Affordable sedation dentistry

[Sausage]

Hi all. I really want to get my teeth sorted but I just can’t do it under my own steam. NHS referral to the hospital for sedation has been rejected twice so that’s a non starter.

I haven’t been in contact with any private practices however looking round at websites that advertise prices the rates are completely unaffordable given the amount of work needed. Ball park seems to be around £200+ for sedation per hour, £500 for surgical extraction, £200 per ordinary extraction, £200 per filling. Then bridges or dentures are around £600. I will need most likely need some gum grafting too.

Setting up a dental plan through my work is a possibility but I think that only covers routine exams and treatment. We are only a very small business of 5 people, this is something we have spoken about before but never really pursued.

Sourcing my own diazepam and trying to get on the NHS list at a well regarded local dentist is seeming like my only realistic option. The one good compassionate dentist who I actually trusted has left the practice I am currently at, and I have no confidence in the others to carry out the work.

What has everyone else done that can’t afford the private costs?

 

[letsconnect]

Hi, how awful that your NHS sedation referral has been rejected . Did they give any reason?? Or did they at least indicate what their admission criteria are? It might be an idea to get in touch with your local MP to highlight the lack of community dental care services for people who suffer with dental phobia in your area.

One option might be to see if any neighbouring areas accept phobic patients for sedation (if you're prepared to travel and have someone who could give you lift as you wouldn't be able to drive yourself back from the sedation appointment). Or as you said, try oral premedication (temazepam is generally the recommended drug for this, rather than diazepam, due to it wearing off more quickly and being more effective for this purpose). If your GP is unwilling to prescribe it as they may not have much training in this field, maybe they could refer you to a psychiatrist who will?

Alternatively, you could attempt the private route by staggering the treatment over a longer period of time, if that would help with financing it. I also would have thought that for a surgical extraction, you might get a referral to an oral surgeon (on the NHS), who may offer sedation? Just thinking out loud here...

 

[Sausage]

@letsconnect hiya. Thanks for the reply.

The first referral I got was to the oral surgeon at the hospital. They don’t do any sedation there but they do have general anaesthetic. The lady at the appointment was very blunt (but polite) that their clinic was for facial surgery and not for dental anxiety, I needed a lot of work doing (some root canal, a few fillings, cleaning etc) however she did say if I got the rest done first she would do the two surgical extractions for my two shattered molars under general if I requested it.

She also made it pretty clear the sedative dentistry clinic is for children and people with disabilities and very busy, presumably that’s why it was rejected, I never got a reason or even a letter or a call, I just asked the dentist to look on the system and it was rejected.

With regards financing, I could probably afford it in a few years time. My partner and I are getting married next year and that is taking all our expendable income. Ideally I’d like to get most of the work done before that.

I think I am going to approach my gp. Hopefully I will have success there, although that still leaves the uphill task of finding a decent NHS dentist that will take on new patients. Diazepam is quite easy to get hold of if the GP isn’t forthcoming.

I have had a lot of time now to think about it all and I think it’s the tools that are the source of my fear, particularly the needle and scalpel. Gas and air would probably be ideal and I think once I’m fully numb and work gets underway, I might settle into it and be ok.

I’ve never had diazepam or any kind of sedative other than gas before, although as a keen partygoer in my teens and early twenties have a lot of experience with different substances and do wonder how they would work on me and if my brain will still function and stay aware!

 

[letsconnect]

Ah ok, so it sounds as if at least the surgical extractions would maybe be taken care of under the NHS (though I don't quite understand why you'd have to get the rest done first?)

Going out of county might still be an option if neighbouring counties still offer a functioning community dental service (sounds as if the service in your area has been scaled back to children and people with disabilities only ). Or else as you said finding a decent NHS dentist in your own area that takes on new patients... if there's a community Facebook group for your area, maybe you could try asking there? I presume you've already asked around friends/relatives/etc...

I wouldn't have thought there'd be a scalpel involved (apart from surgical extractions, for which it sounds as if you could get general anaesthetic anyway), so if injections are your main source of fear, you could try and see if anyone locally is offering computer-assisted injection systems such as the Wand. Have you had bad experiences with injections in the past, or is it more the thought of needles that terrifies you?

 

[Sausage]

@letsconnect I thought I had replied to this, but clearly I hadn’t!

There is another new dentist where I’ve been going who seems to be very good, like the old one who left. The problem is this is just a pure NHS dentists, they’re permanently taking on new patients and seeing anyone. Dentists come and go and some are really good and others not so good.

I just have a really irrational fear of anything medical related but the sharp tools particularly syringes feel really sinister to me. I even feel uneasy having my blood pressure taken and have to actively calm myself and focus on my breathing to stop my heart rate spiking. Dental work is particularly difficult as it’s right there in your face.

The hospital were happy to just do the surgical extractions under local there and then but if I was requesting general they wanted to see a commitment to getting the rest of the work done so I wasn’t back there again in a few months time needed more extractions and expecting general anaesthetic again.

As an aside I find the strictness around the use of gas and air really odd. My daughter had surgery on her finger a little while back and she could use gas and air for things as minor as a simple dressing change but she wasn’t allowed to have it for blood tests or having a cannula fitted which were far more terrifying and painful procedures for her. Same for the facial surgery clinic at the hospital she said they’re not authorised to use the gas and air for dental extractions so it’s just either local or general.