Earlier this year I needed to have root canal treatment. It was an uneasy journey from a generalised and competent NHS dentist into the world of private referrals and hefty invoices. This exposes the state of NHS dentistry. Please bear with me while I share my experience.
The tooth with the hole is the second molar tooth, just in front of the wisdom tooth which had been removed last year. The 3D scan was done just after the root had been removed and before a temporary crown had been fitted. The dentist kindly gave the 3D print to me; he was proud of his equipment and his work on my tooth.
The story started in January in a regular check up with my NHS dentist, a young dentist. While perfectly qualified, I get the impression she is quickly gaining experience and climbing a career ladder ahead of her. And why not? Being a dentist is a perfectly good profession on paper, but mired in the unhelpful NHS dentistry contracts. At least she is sticking with the NHS.
In my check up, I reported that I’d chipped a tooth but only a little and I wasn’t in any pain. She looked at said tooth and gave me some options:
- Leave alone but keep it clean etc
- She could smooth it over as it was only a small chip on the corner of the tooth
- Extract the tooth, not recommended or necessary
- Root canal treatment, taking into account the condition of the tooth which had been filled previously
I said I’d like to keep the tooth going for the rest of my life i.e. another 30+ years and asked what the best option was. She confirmed it was having a root canal treatment and fitting a crown.
Except, she explained, she couldn’t carry out the treatment, it was beyond her level of expertise and didn’t have the right facilities. She offered to refer me to one of her [private] colleagues, at a different surgery but in the same group of dental practices (I interpreted this as being part of the same business structure).
After waiting some weeks and having hearing nothing, I enquired about what was happening. Apparently there had been a breakdown in communication and my referral had been delayed in the system. Many apologies were expressed.
I had my succession of four or five appointments to do the work. This included a private prescription (what else?) for reducing pain and swelling after the first appointment. I had had all my treatment, it seemed to go very well and I was fascinated my the microscope needed to peer deep into my tooth, I tried to be the model patient without moving a millimetre.
The total bill added up to £1830, or thereabouts. I had been asked to pay in instalments, it would be interesting to know the reasoning and not simply pay after the work had been completed to my satisfaction. I was almost in a private ‘consumer environment’ but I was being treated as someone who might not pay up.
Feeling peeved
I had believed I was an NHS patient and yet I had been pushed along the private route. I looked at the dental charges on the NHS website which clearly stated root canal treatment was available in treatment bands 2 and 3.
Next routine check up and I challenged my dentist about this. I could tell she was uneasy about me asking about this. I have never seen her face before, her nose, chin and mouth are always behind a mask and a clear plastic shield covered her entire face. I think she blushed and I had to listen carefully as her rather muffled voice explained the situation.
She explained that she didn’t have the expertise to do this work. As I am considered an “older patient” the canals in my teeth can become narrowed and it is more difficult to remove the old nerves – every last, tiny fragment must be removed. There simply aren’t any NHS dentists available with the skill and equipment to do this work. My only option was to go private.
This shouldn’t have been necessary at all. We should have NHS dentists who are able to do this work under the NHS, albeit with a small contribution from the patient, typically £200 or £300, or thereabouts. Instead those that are around are mostly in private practice, albeit under the umbrella of the main practice, or I mean business.
Perhaps I should think myself lucky. I paid the £1830 bill without batting an eyelid. I have an NHS dentist for normal checks, X-rays and routine work. We hear of stories of people not being able to get an NHS dentist, or not being able to afford private treatment and go many years without seeing a dentist. No wonder problems are building up for some people. Extreme examples are where people resort to pulling their own teeth out. Worse still decayed tooth extraction is increasingly common in hospitals where some children end up. Can you believe this? In the United Kingdom? Sadly this has become the reality.
No doubt this situation is a complicated one and it should never have arisen in the first place; undoubtedly another example of fourteen years of Tory mismanagement. Let this be a lesson to anyone who thinks we can privatise a little more of the NHS, here and there. Fancy business cases can always be written to support the kind of argument but no good will ever come of it.
Believe me, no good will come of it.
Sadly my dentist’s practice made the decision only to offer NHS work for children what must now be almost 20 years ago. I stuck with them, having had to make a similar decision to decline legal aid work in my own business (it was quite simply costing more to do the job than the sum paid). Other dental practices locally swiftly followed and I suspect we are now one of those places where there is a dearth of places for NHS patients. I’m fortunate though in having needed no treatment other than what are now annual check-ups and cleaning for the last 40 years, which theoretically should have given me time to save up for “the biggie”when it happens. When I sit in the waiting room and look at the price list, it is eye watering.
You are lucky to have an NHS dentist for your routine visits, there are none to be had around here. I had an infection in the root of a crowned tooth recently which was treated with antibiotics, if it flares up again then I’ve been told I will have to have root canal work. I’m more frightened of the bill than the pain /discomfort of the procedure!