Dentist - NHS vs private fillings

Soldato
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When I had my fillings done on NHS I had choice of white silver or gold -- obviously I picked gold - That was 51 years ago and the fillings and caps are still in - the only investment I have that has made a profit :)

An investment only your creditors can benefit from as they pull the teeth from your jaw before your funeral :p
 
Soldato
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The private costs are comparable to the rest of the world, significantly less than the US, and in line with most of Europe, and indeed some developing nation when you go for quality work.

With most dental treatment being actively avoidable, or preventative treatment being reasonably cheap and self lead, the reason UK teeth are in the state they are in is all down to the insane amounts of sugar added to things, and how frequently we eat them coupled with our neglect in brushing, teaching and interdental cleaning.
 
Soldato
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I'm about due my 10 yearly trip to the dentist, although I'm not even sure I'm still registered with them. No issues with NHS dentists here, they did me a favour last time by splitting up the cost over a couple of visits without me even asking.
 
Associate
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Hello I am a dentist, work in Liverpool, private practice.

The NHS dental contract states that the dentist has to offer any treatment which is clinically indicated. If an amalgam or composite filling is indicated then the dentist has to offer both on the NHS. Head to the bottom of this link:
https://www.nhs.uk/NHSEngland/About...ges/dental-services-available-on-the-NHS.aspx

The dentist can offer treatment via the NHS and also offer treatment privately; they need to make it clear which is which and in writing using a simple form.

Amalgam is being phased out which is a shame because in back teeth for large repairs it lasts years. They are less technique sensitive and easier to do. I will miss them. They are very strong. I use them for back teeth and building up molar teeth which have been damaged and root filled.

Composites are tooth coloured; they are plastic which is command cured by shining a blue light on them. They are more technique sensitive, they need a dry field (rubber dam) and they suffer from shrinkage as they set/cure which can lead to leakage. They are therefore less successful in mars bar mouths who are susceptible to tooth decay. They also tend to wear faster so they need maintenance and the cycle of replacement is shorter. They are ideal for front teeth and small to medium fillings in back teeth.

I do not match the shade of composites (white fillings) in back teeth, I use contrasting bright white shades, this enables me to monitor the composite at recall and when I repair/replace it I can tell which is filling and which is tooth when I drill.
 
Soldato
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These costs (NHS and private) is the reason why the British have such bad teeth. I've not been since the early 2000s as I fear it will wipe out my ISA and rack up some debt.

LOL, yeah well i had a tooth break in the US and had to have a root canal done over there and it cost me $1500 which at the time was about £1000.

UK Dentists arent too bad. The "bad teeth" thing is cause nobody over here has insurance that will pay for cosmetic work like they do in the US.
 

Pho

Pho

Soldato
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Thanks for all the replies everyone. Had a slight nightmare of a week hence the slow replies. One of the silencers on my exhaust fell off the other day so I've been scrambling to decide on a replacement. Had to stuff a rag down the missing silencer pipe in the meantime to muffle it :p

I decided to opt for the white composites, which is going to cost a fortune but the fact they can be "topped up" if something breaks makes them sound a bit more bearable.


The private costs are comparable to the rest of the world, significantly less than the US, and in line with most of Europe, and indeed some developing nation when you go for quality work

I wonder how much extra it would cost to just tax us like we are for the NHS and to get free dental care? I always find it a bit weird you have to pay for NHS dental treatment. I know it's going to be massively subsidised but still.


Hello I am a dentist, work in Liverpool, private practice.

The NHS dental contract states that the dentist has to offer any treatment which is clinically indicated. If an amalgam or composite filling is indicated then the dentist has to offer both on the NHS. Head to the bottom of this link:
https://www.nhs.uk/NHSEngland/About...ges/dental-services-available-on-the-NHS.aspx

The dentist can offer treatment via the NHS and also offer treatment privately; they need to make it clear which is which and in writing using a simple form.

Amalgam is being phased out which is a shame because in back teeth for large repairs it lasts years. They are less technique sensitive and easier to do. I will miss them. They are very strong. I use them for back teeth and building up molar teeth which have been damaged and root filled.

Composites are tooth coloured; they are plastic which is command cured by shining a blue light on them. They are more technique sensitive, they need a dry field (rubber dam) and they suffer from shrinkage as they set/cure which can lead to leakage. They are therefore less successful in mars bar mouths who are susceptible to tooth decay. They also tend to wear faster so they need maintenance and the cycle of replacement is shorter. They are ideal for front teeth and small to medium fillings in back teeth.

I do not match the shade of composites (white fillings) in back teeth, I use contrasting bright white shades, this enables me to monitor the composite at recall and when I repair/replace it I can tell which is filling and which is tooth when I drill.

Oh OK, thanks really interesting thanks. In my case he did offer both options, and did fix up a slight chip on my front tooth with a composite filling on the NHS but mentioned about the back teeth not being covered like it says in your link.

Shame to know they wear faster at the back, I don't remember him mentioning that at the time.

Free white fillings on the NHS if you go to a teaching dental hospital. Winner.

Wish I knew about this before!
 
Soldato
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I usually book in at the dental hospital and get seen to by the students. This might put off some people but it is in no way similar to getting your hair cut by a college student. The dental students have already been training for 4 year or whatever and everything they do is checked over by someone who is probably more qualified/experienced than your average back street dental practice dentist. Sometimes there is a waiting list but I've never had to wait more than 2 or 3 weeks before the initial appointment.

As already said about NHS dentists having to do the same as private treatments, this still doesn't stop them from saying they can't do this or that or you to pay if you want this etc. They are all on the make in my experience.
 
Soldato
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I'm registered with an NHS practice, my dentist left while I was between appointments to have a filling sorted and my new one decided to do his own check-up and plan rather than use the old dentist's notes. Fair enough, but it did make me wonder if there was more behind the fact my dentist left than the quoted "personal reasons"!

The new dentist seems nice enough and seemed to genuinely want to get to the root (no pun indented) of why I've a few cavities that need sorting out, and gave me far more detail than the old dentist did.

He tried to sell me the option of either going for the silver NHS fillings, or pay for him to do it privately where I'd get composite fillings. He mentioned composite fillings should last longer (10 years?) and not crack over time and allow infection in, which I believe is what happened. He said they were somewhere in the region of £90-£150 each though, which seems rather expensive.

Are they really worth it over normal fillings on teeth I'll probably not see, or am I being taken for a ride with the benefits? My old dentist never once mentioned doing things privately so I'm a bit suspicious.

I seem to remember there's a couple of dentists here, @Hikari Kisugi I believe, so any help would be appreciated.

Cheers :)

are NHS not amalgam fillings. they should be perfectly good for many years if done right. if they crack and fall out it's either the dentists fault for doing a bad job or you're harsh on your teeth or something else
going private will maybe get you some nice white fillings but that should be the only real difference
seems mcdonalds are not the only institutions up-selling now
 
Soldato
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Dorset
Why do we have to pay for nhs dentists?

My last checkup I spent 5 min in the chair and got charged over 20 quid. Please explain this as I dont get it it at all, someone must be making a killing at those hourly rates. I understand paying for treatment in a similar way we pay for prescriptions, it additional work, but I dont pay for a checkup at the doctors but I pay for checkups at the dentists? Its a rip off
 
Soldato
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Why do we have to pay for nhs dentists?

My last checkup I spent 5 min in the chair and got charged over 20 quid. Please explain this as I dont get it it at all, someone must be making a killing at those hourly rates. I understand paying for treatment in a similar way we pay for prescriptions, it additional work, but I dont pay for a checkup at the doctors but I pay for checkups at the dentists? Its a rip off

Someone will claim it's to pay for the years of training and all the equipment. Just like how Opticians charge £200 for glasses when the cost price is nearer to £10.
 
Associate
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As your attorney.........

I assure you that as an NHS patient if a white filling is clinically indicated in a back tooth, such as a small, to medium repair, the dentist has to offer both composite and amalgam on the NHS.

If you read the link carefully it in fact refers to a large fillings, okay, a large may be either amalgam or composite. Most UK dental schools only teach composite now. What does that tell you?

An NHS dentist who selects out NHS dental treatment options and acts to limit the 'patients choice' by only offering, for instance, white fillings in back teeth privately, is in breach of their NHS contract.

And if you do go for the private option, I assume the dentist has more time, uses the best materials, then why not get your few fillings done by paying the dentist for an hour of their time.

If I can do a few fillings in an hour.........at an hourly rate........that is more economical than 3x£95 and much more economical than 3x £150


Ask local dental technicians in your vicinity who are the good dentists? Now where do I send my bill?
 

Pho

Pho

Soldato
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As your attorney.........

I assure you that as an NHS patient if a white filling is clinically indicated in a back tooth, such as a small, to medium repair, the dentist has to offer both composite and amalgam on the NHS.

If you read the link carefully it in fact refers to a large fillings, okay, a large may be either amalgam or composite. Most UK dental schools only teach composite now. What does that tell you?

An NHS dentist who selects out NHS dental treatment options and acts to limit the 'patients choice' by only offering, for instance, white fillings in back teeth privately, is in breach of their NHS contract.

And if you do go for the private option, I assume the dentist has more time, uses the best materials, then why not get your few fillings done by paying the dentist for an hour of their time.

If I can do a few fillings in an hour.........at an hourly rate........that is more economical than 3x£95 and much more economical than 3x £150

Ask local dental technicians in your vicinity who are the good dentists? Now where do I send my bill?

Well, that throws a spanner in the works then. Thanks for your free legal advice ;).

I've re-read the link, and what you've just posted just now and it does seem quite craftily worded from the NHS. So presumably this means that if they're able to do a composite filling privately - e.g., it's obviously clinically possible to do one, they do need to offer the same filling on the NHS and can't say that they can do a composite one privately because "it'll take more time/effort" and an amalgam one on the NHS because "it's easier/cheaper" to do?
 
Associate
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I was always at an NHS dentist during childhood/earlier teens but didn't go back for a couple of years and my name was removed from their register. Went to a provate one down the road and the woman told me I need 12 or 13 fillings. "Aye OK" I thought.
Got back into the NHS one about 6 months later and let him check me over without saying anything. He said I was grand. I told him what the previous dentist said and he was rather shocked to say the least.

Imagine I'd took her word for it? Would have been a clean fortune and filled half my mouth.
 
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In which situations might composite resin materials be unsuitable?

It was agreed that composite resin materials could be considered for placement in all situations. However, care would be advised in the management of elderly patients in whom dentine may be more sclerotic (and perhaps more difficult to bond to). Caution was also advised in the placement of composite onlays in a bruxist who was unable to comply with biteguard therapy.

Full link here:
https://www.nature.com/articles/bdj.2007.726

In my opinion, for small and medium sized repairs in back teeth and most front tooth repairs composites are usually clinically indicated.

Bottom line is I would expect small easy ones on the NHS.

It is not just my opinion, the consensus of dental teachers (above) state they consider there are very few contra-indications.

The dental NHS contract states that if it is clinically indicated it should be offered via the NHS. It can also be offered privately too. The distinction between the two must be clear.

http://www.legislation.gov.uk/uksi/2005/3361/pdfs/uksi_20053361_en.pdf
Top of page 28 points 3 a & b. This is law.
 
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