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NHS or Private? (was:English 'pull own teeth')

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amandah

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Jan 29, 2006
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I am a Dental phobic and have been for many years. This is not helped by my anxiety I know. But its a real shame that there are not NHS Dentists out there who are also good with extreme phobias. Also why are the Hospitals full? Because many people have got huge Dental probelms. I am Lucky as I am having an op soon to remove all my back teeth. but I will be mighty glad when its all over!! Private Dentists are too costly.I will not be able to afford implants as I have little money.Anyway its a sad place we live in. regards amandah
 
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amandah

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I I think I posted this in the wrong area. I am not a dentist Regards amandah
 
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snapper

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I'd just like to put in my two cents worth regarding the attitudes and stigma attached to any degree of anxiety. I attended an open meeting in manchester last year, which discussed the attitudes and stigma associated with mental illness, whilst promoting the 'Time to Change' campaign to improve public awareness.

A member of the audience questioned the moralty of removing patients from NHS dental practice lists if the patient was time consuming or expressed anxieties about dental care. The get out clause being, that, a dentist does not have to treat a patient after a course of treatment or give a reason for their decision.

A pschycologist responded by reporting her experience of teaching dental students. Their attitudes towards dental anxiety or any anxiety related disorder was that, the students had come into dentistry to make a good living, and that given a choice, they would avoid the time consuming needs of the anxious dental patient.

Not to say that all dentists have this attitude but it is worrying that this attitude is expressed at this level.
 
brit

brit

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I'd just like to put in my two cents worth regarding the attitudes and stigma attached to any degree of anxiety. I attended an open meeting in manchester last year, which discussed the attitudes and stigma associated with mental illness, whilst promoting the 'Time to Change' campaign to improve public awareness.

A member of the audience questioned the moralty of removing patients from NHS dental practice lists if the patient was time consuming or expressed anxieties about dental care. The get out clause being, that, a dentist does not have to treat a patient after a course of treatment or give a reason for their decision.

A pschycologist responded by reporting her experience of teaching dental students. Their attitudes towards dental anxiety or any anxiety related disorder was that, the students had come into dentistry to make a good living, and that given a choice, they would avoid the time consuming needs of the anxious dental patient.

Not to say that all dentists have this attitude but it is worrying that this attitude is expressed at this level.
This doesn't surprise me at all but happily there are those gems who find it satisfying and rewarding to help patients get over their fear. Phobic patients don't always remain phobic after all...at least not so long as they can keep their trusted dentist.
In the UK private sector offering more TLC than the NHS is almost a way of life. Dental anxiety but not necessarily avoidance is very widespread, there are a minority of patients who pop along 100% happily - many dentists say they don't like dental treatment themselves (funnily I find it disconcerting when they say this).
If a private dentist can charge for the time taken regardless of what gets done, an anxious person or a patient with lots of questions is not such a turn off.
To an NHS dentist it is a turn off because of the crazy UDA system in England and Wales and the general busyness of NHS dentists and their short 'hello- goodbye' timeslots. Even if they were compassionate and wanted to help, they haven't really got the time and at best, it seems that a referral for sedation is suggested.
As we have seen on here, these referrals vary a lot but people are often unaware of what will be done beforehand (poor communication) or they come round and find the treatment they expected has not been done or at the absolute worst, people are referred for GA for full clearance simply because of their phobia when their teeth are in fact savable.
The unhelpful attitude is especially disconcerting when you consider most patients have their fear as a result of poor experiences at the hands of dentists. I think the easiest fix would be to screen dental students for empathy levels as part of the process. The other issue is the fact that you can teach technique but you can't teach ethics...again choosing the right candidate is important if they are not to bring the profession into disrepute.
 
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amandah

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Hi This really makes me so upset and annoyed as i am one of a great number of people, who have got to get some thing sorted out and I am so so scared of the NHS and I am having an op to remove all my back teeth in The Nuffield, a Private Hospital as I know this way I will get a little better care after the op & before. But Sadly not with the dear NHS, as yes they simply will not have time for a crying lady like me. I have had fears all my life. And its very difficult to over come this now. And with a private Hospital I will have that care factor. Its a real shame for me as I get so worked up before hand, but I cant help the way I am made.Regards amandah
 
brit

brit

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Hi This really makes me so upset and annoyed as i am one of a great number of people, who have got to get some thing sorted out and I am so so scared of the NHS and I am having an op to remove all my back teeth in The Nuffield, a Private Hospital as I know this way I will get a little better care after the op & before. But Sadly not with the dear NHS, as yes they simply will not have time for a crying lady like me. I have had fears all my life. And its very difficult to over come this now. And with a private Hospital I will have that care factor. Its a real shame for me as I get so worked up before hand, but I cant help the way I am made.Regards amandah
Amanda
In my admittedly old experience, you can get plenty of sympathy from staff in NHS hospitals....it's not the same as your local dental surgery; but will you have been referred for appropriate care? Your fear of NHS GA is probably unfounded. If you are only having extractions anyway and not restorative care which may not be available on NHS under a GA, then going NHS will save you a lot of money. Use that saved money to get a private dentist to make you a high quality denture maybe?
:grouphug:
 
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amandah

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Hi Thanks for your reply, But as i suffer with chonic anxiety I am going into a private Hospital because I get so upset and would rather have the care . I also have Hugh my Hubby but he is disabled and he will be able to support me a little better. I am big time terrified of the NHS. They are far too busy for my needs.I will have my own room and if its NHS I will not be able to have my own room. I am that scared as it is so a private caring Hospital in my case will be better for me. My Anxiety/dental fear is extreme and No one really understands, what Amanda is like. I know that I need to get this sorted and I will .To me this is a major op where as some one else run of the mill. But I have always been like this and its sad but there we go. Thanks regards amandah
 
brit

brit

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From the BDA Smile website:

What is the difference between NHS and private dentistry?

Many family dentists offer both NHS and private treatment. Some treatments - like tooth whitening or dental implants, for example - are only available privately, The main difference between NHS and private care is in the materials used, like filling materials and types of denture.

Many dental practices either treat all of their patients privately or prioritise care to children and/or patients who are exempt from NHS charges. Some practices have only been given a very small NHS contract and so can only provide a limited number of NHS appointments. Private treatment can be provided on a pay as you go basis where patients pay for the treatment they receive or as part of a practice plan where patients pay a monthly fee for care.

Is private dental treatment better than NHS treatment?

Not necessarily. Often the difference between NHS and private dental work is in the materials used, like filling materials or even which technician makes the dentures. You will probably find that the dentist spends more time with you if you are being treated privately. Ultimately, though, the choice is yours - whether you decide to opt for NHS or private care, you must feel comfortable with your dentist and with the treatment they recommend.

Why is one dentist offering treatment cheaper than another?

The price for private treatment will often vary from dentist to dentist. This could be because one dentist has more experience in a certain field - like treating gum disease - or because they dedicate more time to each patient, or simply because their practice is in a different area. Dentists operate like small businesses, they have to pay for all their own equipment, their staff and their premises, so if they work in an expensive area - like in the middle of a town - they may have to pass this cost on through their charges.

Many more 'politically correct' gems on this link: [broken link removed] between NHS and private
 
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brit

brit

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http://conversation.which.co.uk/con...n-nhs-private-dental-practice/comment-page-1/

Some balanced comments from dentists in this Which thread such as this one:

Dear Joanna,

Thankyou for your reply – adequate Quality (which needs adequate time to deliver it) is critically important, especially so in busy and over-stretched NHS systems.
Although the Pilots for NHS dentistry only officially started 1st Sept, already it is becoming clear that these Dentists are having to take 30 to 40 minutes to check everything well and communicate this with the patient properly!

Now if WHICH can support Dentists to be allowed this time to spend upon delivering this quality of care, you will see more Dentists (and patients) moving back to the NHS dental system in England by choice – however if the DH pulls it’s usual trick, the right noises will be made then at the last minute Targets will be changed, with the emphasis still on rushing through more patients in less time to meet Political Access targets, with NHS Dental Practices facing massive fines (called clawback) if they don’t meet productivity UDA targets on patients, which ironically would leave the Dental Practice with even less funding for NHS patients who need to be seen

Thus you have a not uncommon scenario of Dentists having to see more patients per hour to meet NHS productivity Targets, so less time is given per patient and then NHS NICE guidance on check-ups says send as many away as you can for 2 years to make room for more so DH can meet political Access targets WITHOUT spending any more money etc, etc.

This is then even more flawed because nobody has yet explained to me how you do Annual Oral Cancer checks on the NHS, if the NHS sends them away for 2 years!

Presumably if patients want this level of ‘Quality’, which your survey noted was an important dental check, they will presumably have to ask a Private Dentist to do this in the year between their 2 yearly NHS dental check-ups?

Given that November is Oral Cancer awareness month and Oral Cancer now kills more people annually than Cervical cancer and Testicular cancer in England combined, such poorly planned economic decisions in the NHS Dental system in England are far from ‘NICE’ and could even be contributing to the increases in Oral Cancer deaths we are now noticing.

So yes IF the new dental contract protects patient time needed to do everything properly on the NHS, it could be a great improvement Qualitatively, but will politics and cost-savings interfere yet again and compromise the delicate balance between Time/Quality ratio for patients???

Whilst Private Dentistry has suffered as generally paperwork increases and thus patient Frontline direct care decreases as a result, in general patients pay 100% direct to the Dentist for their time and expertise. Suddenly the reality then of how costly it is to pay for un-subsidised yet high-tech dental environments directly hits home and frankly patients notice what to them seems like ‘high-prices’, but remember Dentists have even higher overheads than GPs and they are paying for Dentist + Nurse + expensive materials, Xray machines, hospital level cleanliness and growing mountains of paperwork and audits they may never get to see, but which the CQC and other bodies now insist upon, driving costs up even further to patients.

Imagine if you went to Hospital and had to pay ALL the actual costs of your visit, Medics, Nurses, seterilisation, bandages, heating, lighting, Xrays, special tests etc. Basically it would be even more than Private Dental fees, but on the NHS the taxpayer pays it for you.

So yes Dentistry is a high-tech. high cost intensive and detailed medical speciality really, but if you want it to get better for patients, both NHS and Private, without the costs Spiraling ever higher, then reduce our wasteful paperwork burdens by 50%, free-up our hands to spend more protected-time on direct patient care and put pressure on government Systems to enable Professionals, rather than disabling Professionals, to do their best.

What is bad for Dentists and their Teams, is bad for patients too ultimately.

Please don’t get distracted in the petty politicised dogmas of NHS vs Private – the real truth is neither system can meet ALL the Nations needs by itself, so we should plan for synergy and a general raising of Quality in ALL systems.

But to come full circle, less Time = less Quality, so whilst some anxious people may want to get out of that Dental chair as quickly as they can, rushing things helps nobody, apart from NHS management tick-boxers who will tell NHS Dentists they are ‘under-performing’ if they take more time to relax the anxious patients and do everything properly too, I fear

I hope you’ll forgive my frankness, but it seems so easy to blame just the workers, when 80% of the fault lies in a poor-system that penalises time spent with patients – haven’t we learnt anything from the Mid-Staffordshire Hospital disaster where an additional 400-1200 people died, because medical staff were distracted chasing additional paperwork targets instead of providing more direct patient care?

Maybe only public-pressure from orgnisations like WHICH, can now help Professionals (Dental and Medical) get the protected time they need to put Patients before Paperwork targets!

Yours still realistically,

Anthony Kilcoyne.
 
carole

carole

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What a shame it is that we have come to this. Things have improved in dentistry from years ago. I was a child in the 60s and 70s and believe me, things have improved in the way treatment is done. On the subject of NHS or Private I would love to pay my dentist private rates as he does both nhs and private. But I just cannot afford it.The only reason I would love to see him private is for his financial gain, which he deserves. I see him as a nhs patient and the time and care I get would be no different if I saw him private. I know I am very lucky to be a patient at the practice I attend as I have seen the other side of nhs treatment to the cost of my teeth both as a child and as an adult in the last few years before I found the practice I am with now. I am phobic and the care and attention I have received and treatment, and the way it has been given has been and still is 100%. There are caring places out there and very gentle caring dentists as well. It may mean you have to travel a bit further than you'd like and look a bit harder but they are out there.
 
M

mango

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Jan 26, 2012
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I don't pay for any of my NHS treatment as I don't earn enough (I am a professional - there simply is not enough work where I live and the other jobs I do eg cleaning; exam invigilation etc are seasonal. I cannot move easily, and wouldn't want to, as my children are still at school). I have received excellent treatment from NHS dentists including IV sedation. I have never felt I am getting a worse deal than private patients and even experienced my current dentist changing his mind (after consulting me) about a course of treatment which meant a much longer appointment. I am able to ask questions and do trust and like this dentist which means a lot as I am slowly getting over pretty severe dental phobia. I cannot speak highly enough of the NHS.
 
U

upsydaisy

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Nov 18, 2012
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Hi Brit

I think maybe another poster is right and maybe a site such as this which is trying to help people with dental phobia is not the best place to get political, but as the subject has been brought up I have just lost a crown. Purely by chance (clearing out the loft) I came across the receipt for this crown which was done I think in 1995 and cost me on the NHS £65. A crown now on the NHS is in the top tier of treatment and costs £209, although I do accept that all the work, fillings, checkup, x-rays, etc is included in this price. But how on earth is between £400 and £500 (average non NHS fee) justified for just one little old crown, that back in the day cost just £65.
 
brit

brit

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Hi Brit

I think maybe another poster is right and maybe a site such as this which is trying to help people with dental phobia is not the best place to get political, but as the subject has been brought up I have just lost a crown. Purely by chance (clearing out the loft) I came across the receipt for this crown which was done I think in 1995 and cost me on the NHS £65. A crown now on the NHS is in the top tier of treatment and costs £209, although I do accept that all the work, fillings, checkup, x-rays, etc is included in this price. But how on earth is between £400 and £500 (average non NHS fee) justified for just one little old crown, that back in the day cost just £65.
Because the GBP65 figure was also subsidised by the NHS at the time and didn't reflect the true cost, just as most of the Bands don't reflect the true cost now. You also have to adjust for inflation too.
 
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Thephilsblogbar

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Currently see NHS dentist (this is my number #10 dentist since I been a baby at the same pratice, even though in 2013 my dentist bought the pratice as the owners retired, I been seeing my dentist before 2013)

Even though I have seen two other dentists during she took over the pratice. most of the dentists at the pratice know how to deal with anxious patients as well as the dentist assistants, having a helpful receptionist can have a word with the dentist.

As for pulling my own teeth will never try it even though I 100% hate my teeth, with twinges, wisdom teeth problems (some have not come through and I am in my 30s) and having a few fillings in my mouth/root canal. Have I been tempted to do it a few times when I had an abcess problem as was scared to go back to the dentist.

I know private treatment is available at the pratice I attend which would help me if I could afford it

I have a big anxiety about dentists but know it important to get any treatment on my mouth done as soon as possible.
 
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O

Ow

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Re: English 'pull own teeth' as dental service dec

i wrote several letters last yr including one to our prime minister concerning the welfare of our nhs dentists.
when i had an nhs dentist hes was so busy it was ridiculous. he eventually after several yrs was leaving the practice and i was devastated. i wrote and asked why they were treated so badly and worked so relentlessly. the response was dissapointing but at least i tried. i now have the same dentist but he has his own private practice.
Eh, I disagree with this.

The nature of funding is wrong, true - I don't know the specifics, but the fact most NHS dentists appear to be part of larger chains makes me think they are now being won by corporate entities, who the better meaning dentists probably don't want to work for.

What I do know, however, is that at the time this was posted many NHS dentists were charging 'double' for treatments - i.e. not doing a scale and polish, and when a patient requested it, they'd say they would have to charge them privately (and pocketing the cash from the NHS too).

It's been very badly handled, I agree. But I can't see a good dentist working for the NHS anymore, hence why I've had such a bad time outside of London.
 
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Ow

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Because the GBP65 figure was also subsidised by the NHS at the time and didn't reflect the true cost, just as most of the Bands don't reflect the true cost now. You also have to adjust for inflation too.
Well, no. Bands are to subsidise care and are a largely ideological project with no real-term value for the NHS, its patients or the taxpayer.

That and crowns can differ widely in price depending on the skill of the dentist and the materials being used.
 
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