

differentnameforthis re when I went to see my DHs dentist. He didn't spend 5 mins looking at my teeth, it was literelly open up, quick sweep with mirror to see the back and that was it. Literally 30 seconds (or less? it was a while ago) on a patient he'd never seen before.

He just said "your teeth are fine but you need to see the hygeinist at least 3 times a year".

Me: How much?
Him: £40
Me:

The feeling I got if I'm honest is that he was trying to get me onto the paid for services to make money for the practice.

They also cocked up DHs teeth but that's another story!

ImSoNotTelling · 05/02/2010 09:30

mrsgokwan looking at this thread, it seems it is not just me who finds it cheaper in the private sector. Complicated treatments aside.

differentnameforthis · 05/02/2010 09:39

imsonot....I guess if you have no fillings then that would be all it took...but it does seem a very quick visit!

ImSoNotTelling · 05/02/2010 10:17

Well obviously there are good and bad dentists - it was his "bedside manner" if you like, I felt like he just interested in the contents of my wallet!

I really should see if DH wants to look into changing. And no idea what to do about the kids...

ImSoNotTelling · 05/02/2010 10:20

What do the hygeinists do that takes half an hour though?

My bloke scrapes with a pointy thing, then has a drilly/whirry thing that makes a high pitched noise, then a quick polish.

I assume he's doing it right

lilylu22 · 05/02/2010 17:36

Well, low and behold... DP turned up today to have his NHS promised scale and clean...

The dentist seemed to have changed his mind after my waiting room strop yesterday and gave DP a full / deep clean (took 45 minutes)....

We're not sure why / how - back Tuesday for more work apparently

I do count myself extremely lucky but it makes me wonder about the extreme inconsistency of the system

OP posts:
MmeBlueberry · 05/02/2010 18:35

Imsonottelling,

When I see the dentist, he starts by asking about my overall health. Then he does a check for mouth cancer, and checks that my neck, jaws and bite are well aligned. He inspects all of my teeth. After that, he does a perio check, where he measures how far he can probe under my gum, and assesses how much gum I have. He may take bitewing x-rays (once a year) and full x-rays (every 3 - 4 years), and lots of photographs.

Only then does he start the cleaning, followed by a thorough floss and polishing.

He finishes off by advising me about my oral hygiene routine.

Overall, that takes 45 minutes.

MmeBlueberry · 05/02/2010 18:37

Did he have an anaesthetic for his clean, Lily?

45 minutes is what I get for normal (no gingivitis).

ImSoNotTelling · 05/02/2010 18:50

Blimey that sounds comprehensive mmeblueberry!

Mine says hello, asks after the children and my parents, tells me about his new girlfriend.

Open mouth, has a look at each tooth and seems to count them and poke them and prod them a bit for a while.

Then delivers his verdict, which is always a stern reprimand, then a brief lecture to impress the importance of daily flossing and interdental brush etc.

Followed by much scraping and prodding and a polish.

He does x-rays once a year but has never photographed me!

I don't have any fillings or crowns or anything though so maybe they're straightforward.

I also want to end this post with a which goes ping like on the ads!

I was just wondering what a hygeinist does that takes so long TBH, mine is about 25 mins all in, including the dentisty part IYSWIM.

fanjoforthemammaries7850 · 05/02/2010 19:16

differentnameforthis - I wasn't saying you weren't telling the truth, I was just a bit bemused, I actually know nothing about the clinical side of things, so thanks for clearing that up.

lilylu22 · 05/02/2010 19:21

Yes, he did have anesthetic and has spent all afternoon complaining that his mouth is sore

OP posts:
differentnameforthis · 06/02/2010 00:15

imsonot..that sounds like a basic scale & polish which means that you probably have reasonably healthy gums.

That's good!

differentnameforthis · 06/02/2010 00:16

lily, NO ONE gets a 45 minutes clean on the NHS. They don't provide for it. You get 20mins max on NHS.

You got something for nothing....

differentnameforthis · 06/02/2010 00:19

Sorry imnot, didn't answer your Q. If you have gingivitis it usually means that you have hardened plague under your gums. This is usually very hard to remove, so takes time.

Once this is off, the area under the gums need cleaning to make sure all the debris is out.

A good thorough job takes a long time if the gingivitis is severe.

lilylu22 · 06/02/2010 00:40

Well. I am not sure I agree that the NHS don't provide for it.

Certainly the general consensus was that NHS dentists don't provide it - however, NHS direct as well as our local primary care trust feel that they SHOULD under their contracts.

OP posts:
differentnameforthis · 06/02/2010 00:47

lily, when I worked for the NHS, in dentistry they offered either

1 appt (the cost for which basically allows a 20 min appt) for a basic scale

or

2 x 20 (one a week) for a more thorough scale

or

3 x 20 (one a week) for more intensive work.

Never have I seen or heard of a pt being seen for 45 mins, in one block on the NHS. Dentists cannot afford to do it on the fees they are paid.

But as I said, you got what you wanted, at the dentists expence.

ImSoNotTelling · 06/02/2010 12:05

Well this thread has made me realise how much I want to keep my gums healthy as having have someone clean under them sounds ouch in the extreme!

I just got a new electric toothbrush fro my birthday and it seems to be really super-duper so fingers crossed. need to get a bit more regular with the old flossing though...

lilylu i do hope your DP gets everything sorted out with his teeth.

Earlybird · 06/02/2010 12:29

What causes gingivitis?

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