I actually did it today

Two years ago I managed to make an appointment to get my two front teeth crowned. I got there with the usual knots in the stomach and feeling sick and anxious but managed to get through it.

The dentist told me at that time that I had gum disease and to come back when my two teeth on the bottom needed extracting, he didnt offer any help or treatment at that time although they were slightly loose at that time. I figured I had had my £200 worth or treatment on the NHS for that time. Of course being terrified of the dentist I was just glad to be able to get out of there. I have tried my best to take care of what I have but obviously the only outcome with no treatment was extraction.

Two years on and the time has come to get the bottom two teeth taken out they have suddenly become quite loose and I know they need to be taken out but I am terrified of what alternatives I might be offered on the NHS.

My appointment is 10th April for an assessment, it has taken me many months to be able to make the phone call today to make the appointment, I am anxious already about this appointment and it is also difficult to get time out of work for appointments which makes it even worse as everyone knows where you are going and then pointedly look at your mouth when you walk into the office. I had a nightmare last night that I walked into work and the dentures fell out onto the floor.

Has anyone had the two middle bottom teeth out and how and what treatment did you get for this problem. I am hoping i might be able to sleep tonight as I have had two years of worry about this knowing what the final outcome would be.

I am sorry I don't have any answers for you, I do know that Jaylah that comes on here had to have a bottom front tooth out and they took off the root and fixed it to her teeth at either side. She can't bite with it but she is quite happy with it because she doesn't have a gap and she can always cut things up to eat them. I am sure when she comes on she will answer you and tell you details.

I have top two front teeth that I have always worried about and a bottom front tooth that doesn't feel comfy, these were chipped when I was a child, so I've always been afraid they would break, so I won't bite things like apples etc... with them. This can be got around easily by cutting food and chewing it with the back teeth as normal.

I would think if removal is what you are talking about, they will be out in seconds, you would be numb, so no pain.

I think when you see the dentist he/she will discuss your options with you, you don't have to have anything done on the first consultation, other than letting them have a look and sometimes an x ray.
They cannot do anything you don't want, if you don't feel you can work with the dentist, find another.

I wish you well and try not to worry too much, if you need to get things off your chest, just come on here and we will offer you as much support as you need. We are good at that. I would be interested to hear how you go on if you would be kind enough to let us know.

Hi Carole,

Thank you for your reply it does help when someone says some kind words to you about your fears.

Barbara

Hi Barbara,

First, I have to say that I'm rather surprised your dentist just told you to just wait until your gum disease got so bad the teeth needed to be removed.

I have severe bone loss (from periodontal disease) on the front of my lower jaw, and that's why one of the teeth eventually needed to be removed. Not enough bone left to hold it in place. The other front tooth isn't in much better shape, as far as bone structure, but it isn't loose yet (or at least not so loose as to need to come out), so my dentist did a "deep scaling and root planing" on my whole mouth and -- as long as I am practicing seriously good oral hygiene (like brushing twice per day, flossing, using my interdental brush, etc.), so that I don't suffer any more bone loss, there isn't really any reason why the second tooth would need to come out.

As Carole said, once the tooth had been extracted, and the extraction site had healed for about 4 days, the dentist ground the root off of the extracted tooth and then bonded it to the two adjacent teeth. Now it's just "for looks" and if I try to use it to bite hard things (carrots, apples, etc.) it will probably come un-bonded, so I have to kind of baby it a bit. But at least I don't have a gap there, and it was a lot less cost than getting a partial denture. Plus, it doesn't come out, so there wasn't any adjustment period as far as getting used to a partial, etc.

However, I'm not sure how successful that would be with two teeth. I'm afraid it might not be stable enough to hold.

I think, if I'd had to have both bottom teeth removed, I probably would have asked for a partial or a "flipper." Don't worry about something like that falling out onto the floor. Made properly, they fit tight enough so that won't happen.

Tell me, though, is this the same dentist that told you just to wait until those teeth needed to be removed? In all honesty, that doesn't impress me and, if so, I think I'd be looking for a different dentist.



Edited to add: The good news here Barbara is that when your teeth get that loose, extracting them is a real piece of cake.

Hi Jaylah,

Thanks for your reply I appreciate it very much, if I can explain it is rather different here in the UK for dental treatment. We have the NHS or Private treatment and if you cannot afford private treatment you are at the mercy of the NHS system.

To even get a dentist on the NHS these days is a miracle, people line up for miles if a dentist advertises vacancies for NHS patients.

My last appointment two years ago was when I had two crowns done in the NHS system of things I had to pay the maximum of £198 as it was then it has since gone to I think £204 or thereabouts. I honestly think the dentist thought with two crowns I had had my £198 worth at that time. It is disgusting as years ago this did not happen you got the treatment you needed once you had made the initial appointment.

At the last appointment the two lower teeth were very slightly loose and he told me I had gum disease and I asked what I could do about this and he told me to keep brushing. I suppose in a lot of ways it is my fault this has now got to the stage it has but you know what it is with dental fear you put it off until its desperate.

I was at no time offered any help with the gum disease and yes I need to go back to the same dentist as I explained to even get an affordable dentist in the UK ie NHS is a miracle.

Hello again, Barbara,

I know about the NHS, but as others here have said, there are good NHS dentists, not-so-good NHS dentists, and not-worth-a-darn NHS dentists.

I know that Carole is getting her treatment through the NHS and her dentist has been very good from what she writes. But she had to kind of "shop around" to find him.

I know trying to find a dentist that will accept NHS can be a pain. We sort of have that same situation here in the US with people on Medicaid. Dentists that accept Medicaid patients get reimbursed less for their services than they do with private-pay or insurance-pay patients. So they typically only accept a certain number of new Medicaid patients per year.

But here's the deal the way I understand it, Barbara: you pay your "co-pay" for treatment once per year and that's basically like an insurance deductible. (And for NHS, that amount depends on your income.) That just means that's all you have to pay "out of pocket" for a given year. That does NOT mean that a reputable dentist or doctor is supposed to decide you've had that much worth and then do no more.

If your co-pay for the year was £198 and he needed to do £1,980 worth of work on you, he should have done the whole thing, and he would have gotten reimbursed for the rest from NHS. (That's why you folks in UK pay such high taxes.)

Seriously, I'm not at all impressed with your current dentist. He could have kept you from losing at least one, if not both, of those teeth. Yet he chose not to. That's a serious breach of ethics in my opinion.

Hi again, yes I am NHS and it is a mine field, I know it isn't easy to get a good one but they are out there. I travel for an hour and a half nearly to go to my practice, so when I go it is almost a day taken up. If you go onto the links section on the top of the page there is a section there where you can find a dentist. If there isn't one in your area go to the NHS Choices website and under dentists put your postcode in and it will bring dentists up in your area expanding out to 50 miles or so. It tells you if they are taking on new nhs or not, as a lot, well most do private as well. I don't know where you are but I hope this helps, mine is in Leeds, and they are still taking new patients both private and NHS.

Jaylah it's not as simple as you think it is, I am extremely lucky to go where I go. A lot of nhs dentists now remove teeth instead of doing a root canal, and an awful lot of them don't tell you if you have a gum disease and just deal with the teeth when they are loose.
People do que for hours to get taken on as well, you can have over 200 people queing for 30 places. A lot of nhs only see patients once a year as well, and if you need to go inbetween you are being a bother. I don't think in most practices you can see the hygienist unless you pay extra for it.
Thinks are improving a bit but it is really hard to get a good dentist, or a dentist at all if you are nhs, if you look around and keep at it, they are there but you need to be prepared to travel in a lot of cases. In a lot of cases if you need treatment out of hours the emergency dentist just offers to pull the tooth/teeth you have problems with, I would always wait for my own to be open. Also the ones that do the out of hours emergency are not very good and can be quite nasty and rough.

I wish you luck BarbaraM and I hope you manage to get sorted out. It is worth looking around for another dentist, even if you have to see the one you are with for the time being.

The only way that NHS dentistry seems to work well is for under 16 year olds, as lots of private practices (round our way anyway) will see children and then once you become an adult they are hoping you just swap to being a private patient with them. Finding an NHS dentist where I live is actually basically impossible, I would have to travel quite a distance and even then to find vacancies would be a miracle !

Thank you, Carole. I didn't realize most NHS dentists were doing that.

I still say that's a terrible way to practice dentistry, and pulling teeth when you don't have to is a serious breech of dental ethics. Even if that's seen as okay to the morons running NHS.

That's almost enough to make me happy about our situation here in the US. Yes, dental care (unless you're lucky enough to work at a place that offers group dental insurance) is hideously expensive. But at least, if you do go to the dentist, they'll be crabbing at you to find a way to pay for your necessary treatment, and not just sending you home to wait until things get bad enough you have to have the tooth pulled.

Not all nhs dentists are like this, but a lot are. You can also mix private with nhs, by this I mean if you need to see a hygienist you can pay the £35 approx and have it done private then carry on with the treatment you need on the nhs. But saying this my dentist said in Sept that I needed to see one where I went, but when I got to Dec when I was due another check up he said there was improvement so I didn't need to see the hygienist, so I don't know what it would have cost extra.

The £204.00 charge is the most nhs patients pay for treatment and I know you can only have 2 crowns done in any 6 month period, so if you need more crowns a dentist would do the most needed first and do another 2 in the next 6 months, but the dentists do have insurance cover just incase someone needs more, because the nhs won't pay for more than 2 at a time, if more are needed they can apply to their insurance to see if they will cover it, if the dentists insurance will cover the cost they will go ahead and do what is required. I only found this out in Dec because my sister has 6 front teeth crowned and her dentist explained this to her because he thought he might need to do more than the two allowed on the nhs.

It is all very confusing as different dentists do different things on the nhs.

carole said:

The £204.00 charge is the most nhs patients pay for treatment and I know you can only have 2 crowns done in any 6 month period, so if you need more crowns a dentist would do the most needed first and do another 2 in the next 6 months...

Click to expand...

Well, that part does make a certain amount of sense to me. I mean, even dental insurance plans here usually have a "maximum annual benefit" which means -- if you need LOTS of work done -- you might have to get part of it done now, then wait for the new year, etc.

But what I cannot, and never will, understand is a dentist that doesn't bother to tell a patient that -- if they can find a way to scrape up the money -- there is a way to at least possibly avoid losing teeth. To just tell someone, "Go home and, when it gets bad enough, come back and I'll pull them."

I mean, it's not like there aren't what I consider to be some bad dentists in this country. A lot of them seem to act as though they think everybody has the best dental plan in the world and cost is never an object. If they recommend something and you flat-out tell them, "I'd love to do that, but there's no way I could afford it", they'll get this look on their face like they just smelled something really, really bad. They'll tell you about how it's such an absolute necessity, but -- of course -- never bother to say anything about how you'd pay for it.

The dentists that I respect the most are the ones that will outline a "best" possible treatment plan for you and then, if you say you can't afford that, will -- first of all -- help you prioritize things. What, if left untreated, will have the most drastic effects, so should be done first. And then be willing to work with you on the plan as long as they need to, as you can afford each step. Some (fewer and fewer now) will work with you on a payment plan. Even if they're not willing to do that, many of them will help you find the lowest-cost dental insurance plan, or even point you to a discount plan and a different "participating" dentist if they don't participate in that plan themselves.

But, as far as I'm concerned, a reputable dentist will do everything in their power to save a tooth.

Heck, as I think I mentioned before, even when I had that awful abscess in a back molar and got seen by the VA dental clinic for an "emergency", I fully expected them to just pull the tooth as being the most cost-effective way to treat the abscess. Instead, that dentist did a full root canal on it, and then put a crown on it. When I expressed surprise about them going to that length to save the tooth, the dentist seemed surprised that anyone would consider pulling a good tooth.

In my experience, good dentists consider an extraction to be the very last option. So it saddens me to hear that some NHS dentists are so cavalier about pulling teeth.

Yes it is a sorry state of affairs but our politicians don't help, there used to be a free for all here, but a lot of work that was not needed was being done, that's why a lot of people my age here have fillings etc... that we did not originally need, because they were paid for each procedure, it's not all down to neglect, or bad oral hygiene. So they changed the system so that it was a three tier price charge, as I have explained. But now because they only get £47.00 for a root canal its too much time and work for them. Saying this the practice where I go have fought tooth and nail to save my 2 teeth that I had rct on, so there are good caring dentist and practices out there.

To be fair to the dentists as well I think they have to do so many patients per week, month or whatever period they are set, so they are under pressure as well, the system at the moment is unfair to both patient and dentist alike really, I know they are testing a new system of charges out in different parts of the UK but I don't think anybody knows the outcome yet.

As Carys mentioned earlier most private dentists do children up to the age of 18, so unless they can afford to continue with the dentist they know and trust, and having the luxury of private treatment, I feel very sorry for them if they are then left to the mercy of some of the NHS dentists.

I have only ever experienced the positive side of NHS dentistry. I have always found one relatively close by (and I live in a very poor rural part of the UK), have had IV sedation and at present my current dentist is hoping that a rct treatment will save a badly decayed tooth. These dentists have always been kind and patient. There are some excellent nhs dentists.

I agree Mango and I praise my dentist every moment I can, I have had very good treatment over the years and I have been very lucky to find some very good caring dentists, but I also understand that not everybody is fortunate enough to have the experience's we have. I myself had to leave a dentist to go to the one I see now because of neglect and bad treatment. So I know it does happen. I am in West Yorkshire, I don't know where you are, but I am pleased you have a good dentist, I hope your dentist doesn't leave as they often do in the NHS. But if the practice is a good one as well as the dentist they will always get another good replacement.

I feel sorry for the people who cannot afford to go private and cannot find a good NHS dentist, but unfortunately in some areas, people are not as fortunate as you and I.

I have in the last 6 months had over the top, going the extra mile treatment from both my dentist and the practice, I do have to travel quite a way though, but it is worth it.

There are some excellent nhs dentists.

Click to expand...

Yes, there are, you are quite right. Unfortunately it is a lottery finding them and being able to see them.

Thank you for your replies and the debate on the awful state of our NHS dentist situation.

Well tomorrow is appointment day and I am hoping I might actually see someone who will help me.

I finally told my husband the other day that I was going to the Dentist and what the problem was and he has been so supportive. I hadnt told him before now because I think I was doing the ostrich thing and ignoring the problem for as long as I possibly could although I have been doing my best to care for my teeth.

I am at the moment in a cold sweat thinking about tomorrow so please wish me luck and courage although I know that tomorrow will probably only involve an assessment.

I am hoping that once I am finally clear of these problems I will be able to offer support to others going through bad times with dental phobias and fear as having found this site and lurking for quite some time it has helped me to realise I am not alone with my fears and it does help xxx.

Good Luck for tomorrow, you will be fine, really explain how you feel and what bothers you, and hopefully the dentist will put your mind at rest, this is the biggest step. Really well done. I am glad your husband is supporting you, it helps a lot.

All the best

Hi Carole,

Ty so much for your reply as you may guess I cannot sleep grrrr. Its the whole getting into that chair thing, the total loss of control and I cannot tell you the moments of panic this past couple of weeks since I made the appointment.

I keep telling myself you have done this before and you can do this but I so have to force myself to do this. I hate the smells, I hate the sounds and right now I am really feeling scared.

Good luck for today - really hope all goes well for you.

I am so glad you have been brave. Telling your husband was a major thing as well.
All will be well and please let us know how you get on.
Good luck.