Private versus NHS dental treatment
Discussion
I had quite bad teeth for a while and opted to go private due to working away from home and being able to get in when the local NHS guy couldn't. Started off as one of my front teeth were snapped down to the gum line and had a dodgy post put in many years prior that broke off.
All in all I think I had 2 wisdom teeth out, 2 fillings, some sealant and the root canal, post, crown jobby up the front. All in for something like £1500.
Probably the best money I've spent. I was in and out for weeks, and the dental team was one of the best I'd dealt with. One thing that struck me with having the private treatment (not sure if it goes with NHS...?) was pretty much a 3d scan of the inside of my mouth, with the crown modelled and sent to the milling machine on-site (Yep, in the room next door he had my tooth carved out by a computer controlled CNC type machine!).
That entire procedure has made me a customer for life!
I would say, if your private dentist is good, then the money difference is well worth it. Having your teeth done is not a nice experience!
All in all I think I had 2 wisdom teeth out, 2 fillings, some sealant and the root canal, post, crown jobby up the front. All in for something like £1500.
Probably the best money I've spent. I was in and out for weeks, and the dental team was one of the best I'd dealt with. One thing that struck me with having the private treatment (not sure if it goes with NHS...?) was pretty much a 3d scan of the inside of my mouth, with the crown modelled and sent to the milling machine on-site (Yep, in the room next door he had my tooth carved out by a computer controlled CNC type machine!).
That entire procedure has made me a customer for life!
I would say, if your private dentist is good, then the money difference is well worth it. Having your teeth done is not a nice experience!
I've had very good and very bad experiences with NHS dentists with root work.
Most of my issues revolved around them expecting to start working on you the minute after giving you the anesthetic jabs. They don't seem to realise (or care) that these things take time to have an effect and it varies from one person to another. Unfortunately for me I seem to be fairly immune to them and having them start digging around in your gums without any anesthetic is a horrific experience let me tell you.
I suffered 3 rounds of that with one particular dentist before putting in an official complaint with the governing body and then finding a different dentist. The (female) one I found (also NHS) was very good and she even suggested that I come in 30 mins earlier than my appointment and she'd give me the anesthetic jabs so that it would have time to take effect before commencing work. Worked like a charm and the eventual tooth extraction (a very large and odd shaped molar with a prong coming out at 90 degrees) as a result of his poor canal work went without me feeling a thing although she did keep apologising over and over for all the crunching noises as she had to literally destroy the tooth to get it out.
I've since learned my lesson that giving my teeth a very thorough scrubbing at least once a day without fail stops any problems developing and I've flown through every check-up for past 6 or 7 years now without needing anything other than very minor de-plaqueing on the gum line behind my lower fronts.
Personally I would feel uneasy about continuing with a dentist who was trying to force you to go private under the threat of poorer treatment and sub-standard materials if you stayed with NHS treatment. That feels like blackmail to me and I would worry that he would deliberately make the experience more painful than it needed to be just to teach you a lesson for not paying extra. As some others have said above, they've paid extra for private treatment and not seen any quality improvements to match the higher price. I think they like to prey on your vulnerabilities when you're in excruciating pain as they probably know most people will just pay whatever they want in order to make the pain go away.
Most of my issues revolved around them expecting to start working on you the minute after giving you the anesthetic jabs. They don't seem to realise (or care) that these things take time to have an effect and it varies from one person to another. Unfortunately for me I seem to be fairly immune to them and having them start digging around in your gums without any anesthetic is a horrific experience let me tell you.
I suffered 3 rounds of that with one particular dentist before putting in an official complaint with the governing body and then finding a different dentist. The (female) one I found (also NHS) was very good and she even suggested that I come in 30 mins earlier than my appointment and she'd give me the anesthetic jabs so that it would have time to take effect before commencing work. Worked like a charm and the eventual tooth extraction (a very large and odd shaped molar with a prong coming out at 90 degrees) as a result of his poor canal work went without me feeling a thing although she did keep apologising over and over for all the crunching noises as she had to literally destroy the tooth to get it out.
I've since learned my lesson that giving my teeth a very thorough scrubbing at least once a day without fail stops any problems developing and I've flown through every check-up for past 6 or 7 years now without needing anything other than very minor de-plaqueing on the gum line behind my lower fronts.
Personally I would feel uneasy about continuing with a dentist who was trying to force you to go private under the threat of poorer treatment and sub-standard materials if you stayed with NHS treatment. That feels like blackmail to me and I would worry that he would deliberately make the experience more painful than it needed to be just to teach you a lesson for not paying extra. As some others have said above, they've paid extra for private treatment and not seen any quality improvements to match the higher price. I think they like to prey on your vulnerabilities when you're in excruciating pain as they probably know most people will just pay whatever they want in order to make the pain go away.
Had three private root canals and they all failed so needed extractions. Then had one private implant and that failed. I had one private extraction in Hatfield and the guy just left me with an infection and referred me to the NHS who never saw me.
I have an excellent dentist now but he doesn't do root canals or implants.
A guy on the train was telling me (probably rubbish) that in countries with more developed dental practices, jaw surgery like implants and extractions is followed up with a treatment of steroids to help healing. In this country they just send me on my way with a cotton swab lol.
I have an excellent dentist now but he doesn't do root canals or implants.
A guy on the train was telling me (probably rubbish) that in countries with more developed dental practices, jaw surgery like implants and extractions is followed up with a treatment of steroids to help healing. In this country they just send me on my way with a cotton swab lol.
Driller said:
Mrs Muttleysnoop said:
Driller said:
Only £233 for all that treatment, how is that possible?
My lab charges £100 for a ceramic crown. One!
It is possible as it is the NHS.My lab charges £100 for a ceramic crown. One!
I have never paid for any hospital appointments or operations as it is NHS.
"It is possible because it's the NHS" doesn't explain it.
I feel we got bounced into private treatment when our dentist decided to go private only. The only difference I can tell is that now comes to get me herself instead of sending her assistant.
Sheepshanks said:
Driller said:
Mrs Muttleysnoop said:
Driller said:
Only £233 for all that treatment, how is that possible?
My lab charges £100 for a ceramic crown. One!
It is possible as it is the NHS.My lab charges £100 for a ceramic crown. One!
I have never paid for any hospital appointments or operations as it is NHS.
"It is possible because it's the NHS" doesn't explain it.
Driller said:
Sheepshanks said:
Driller said:
Mrs Muttleysnoop said:
Driller said:
Only £233 for all that treatment, how is that possible?
My lab charges £100 for a ceramic crown. One!
It is possible as it is the NHS.My lab charges £100 for a ceramic crown. One!
I have never paid for any hospital appointments or operations as it is NHS.
"It is possible because it's the NHS" doesn't explain it.
The average UDA value is £24, so the dentist gets £288 in total for this course of treatment. Patients who are not exempt from paying for their treatment pay £233 and the NHS pays me the other £55.
The dentist has to pay all overheads out of this payment. These include payments to a lab to make crowns/dentures etc that can sometimes exceed £288.
The general public have zero clue how the NHS dental contract works.
The situation is unsustainable and is the reason I'll be jacking it in soon
Rollin said:
Band 3 course of treatment which could include all required crowns, fillings, dentures, RCT, radiographs etc etc. earns a dentist 12 UDAs.
The average UDA value is £24, so the dentist gets £288 in total for this course of treatment. Patients who are not exempt from paying for their treatment pay £233 and the NHS pays me the other £55.
The dentist has to pay all overheads out of this payment. These include payments to a lab to make crowns/dentures etc that can sometimes exceed £288.
The general public have zero clue how the NHS dental contract works.
The situation is unsustainable and is the reason I'll be jacking it in soon
That's exactly what my understanding was Rollin i.e. not what Sheepshanks was saying about the dentist getting paid the £288 and then UDAs on top of that.The average UDA value is £24, so the dentist gets £288 in total for this course of treatment. Patients who are not exempt from paying for their treatment pay £233 and the NHS pays me the other £55.
The dentist has to pay all overheads out of this payment. These include payments to a lab to make crowns/dentures etc that can sometimes exceed £288.
The general public have zero clue how the NHS dental contract works.
The situation is unsustainable and is the reason I'll be jacking it in soon
Absolutely and clearly unsustainable as you say. People need to be made to understand about how much it costs to provide a dental service and all of the overheads the dentist has to pay .
Sheepshanks said:
The way check-ups are done now, based on what I've heard from many people, is ridiculous - you're in and out of the dentists' chair in 2 mins and a minute of that is selling you a private hygienist appointment, instead of them doing the scale and polish.
Could it be that this is because whilst they are doing this scale and polish they are working at a loss?Know any other person who provides a service who is prepared to work for a loss? Would you like to?
Driller said:
That's exactly what my understanding was Rollin i.e. not what Sheepshanks was saying about the dentist getting paid the £288 and then UDAs on top of that.
I never said they got both! And the £288 is the UDA figure - the patient pays £233.Driller said:
Could it be that this is because whilst they are doing this scale and polish they are working at a loss?
It would take another few mins. I'd expect doing check-ups they could make decent money by packing 'em in. It's more understandable that they're going to lose money on time consuming complex work.Driller said:
Know any other person who provides a service who is prepared to work for a loss? Would you like to?
I work in high tech and we do a lot of pre-sales and support work that doesn't generate any income at all. Some of it does pay, obviously, but it's very difficult to figure out in advance. Edited by Sheepshanks on Sunday 18th September 19:19
To provide a dental examination in 2 minutes is impossible and it would be ridiculous to think that this is a routine occurrence. Any dentist working in this manner would be struck off if the GDC was made aware.
The GDC also take an extremely dim view of any hint of dishonesty (especially financial) or putting your own interests before a patient's. This applies in and out of work.
I book 20 minutes for a routine examination (30 mins for new patients)
Patient gets examination, any required radiographs, prescriptions, advice, scale/polish
Takes 5 minutes to clean up surgery between examination patients
For this I receive 1 UDA which is equivalent to £24.
Nurse and receptionist receive about £9.50 each per hour. This is paid from that £24 along with all other practices running costs.
You are more likely to get sued by a patient in the UK than any other country on the planet (yes, including the USA)
My compulsory insurance against this costs about £5500 per year.
The GDC also take an extremely dim view of any hint of dishonesty (especially financial) or putting your own interests before a patient's. This applies in and out of work.
I book 20 minutes for a routine examination (30 mins for new patients)
Patient gets examination, any required radiographs, prescriptions, advice, scale/polish
Takes 5 minutes to clean up surgery between examination patients
For this I receive 1 UDA which is equivalent to £24.
Nurse and receptionist receive about £9.50 each per hour. This is paid from that £24 along with all other practices running costs.
You are more likely to get sued by a patient in the UK than any other country on the planet (yes, including the USA)
My compulsory insurance against this costs about £5500 per year.
The general public have no idea what mental and financial stresses dentists are under. They just see the nice car outside and assume it's all 2 minute check ups and £200k in the bank. Our practice costs £94/hour to run, we have receptionists to pay, nurses to pay, the nurses professional registration to pay, our own professional registration to pay at £1,000 a year, CQC registration costs, professional indemnity, for which i've been quoted £8500 for the coming year, Local Dental Committee levy to pay, rent to pay, bills to pay, lab bills to pay, very expensive equipment to maintain and regularly purchase...the list goes on and on. The General Dental Council is currently out for us and bringing frankly ludicrous cases to counsel then throwing them out, creating a horrible working atmosphere amongst dentists across the country, and the last thing we honest dentists need is more aggro. I'll leave you with a simple maxim
"Dentistry is not expensive, neglect is"
"Dentistry is not expensive, neglect is"
I've been using the same NHS dentist for ten years or so.
I've never had any problems with my teeth, typically brush them 3 times per day.
My dentist takes a MAXIMUM OF 2 minutes for my appointment.
Procedure normally starts with a 'any problems' question and then a quick look at my teeth - perhaps a quarter of them might be touched with his pike (if that's what they call it!).
In a way, this pleases me, as I'm not comfortable there and want to be in and out with no problems
I've never had any problems with my teeth, typically brush them 3 times per day.
My dentist takes a MAXIMUM OF 2 minutes for my appointment.
Procedure normally starts with a 'any problems' question and then a quick look at my teeth - perhaps a quarter of them might be touched with his pike (if that's what they call it!).
In a way, this pleases me, as I'm not comfortable there and want to be in and out with no problems
I have just completed 6 weeks of treatment on the NHS. My Spanish dentist was wonderful. She explained everything to me as she went along. She gave me my smile back.
It is the first time I have used a NHS dentist for 45 years and I can honestly say it was the best treatment I have ever had. So a big thank you to the NHS.
It is the first time I have used a NHS dentist for 45 years and I can honestly say it was the best treatment I have ever had. So a big thank you to the NHS.
@ the resident dentists here : why do NHS work at all if the pay is so shockingly bad? What's in it for you or is it just a gamble in the hope that you can talk the patient into going on your private books? There's got to be something in it otherwise no dentist would do it. Are we not being shown the full picture here? 
I've been both private and NHS over the years. The best dentist was private in the sense that she was gentle and took her time. However, I had an abscess which required treatment over a four year period. In the end I went to another dentist, NHS, claiming to be new to the area. He was of the opinion that the only option was to remove the tooth. It faught a bit, the infection causing the tooth and jaw to meld, and I had to have the remains drilled out a few weeks later.
The infection was cured. I didn't realise how much pain it was causing. I had a gold coloured tooth screwed in (probably not the technical term) after a period of time and it is still there after 20-25 years. The next door tooth went a little later, as promised by the new dentist, and I had a white implant on that, just a crown. That's still there.
I was going to work out how much the private dentist cost me, but then put it down to experience.
Oddly enough, I then went private with a different dentist - I did move - but when the dentist left the area I didn't like her replacement and I stopped going.
Seven or eight years later a filling and I parted company and I went to an NHS dentist, a Romanian.
Before he would take me on I had to pay for a thorough examination. It took 20 mins. I forget the cost, but it could have been £50, non returnable. I asked the reason for the examination and it was he would not take on someone who had not taken care of their teeth. I clean twice a day and floss once.
He's got no chat, is thorough and the only downside is a month's wait for appointments. I've just had a filling fall out, or a bit of the tooth come off. I phoned the day it happened, last Weds, and I go tomorrow eve.
Every visit I have a scour. It's about £20. It makes my mouth feel better and I'm aware of how difficult it is for dentists to make a lot of profit. So I'm happy.
The infection was cured. I didn't realise how much pain it was causing. I had a gold coloured tooth screwed in (probably not the technical term) after a period of time and it is still there after 20-25 years. The next door tooth went a little later, as promised by the new dentist, and I had a white implant on that, just a crown. That's still there.
I was going to work out how much the private dentist cost me, but then put it down to experience.
Oddly enough, I then went private with a different dentist - I did move - but when the dentist left the area I didn't like her replacement and I stopped going.
Seven or eight years later a filling and I parted company and I went to an NHS dentist, a Romanian.
Before he would take me on I had to pay for a thorough examination. It took 20 mins. I forget the cost, but it could have been £50, non returnable. I asked the reason for the examination and it was he would not take on someone who had not taken care of their teeth. I clean twice a day and floss once.
He's got no chat, is thorough and the only downside is a month's wait for appointments. I've just had a filling fall out, or a bit of the tooth come off. I phoned the day it happened, last Weds, and I go tomorrow eve.
Every visit I have a scour. It's about £20. It makes my mouth feel better and I'm aware of how difficult it is for dentists to make a lot of profit. So I'm happy.
My parents were both dentists and my dad used to go private for his own root canal as it wasn't economical for an NHS dentist to do it due to the costs involved. It's a shame that charges were brought in for most people as they used to work in quite a deprived area and when my dad retired no one would take the practice over and the town lost their dentist. It just adds to the pressure on hospitals as people go there instead when in agony as there aren't any local options. Sadly the media focus on stories of three or four millionaire dentists rather than the lack of cover for deprived areas.
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