Private Fee's for NHS Dental Patient

[WutheringMights]

A little background info. My DH has been a NHS patient at our local dental practice for 15+ years. He has attended his annual checkups every year.

2 months ago, he booked an appointment due to pain under a back tooth. He was advised it looked like he needed either root canal treatment or a removal of the tooth but the dentist said my DH should book another appointment to see a different dentist at the surgery for further advice. I wasn't aware at the time that DH was asked to pay the standard NHS checkup fee for that initial consultation plus £50 to book the next consultation appointment for further advice.

After the recent consultation, the dentist explained there were 3 options available ranging from root canal to a crown or an extraction. The prices DH was quoted ranged from £900 to £2800 depending on what option he went for.

When he arrived home, I was taken aback at the prices and suggested he called the practice to find out why this suggested work wasn't covered by the standard NHS price banding. The practice said they don't have a dentist that can do that work and it was considered private treatment because they would use their specialist dentist.

I assumed that root canal or a crown was a routine job for a qualified dentist but maybe I'm out of touch. Has anyone else experienced a similar situation? I'm feeling like the dental practice just want to make money out of their NHS patients when they should be covering it under the NHS pricing.

Some root fillings are unable to be done by NHS dentists and they have to refer you on. This happened to me a few years ago. I was told that it depends on the tooth's roots, if the root is too complicated the NHS dentist doesn't have the equipment needed. They would need a more specialist drill.

I'm a dentist that works with newly qualified dental graduates all over the UK. It is a GDC requirement that all undergraduates are competent in general endodontics ( root canal) and in making crowns. These are both available on the NHS.

Yes, it's possible that a tooth might require a specialist endodontist ( not available on nhs) but that's quite unlikely. Very rare in fact. Maybe if a file was stuck in a canal, or there was a perforation on the root canal has already been filled and needs redoing.
Same for crowns. That's basic dentistry.

One thing is for certain, and the GDC, and inspectors ( depends where you are in the country) require that all options must be given, and any explanation as to why NHS not possible must be detailed, and written in notes

Absolutely rubbish @ordinarilyordinary there are many reasons why a tooth may need a specialist for root canal treatment. For instance: curvature of roots, length of root, shape of root canal, presence of pulp stones, whether the canals are sclerosed, accessory canals etc etc

Yes I was told it was something to do with the shape of my roots. I have had a root filling on the NHS but it was a pretty straight forward job.

Thank you everyone. It seems the practice can say certain aspects of work aren't covered by NHS pricing which is a shame. We can save to get the work done but I appreciate that isn't an option for everyone depending on personal circumstances. I assume that for some, they will likely have to put up with discomfort and ultimately, good dental hygiene could become a thing of the past if you can't pay private prices. What a shame.

Is the extraction covered under the NHS or has your practice, like many, handed their NHS contract back?

@ordinarilyordinary i don’t usually do this but seeing as you are working with new dental graduates, you should probably be equipped to know what standards they have to meet. I’d suggest you and the OP read the Commissioning Standard for Restorative Dentistry - NHS England. The guidance on level 2 and level 3 endodontic referrals are outlined on page 12.

TLDR for the OP. There are reasons why a general practitioner may refer to a specialist. It is usually to safeguard your health when things look tricky. A generalist should be able to tackle most things but some things fall out of their scope of practice and a good practitioner would recognise this before they start and make a suitable referral.