I have been to the dental Hospital, am being referred back to dentist

[swampiesue]

Hi to those of you who are familiar with my problems over the past year or so.. here is an update and a couple of questions.

I attended the Eastman Hospital yesterday after many months of waiting. Everyone there was very nice and made me feel at ease straight away. After a very short wait I was seen by a very nice lady consultant, who examined me and sent me for some X rays. It was not long before I went back into see the consultant again and here is was was said,

Firstly I have, as I suspected developed TMJ probably caused by the high bridge and the problems with the filing down of my teeth. My lack of being able to find a comfortable bite position has caused me to over work the joint. So I need to have a hard splint made and need to wear it for about 6 months before even attempting a new bridge. After this, once I have found a regular bite position my dentist should be able to redo the bridge, however more tooth needs to be removed in order to prepare the teeth to be able to except the bridge with the correct amount of Porcelain. Which is why the bridge was to high before. Also I will need to wear a temp bridge again for a while to make sure it is comfortable and to ensure the nerves in my teeth are going to recover as they still seem to be a bit erratic. My other bridge that was lowered should be able to stay, as once the other bridge is done and holds my teeth stable my teeth won't slide around so much on that bridge either.

I may also need to have my lower gold crown removed and redone as it looks like the pain I have been experiencing in that lower gold crown may have a third root that may have been missed back in 1995. Not sure why it has started playing up now though

My questions are, there is no way I can afford to go private for the RCT how complicated is it to do a third root RC after all this time

Also can anyone tell me more about the type of splint I am likley to need and how exactly do they work and do they work

I must confess I am more than little disappointed I am not able to have all this done at the hospital as I was told.

Thanks for all the support to those of you who have helped me over this crisis over the past year or so, and it looks like my saga still goes on

 

[brit]

Third canal in an old rct might be beyond your dentist's comfort zone even if it has been identified for him. I thought the Eastman had an endo department because I am sure I emailed them for advice once and they told me I could self-refer to their clinic (I was abroad at the time).

It may be private but it may be quite low-end costwise as they train qualified dentists in endo there.
The bridge stuff, your dentist should be able to do. Also he may know a local endo who can help you at reasonable cost or may be able to refer to endo specialist under NHS (who knows?). It is in London where they are mega expensive not elsewhere in the country necessarily.

Good luck - glad you have made some progress.

This is the guy I e-mailed he was really helpful: [out-of-date link removed]

You do wonder if the nice lady Consultant was thinking straight. She must realise rct re-treat is beyond the scope of most UK General dentists as they wouldn't have a microscope usually. Maybe your dentist is supposed to refer you back to the endo clinic - dumb I know.

 

[swampiesue]

Hi Brit, I mentioned that if my dentist was unable to do it, there was no way I could afford to go private..she did not really say anything. I had hoped they would do all the work for me, that was the impression my dentist had given me as that is what he understood too. He even wrote to the PCT to ask for permission to send me there. I was very disappointed, (Gutted ) when after all this waiting I was told I was being referred back to my own dentist to do the work. I had also travelled all the way from Norfolk and was willing to carry on going up there for the treatment. The consultant did say something the bridge not being as complicated as first thought and something about the Eastman being a teaching hospital, and funding... but I was not sure if she was talking about implants at the time as she had also suggested two crowns and an implant instead of the bridge..

The chap you E-mailed was he private or NHS ?

 

[brit]

I emailed him as Head of Endodontics at Eastman.
Maybe your dentist just needs to get the PCT to agree to pay for the treatment. Maybe they have already agreed but the Consultant didn't read it properly.

 

[swampiesue]

Hi Brit, I am not sure what has happened, I do know that the Eastman only do what they think to be complicated work on NHS unless they come under specific criteria. When you look at this on their site it is very strict. The consultant will be writing a report to my dentist in about 3 weeks and sending me a copy, I will then need to make an appointment with my Dentist and then I can find out what he thinks.

There was a girl I got chatting to who had been sent there with a curve in her wisdom tooth, she had been sent to the Eastman for consultation and hopefully removal, however she after the examination as told she was being referred back to her dentist and they would not do it.

I checked their site for the cost of Private RC and it was from £600.00 looks like I will just have to hold on to the tooth as long as possible and have it extracted if it gets really bad Think I will ask some of the dentists some advice on here about the tooth....

 

[brit]

A private endo in Norfolk would probably be cheaper than 600 especially for non-molar.

NHS Dental really needs to sort out the provision of specialist care for dental. Fine if it's extractions/jaw surgery but there seems to be no established route for endodontics/restorative and you just have to fall back on teaching institutions.

 

[swampiesue]

Hi Brit, sadly it is a Molar, and the largest at that...I agree, it is about time something was done about specialist endodontics/restorative dentistry, the Eastman IS a teaching hospital, but they did not want to know. I really could kick myself now for not asking more questions and asking more why they are sending me back to my dentist and not doing the work after all this waiting and being passed from pillow to post. Although the lower molar needing the RC re-treatment is something new and not connected to my original problem. I would have felt a lot happier if part of it was at least sorted.

I don't work Brit due to my epilepsy and other medical problems and the money for a RC is a lot of money for me to find, I still have to find £207 for the Mouth Guard and 6 months later another £207 for the bridge, that is on top of the money I already forked out for the original bridge. So despite it being my last molar on the lower left it will have to be extracted because there is no specialist help on the NHS. Despite all the advances in dentistry, sadly there is no NHS for those advances.

 

[swampiesue]

Hi just an update, went to dentist today, after receiving a copy of the report from the Eastman hospital, My Dentist is really upset to say the least, it appears the PCT has already agreed the cost and it has already been agreed by the Norfolk consultant that the work needs to be done at our nearest Teaching Hospital... the work is beyond my dentists capabilities which is why I was sent there in the first place... I now have to write a letter to the PCT

I am not sure how much longer I can cope with all this ...

 

[brit]

Hi just an update, went to dentist today, after receiving a copy of the report from the Eastman hospital, My Dentist is really upset to say the least, it appears the PCT has already agreed the cost and it has already been agreed by the Norfolk consultant that the work needs to be done at our nearest Teaching Hospital... the work is beyond my dentists capabilities which is why I was sent there in the first place... I now have to write a letter to the PCT

I am not sure how much longer I can cope with all this ...

Can't your dentist make a phone call for you? It's good news though in the sense that they had authorised the work.
Re your other post, are you sure you should be paying NHS charges at all. Are you not exempt? I know the exemptions for adults are not as wide as they used to be though.

 

[swampiesue]

Hi Brit, My dentist is writing a letter to the PCT as well.

I am not entitled to free dental treatment as I am not on a means tested beneficent as my husband has a company pension ( not a gold plated one like the government harp on about) It's only the top bods that get those sort of pensions, but one that takes us over the threshold for getting help.

I can at the moment just about afford to pay NHS fees however there is no way I could afford to go private. We are both at the moment sitting on the sofa under our blankets because the heating oil is so expensive and we don't want to waste it.

 

[swampiesue]

Hi am feeling really low today, and all my positive thinking and coping strategies seem to have gone out the window.

I am wondering just how much longer all this is going to go on...at what are my chances of getting all of this sorted.

I just wondered, does anyone know what my chances are of getting this sorted out, I am at the moment in a lot of pain with my jaw, I know the hospitals are busy but surely if a hospital Consultant in Norfolk thinks the work is complex then it is,not to mention the TMJ which is not only aching but I am sometimes having problems swallowing now and knocking noises sometimes when I am talking, it's weird. I have a temporary bridge that does not meet on one side and I have been wearing for 11 months and teeth that might now need RC treatment due to occlusional Trauma. There are lots of technical information on my report

So if anyone can please help, are the NHS obligated to get this sorted I would really appreciate some advice.

 

[drhirst]

Hi Swampiesue,
I am so sorry to hear about your problems, it must be so disheartening and frustrating.
The Eastman is highly over subscribed. Rather that admit they cannot cope, they appear to be adopting the tactic of referring most things back to the dentist even though they know it is beyond their experience. I watched their service gradually deteriorate over the last 23 year years.
The pct has an obligation to find you specialist care even if they have to pay a private specialist on your behalf. This is not widely known and I would suggest you let them know you are aware of this.
Combine this with asking your dentist to keep the pressure up on them.
In addition, it might be worth writing the Eastman informing them that you are starting a formal NHS complaint.
You will really have to fight but if you fight tough and persevere they might just crack and give you the treatment you are entitled too!
Keep us informed of your progress so we can advise you further.

Lincoln

 

[swampiesue]

Hi Drhirst thank you so much for your help and advice, you have made me feel so much. I will follow your advice and keep you informed of my progress.

 

[swampiesue]

Hi Just an update, The PCT have referred me to another local dentist who is willing to deal with it, Went today, had X rays taken and have sent him my letter from the hospital today because I forgot it.. However am not sure what he thinks to be honest until he sees the letter from the hospital

 

[swampiesue]

Am still waiting for the dentist to get back to me, he took Xrays and said, he would have to check if the PCT would fund the work, which seems a bit strange as it was the PCT that sent me to him. I did e-mail the letter to him, but to be honest, not sure if it was me being paranoid but I really got the feeling he did not take to me at all and resented me being there. I did not have the courage to put this the other day, but I came home in tears.