When a dentist is unprofessional?

[Muddays]

My friend is really upset about the treatment she received recently from a new dentist who joined the NHS surgery she's grown up with. He grilled her about her sugar intake, prescribed some extra fluoride toothpaste and said unless there was an improvement in 6 weeks or so he wouldn't treat her as there were people who deserved his time more. Is this acceptable? She's 44 years old, got a young kid, a lovely partner and has always paid her way and is polite to everyone, probably too nice tbh. She's had a tough few years dealing with unexpected deaths of close friends and family but still has been heroic and saved many troubled teenagers from suicide and self harm (an online support service) which has left her exhausted and with understandable health issues.
I don't know how to help her. This upcoming dental 'review' has said she's not worth helping. if she's kicked off the NHS register there's no appeal is there?

Yes, that's unprofessional and sad that's the point of view an NHS dentist.

@Museya15 thanks for your kind response. It's maddening how many people I know are being treated badly for no justifiable reason other than money squeezing the worst out of people who should know better.
It's not unreasonable to hope that a qualified doctor/dentist would understand that they are the field doctors in life's battlefield and every person who walks through their door for help deserves being patched up as best they can before being sent out into battle again.
Helping life's soldiers feel a little less pain, maybe a bit stronger and however briefly, valued; is a privileged and powerful, as in genuinely worthy, position to be in, and any medical professional who forgets that should be a 'top' corporate lawyer or hedge fund gollum who's comfortable with being soul/pointless.

Talk to the Practice Manager. Sat what was said to her.

Yes very unprofessional!

I moved a few years ago and joined my local nhs dentist. As I sat in the waiting room the receptionist was fielding calls and then slagging off the people she had just spoken to with the other receptionist! I was shocked by how unprofessional they were. The dentist wasn't that great either and I never went back. Had to join a private practice 😨

@Oblomov22 no can do because the problem dentist is the practice manager. I don't want to make her situation worse. She's got a review appointment coming up but if 'failed', she won't be treated anymore.

@catsnore I've seen worse unfortunately but I know what you're saying and it's very sad.
Private care is difficult for many people due to some truly staggering expenses for once basic treatments.
However, luckily most people won't crawl under a rock and wait to die slowly.
Encouragingly, several official bodies are being investigated for alleged misappropriation. And,
Increasing numbers of people are now consulting retired doctors/dentists and are studying medicine on intensive courses, rather than wait for another year later appointment. Knowledge is power.

I used to work in dentistry. Dental problems are largely genetic. He was an arse.

@HammergoHammer thanks. I'll let her know not to take it so personally although she feels really let down.

And,
Increasing numbers of people are now consulting retired doctors/dentists and are studying medicine on intensive courses, rather than wait for another year later appointment.

What? Any source?

There is a new dental contract being trialled in many areas, and is the norm now in Wales . People are graded red, yellow or green depending on their dental health.
if you are on a red path advice and treatment is given to help you become healthier but advanced treatment is not allowed until eg your gums are healthier and cleaning and diet is better . The dentist is not allowed to carry out any advanced treatment until the patient has taken steps to improve their oral health .
This is not a dentist decision and they cannot easily over ride the grading which are based on gum , tooth health and diet and cleaning.
I wonder if this is what she has been told about , perhaps in not the best way.

There is no such thing as registration in England and Wales so if you are still on the red path at review that course of treatment is shut down and you will be recalled for another check up when the surgery has capacity. The rationale from the NHS is 99% of dental treatment is preventable and until the patient starts to make changes in diet and cleaning providing any advanced treatment is doomed to failure.

Unfortunately this system is causing much frustration to patients and dentists alike with people coming in for appointments , having cleaning etc demonstrated but not progressing into yellow or green zones so not being able to the treatment they originally came in for and instead having to come back in three months for a check up again.

@SpangoDweller no official source other than various social discussions/forums, otherwise I would have quoted or mentioned them. This is not the New Scientist.

@Lollygaggle thank you for your considerate response, which has helped explain a few issues here. This red, yellow, green grading is interesting.
So healthy or middling mouths are treatable, green and yellow yay! are easy peasy and really not in need of too much treatment then.
But the red ones are the dental version of a heart attack and obviously should be avoided and left to get worse and worse, until a by now absolutely pointless, 'check up' 3 months (that could save them a world of pain) later.
The whole point of being a doctor is to treat and heal (and not judge) those in the red zone, not the effing green!!!
People's dental health and subsequent 'worthiness' can't be judged solely on diet and apparent disregard of health advice. That's incredibly irresponsible and unfair.
If a patient 'can't be treated' then the doctor who says that shouldn't be in a profession that prides itself on never giving up and always fighting for a better life and outcome for everyone.

The grading is nothing to do with individual dentists but everything to do with a government that has never funded dentistry properly hence NHS dentistry is in collapse.
There is a good clinical principal here , that health is an interactive process , that it is not a passive process . Dental health, particularly , is mostly in the hands of the patient. 99% of all dental treatment is avoidable . By giving patients the information to make the right choices you make sure more dental treatment is avoidable and what dental treatment you do have lasts longer.
The problem is twofold
a dental prevention is not funded on the NHS
b changes in peoples behaviour is very difficult to achieve.

It is very difficult to change a lifetimes diet and cleaning habits based on a couple of minutes in the dental chair.

In Sweden the rate of decay is much,much less. Fillings will not be given until diet and cleaning is under control . But they have a good dental prevention set up going into schools and nursing homes etc.

The basic problem in the U.K. is the government is trying to get more and more out of a failing system for less and less money. Hence tinkering around with systems not for better clinical outcomes but to try and get more people through the NHS dental sausage machine.

The point here OP is that dental disease is largely preventable and there is little point in providing complex operative treatment if a patient is unwilling to modify their risk factors (eg brushing frequency/technique, sugar frequency in diet, smoking) because the work will fail and new disease will occur. I'm not saying his bedside manner doesn't need so e work but their is merit in his approach.

I missed the last bit of your post!! I don't think there is merit in kicking her off the books. Sine patients need support in addressing risk factors and establishing a firm preventative approach prior to progressing to operative dentistry, that way my point.

This!

dental problems these days are now acknowledged as not being largely preventable. of course some problems are and measures can be taken but that’s not the only reason. It’s an outdated view to say this

my issues were a dentist prosecuted for unnecessary procedures on young children and then a dentist much later on who recognised genetics. I finally got an absolutely fantastic dentist who saw my mouth as a 'challenge' to fix not my issue

please get your friend to complain, you can’t be failed by a dentist surely? It’s wrong

So potentially dentist avoiders finally get their shit together, get to the dentist after 10 or 20 years and then the dentist makes them scrub at broken knackered teeth for months before they give them a glimpse of hope. Make sense.

Ds had a huge row from the dentist, 3 teeth were beyond hope, she really made him and me feel like shit. Saw another dentist because ds hadn’t understood a thing. New dentist says, all other teeth are perfect, gums are perfect, the bad teeth are all the same stage, clearly they were never any good. But the first dentist never even considered it.

I think this is back door method to push your friend onto private treatment at same practice...my old nhs dentist used to do this sort of thing....only treated smokers private...removed them from nhs etc...

@Bs0u416d 'sugar frequency in diet' is worth investigating that's for sure. So called sugar free food or drink options usually contain artificial sweeteners that contain high amounts of acid which damage and erode tooth enamel. The list of foods to be avoided is bewildering, let alone the sugars in the pain relief medication that eventually becomes as important as water.

@OnTheBoardwalk @Phlewf @earsup
Agree with all of you, and thanks for acknowledging this flaming sh!tstorm of a system.

Ask to see an alternative dentist in the practice. I had issues about one dentist that I saw and after discussion with the Practice Manager was switched to a different dentist.
I realise that at your practice they are one and the same person but just ask the receptionist to book you with someone else. If they ask questions, you can just say you didn't get on with them or they didn't instil you with confidence and you would prefer not to see them.

My old nhs dentist waiting room was plastered with notices about refusing to treat on nhs, patients who smoked, didn't brush regular, didn't have regular check ups etc etc....no idea if that was legal.....but the practice did have one excellent nhs dentist who had a huge waiting list....so can pick and choose.

@Rainbow1901 it's unfortunately not that straightforward although you're right about not instilling any confidence in the dentist's capacity to treat her effectively. She's not a drama queen at all and will probably be pissed off with me when I show her this thread.
But I care for people who don't speak up for themselves, especially when they give so much to the world. So the rare moment they finally ask for help from a trusted professional they're then made to feel like they're not worth the bother and are blocking far better people from getting treated. It's really hit her hard and she's started to change and get more withdrawn.

Went to see my lovely dentist recently, to find she had left the practice, as had my children's dentist, when I mentioned their name, so I saw a new dentist.
I actually left crying as he talked to me throughout as if I was a complete idiot
to him. I asked questions about a treatment which seemed to get him more and more aggitated, with his reply repeating the same words which weren't what I was asking ( and was information which I had understood )The atmosphere was just awful. I turned to his assistant who clearly explained what I had asked in a professional manner.
He didn't seem to want to be there and had a very brusque, impatient manner -prodding my gums and teeth -almost jabbing at them. He was actually a bit intimidating to be quite honest and made me feel so uncomfortable.
I have a disability and find it difficult to communicate clearly sometimes and it had taken a lot of effort to get there. My husband said I should complain but I have self doubt as to whether I was simply being a bit slow to understand him.

She won't need to comment on his capacity to treat her but rather treat it as if they didn't hit it off. There's been many a time when I didn't particularly like someone but couldn't put my finger on why but someone else would have no issue at all them at all.
Funnily enough the dentist I had issues with treats my daughter who can't praise her high enough. So a personality clash if you like lol!