Hi,

I am a bit confused about what I should receive as an NHS patient at a dentist.

My OH and I have always gone private and paid lots of the years, but neither of us have a check up in over six years. I always felt I had good teeth and have flossed since my teens.

Anyway, I broke a tooth last week and rang around to see if any local dentists were taking on NHS patients locally. I found one and booked the earliest appointment they had, which was last Friday.

The dentist took about 4 x-rays and told me I had severe gum disease and no teeth could be replaced until this was treated, but said I would probably need this treated privately at over £1,000. I know it is not a huge amount for dental work, but it is for me.

I said I would speak to my husband before agreeing to anything, to which she responded "THEY ARE YOUR TEETH!"

My husband emailed them as to why the work was not covered on the NHS and he just received back a reply saying:

"She was informed that she has advanced periodontal disease.

She informed us that she had not had a dental check up for several years which is perhaps why it had not been identified earlier.

She also presented with 2 broken teeth which we have had a look at and advised that they are broken down to a level where they cannot be fixed and removal is indicated.

Removal of teeth can be done any time and it was not said to her that she needed to have gum disease treatment before this could be carried out. However, no advanced restorative work (if indicated) can be carried out until her periodontal disease is stabilised which can take several months.

Three options were given to her for treatment of this, in order of level of success rates:

1) Private referral to an external periodontist (specialist in gum disease treatment)-best option for someone with advanced gum disease

2) Private referral to the hygienist (in house)-second best option for someone with advanced gum disease; reassess and consider a referral to a specialist if no response to treatment

3) NHS band 2 treatment as an initial course of treatment-this would be standard treatment with the dentist; reassess and consider a referral to a specialist if no response to treatment

Please let us know which way Maggie would like to proceed."

The tone of the email seems going for Option 3 would almost certainly lead to a referral to a specialist.

Should I look for another dentist? Any advice, based on experiences, would be greatly appreciated.

Thanks,

Maggie

That all looks really sensible and clearly laid out to me. You've been provided with clear options, it's entirely up to you which you choose. Doesn't appear to me like you're being pressured into anything.

My OH had advanced gum disease and it's a sure bet that you'll need regular care for the next few years. It's really difficult to get under control, and we looked at various options, with private specialist treatment offering the best outcome. You can fudge along with the NHS treatment, but some necessary work isn't covered by the NHS.

I couldn't find anything online to say what treatments weren't included, just the NHS website stating:

All treatment that is, in your dentist's opinion, clinically necessary to protect and maintain good oral health is available on the NHS. This means the NHS provides any treatment that you need to keep your mouth, teeth, and gums healthy and free of pain, including dentures, crowns, bridges

So I didn't know if I was being taken for an idiot.

I found a different website with this information, don't know if it will help.

https://www.nhs.uk/NHSEngland/Healthcosts/Pages/Dentalcosts.aspx

HB

I'm not clear on how NHS dental hospitals work nowadays, hopefully someone else does. Do you have one near you?

HB

I found a different website with this information, don't know if it will help.

 

 

https://www.nhs.uk/NHSEngland/Healthcosts/Pages/Dentalcosts.aspx

 

 

HB

Thanks Honeybee, I was fully expecting to pay for the Band 3 treatment, but I tend to see things in black and white, to my detriment at times, and thought all dental treatment was covered.

Hannya obviously has first hand experience of this and has done her groundwork. Just a bit annoyed as I have never claimed anything before.

Maggie

It can do no harm to get a second opinion, particularly as this will be extensive treatment.

Hannya, you have obviously done your research thoroughly on this, so I hope you don't mind if I ask you a few (really stupid) questions:

1. If my GP refers me to a specialist I get to see one. Not as quickly as going private but I still see one. What's the problem in the dental world?

2. Why am I asked to pay for a hygienist within an NHS practice?

3. Why is the NHS option accepted as being third tier, and the worst option?

Thanks for your time.

Honestly Maggie, there are so many variables with dental treatment, be it NHS or private, depending on your practice and where you live. From what I understand, with advance gum disease there are some treatments that the NHS don't cover that may be better for you that a specialist would. Obviously, the speedier the process too the better. Whether that specialist covers them via the NHS I couldn't tell you. That's why I'd get a second (or even third) opinion and a treatment plan, then make some comparisons and do the math.

All I can tell you is that it can take years to get this under control, and until it is I thought that a dentist wouldn't do any invasive procedure because gum disease harbours a bacteria that can cause severe heart damage if it enters the bloodstream. I don't believe this to be the exception to the norm as I know 2 people who've ended up in hospital with this issue.

There's a wealth of info on Google (don't freak yourself out though!).

Thanks Hannya - that is invaluable information, as I suffer from angina. Thankfully, I have a great GP and I think I need to discuss this with him first.

I think that closes the book on NHS treatment and second+ opinion are an excellent idea.

I think the dentist and I just didn't click.

Thanks again.

Maggie

All I can tell you is that it can take years to get this under control, and until it is I thought that a dentist wouldn't do any invasive procedure because gum disease harbours a bacteria that can cause severe heart damage if it enters the bloodstream. I don't believe this to be the exception to the norm as I know 2 people who've ended up in hospital with this issue.

Sorry Hannya, the 2 cases you mention - was this because of lack of treatment (not aware or the issue) or poor dental treatment in tackling the problem?

I have a telephone appointment with my GP booked for tomorrow to discuss this.

Thanks,

Maggie

I don't want to speculate on this, so can provide little information. My friend who ended up in UCH in London in intensive care was told that the bacteria causing the issue was a periodontal one that had entered the blood stream. No poor dental treatment that I'm aware of. From a personal perspective, whenever I've had any kind of invasive dental treatment I've been given antibiotics to start a couple of days before treatment and to continue for a few days thereafter.