Gum disease NHS

[southern82]

I've just been to the dentist today as a NHS patient and I'm really confused.
I was told that my teeth are in a terrible condition and that I have severe gum disease.
I asked about root planing and the dentist looked shocked and said "where did you read about that?" And gave me some strange reply about how I'm not able to have root planing done.
She said she will clean my teeth the next time I visit, but I was under the impression that root planing is the treatment available for severe gum disease.

Should I make a complaint?

According to this it is a band 2 treatment? I'd perhaps email and ask for clarification?

www.nhs.uk/nhs-services/dentists/dental-costs/what-is-included-in-each-nhs-dental-band-charge/

Root planing is the removal of the outer layer of cementum of tooth, it is an old fashioned technique really and is not a term used often in the UK. Root Surface Debridement is the removal of plaque and calculus subgingivally, essentially a deep clean.

But it depends if you have pockets or just gingival inflammation, and it depends on your oral hygeine

A scale and polish is the first line treatment for gum disease and improved oral hygiene. Technically you should do this before attempting root surface debridement as it could be false pocketing due to inflammation, and if the patient does not have good hygiene root surface debridement is a pointless exercise as the pockets will just get reinfected.

Basically your dentist giving you a clean is the right course of treatment.

Also I'm not sure why you'd jump straight to a complaint before clarifying with your dentist. Gum disease isn't as simple as do a dental treatment and it's better, the majority of work is done by the patient

Forget the complaint, I have no idea why you think the dentist is refusing you this, they aren't there to be difficult. Concentrate on flossing, cleaning properly & using adequate mouth wash to heal the gums & prevent reinfection.

As @OrangeShark27 says, the main treatment for recently diagnosed severe periodontitis is YOU brushing effectively (modified bass technique) twice daily and using correctly sized TePes daily to interproximally clean.
Unless you get on top of this from the off, no amount of periodontal treatment from your dentist will help you.
The term root planing hasn't been used for about 20 years so maybe that's why your dentist looked perplexed. Root surface debridement is the correct terminology and even so, general debridement comes first and then review.

I have gd and this is my routine as advised by dentist

you need to floss every day and brush twice a day
use a capful of mouthwash at night too the one for gum disease.

Never eat after brushing your teeth at night or drink.

This helps you get on top of it. The dentist can do a regular clean but its down to you to keep on top of it. HTH.

@Sportslady44

I have gd and this is my routine as advised by dentist

you need to floss every day and brush twice a day
use a capful of mouthwash at night too the one for gum disease.

Never eat after brushing your teeth at night or drink.

This helps you get on top of it. The dentist can do a regular clean but its down to you to keep on top of it. HTH.

Doesn't everyone do this anyway?

Surely you need to see a hygienist regularly to get on top of this? How is waiting 6 months going to help you? I suspect you may have to pay privately to get decent on-going gum care.

No that's not true.

Band 2 covers Perio. Which is a deep clean of the gums and the pockets. We measure each pocket of each tooth.

Maybe your surgery offer Perio Chips? They're private but do help people with Periodontal issues.

Hi OP,

you are right, root planing should definitely be done in a deep cleaning. I was diagnosed with gum disease in Spain and Spanish dentist root planed all teeth. However, in UK they don’t bother. I don’t know why. I think bad dentists here, sadly. I had deep cleaning here and not one dentist has bothered to plane roots. I would complain because people are losing teeth through dental neglect. Clearly, root planing is part of the deep clean and they should not be neglecting that.

@AmandaAmanda85
You don't know what you're talking about.

Clearly, I do. I have had experience in several countries and nowhere is worse than UK. Dentist here just don’t care about their patients and the OP should complain. Bad British dentistry made worse with NHS. Unless people complain then dental care will not get any better.

Root planing is archaic. It damages the roots of the teeth.

@AmandaAmanda85
3 UK dentists on this thread disagree with you. The very fact that you're wittering on about root planing, which is so antiquated, shows your complete lack of knowledge.

Another dentist here, root planing is an outmoded treatment.
First line management is improvement of oral hygiene with home care; careful, thorough hygiene with daily interdental cleaning with interdental brushes and ideally an electric tothbrush-without this any other treatment is not going to work. Then reassessment and treatment from there.

I would not want to take advice from any British or NHS dentist, thank you very much. Spanish dentistry is so much more advanced than in the UK and they DO stress how important root planing is. Hence, they take time to do it. Also, the products available for oral care are so much more advanced than the rubbish they stock on shelves here. Likewise, Mexican dentistry is better too. Also, far cheaper.

I put in a complaint about the British dentist and I went direct to the GDC over the same issue as the GDC. I suggest that people who have a grievance complain and that way dental care may eventually improve in UK.

I brush twice and sometimes three times a day and I also floss daily. I pay for my treatment, despite being entitled to free NHS treatment, as I wouldn't want it, ever again. Perhaps you should go abroad and see for yourself how much better dental care is outside of the UK. When people are going abroad for treatment, it speaks volumes about your profession. Sorry, but British dentistry is appalling.

How is the root cleaned of tartar with a brush that cannot even reach below the gumline? It is simply left along with the pockets and eventually your patients lose teeth. Seriously, how you can even defend this is mental.

Also, you should know as a dentist that gum disease has several causes: genetics, smoking, hormonal changes and overbrushing. It is not always down to poor oral hygiene, so perhaps think before insulting. Thank you.

@AmandaAmanda85 you have absolutely no understanding of the terms you are throwing around . You clearly don't even understand what root planing is

British dentists are not all trained on Britain, surprisingly there are may Spanish and Mexican dentists in the UK and many UK trained dentists in Spain. British dentists and dental associations don't just ignore research from other countries, why in gods name would they just pretend good research doesn't exist? Do you think a dentist who trained in Spain suddenly gets indoctrinated by the demon brirish dentist and forgets all their knowledge? Or that British dentist just read the textbook of British dentistry and nothing else 🙄

You know fuck all about what your talking about, so please don't. It's dangerous to give advise when you aren't qualified to and your vendetta against British dentists could result in people not seeking appropriate care.

@AmandaAmanda85 you are talking nonsense

Oh, I beg to differ. I may not have trained as a dentist, but I have done my research and I have plenty of experience. They train in Spain, yes, but British standards are nowhere near the same level. Hence, they have to conform to 'the British way'.

I have simply relayed to the OP what I was told by the Spanish dentist, root planing is crucial in the management of periodontitis. Simple. Therefore, standards are not the same and Spanish trained dentists are far better.

Try looking after your patients and doing your job properly. Maybe if you did the British public would not have to deal with the stigma all over the world that 'all Brits have bad teeth'.

I stand by my comment, root planing is IMPORTANT and the OP should complain. You cannot leave pockets to get deeper because teeth fall out!

P.S. Swearing does not help your cause either. If anything it makes you look even more professional. 😳

You must admit NHS dentistry is appalling though

It isn’t called root surface debridement any more either. PRPM now- professional mechanical plaque removal.

So you aren't Dentally qualified but you've done your research.
An obvious place to do this would be the British Society of Periodontolgy. They have set very clear guidelines on the management of periodontal disease and nope, no mention of root planing there either.

I don't know much about how Spanish Dentistry is regulated and what you do if you have a problem. I've had a look and it looks like they don't have the same draconian regulators like the GDC here. If you have a complaint you have to take the Dentist to the Civil Court. This would in part explain why Dentistry is cheaper there; no UK indemnity simpler Civil Liability insurance, reduced registration costs and no CQC costs.
I had a Spanish locum over a decade ago and they said that in their degree they chose to study areas of Dentistry so there were some treatments they would refer to a colleague as they had no experience. Perhaps in your extensive experience AmandaAmanda85 you can tell us more, since you believe we are so poorly trained here.

@AmandaAmanda85 so one Spanish dentist has told you root planing is absolutely vital? And obviously this one dentist is right and British dentistry is shite? If you'd asked British dentists 40years ago I'm sure they would have said it was vital but the evidence and guidelines suggest otherwise

There is no British way. As I said, if you trained abroad you are welcome to continue your practices if they are evidence based and 'so much better'. Having a quick read of the European perio guidelines they look pretty identical to the bsp, and are based of in some cases the same research. No mention of root planing. Makes me wonder where you've gained your very extensive experience

I'd like you to actually define root planing and perhaps summarise how to carry it out. Because whilst your so pro root planing your post shows that you don't understand it, or the various perio treatments available.

I had my root planing done in Dos Hermanas, Seville in October 2020, by a dentist at a private Dental Clinic whose name I am not willing to publish for privacy reasons. The dentist was an experienced periodontist and a very good one at that. He root planed all my teeth over two appointments and if you search on Google you will find many other dentists in the UK are also saying that root planing is part of a deep clean. Just search it as it seems like it is you who has no idea of what you are talking about.

You can swear and come back with attitude all you like. It doesn’t change the fact, that British dentistry is poor.

I am not going to continue arguing on a public forum. I have simply shared my experience in Spain of periodontal maintenance and contrasted it with the British one. If you don’t like it then that is your problem and not mine.

Have a nice day.

Absolutely have to agree with @AmandaAmanda85

My dentist totally neglected my teeth, I went to the hygienist on a regular basis and having my 6 month appointment the dentist said "I really really suggest you should book appointment with the hygienist. She will deep clean the teeth...." I didn't let him finish. I said "I've seen one past 6 months every 5-6 weeks based on her availability!" The LOOOK ON HIS FACE!!!!
I asked if she's not doing good enough job then that you would even say this?
I got some nonsense reply.
I said I shall get 2nd opinion.
Went to EU, one of the Scandinavian countries and that dentist told me to make a complaint.
I basically took dentist to the cleaners and won 20k. Went back to the Scandinavian country, got my whole mouth redone and I'll be damned if any of the Uk Dentist gets another penny from me or my kids. We do several trips a year to this country and go to the dentist there. I pay the visitation fees, but at least I know we are being taken care of.
@AmandaAmanda85 is absolutely right when she said that Spanish dentists "adapt to UK way". I spoke to someone recently. Their brother is from Eu country and works here 3 days a week as a dentist. According to them their brother said "If I'd do dentistry work in EU like I do here in UK, I would've been sued million times. Easy money, blame the patient every time!"
So all these UK dentists here getting their backs up - nah, go and study abroad. Widen your horizons on how to be a decent good quality dentist.
I'll never step over the UK dentist practice threshold.