Dentist - NHS vs private fillings

[Pho]

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

 

[Pho]

I just paid £80 for 15 minute check up today. Private all the way. My missus had a filling by NHS dentist and she's got issues.

I've generally never had any issues with NHS dentists to be fair. £80 for a 15 minute checkup is a pretty good hourly rate by anyones book though!

My prices for white composites are between 55-94 on back teeth, varies with size. Nhs amalgams here are paid for per tooth, i believe this is different in england given the banding system.
Personally as the amalgams in my own mouth fail, i have them replaced in composite.
That said, i offer the choice to every patient, and every day i place both composites and amalgams.
Composites do bond to the tooth, by their nature the prep for such a filling is less destructive. When placed well they are the better treatment, however, there are a few clarifications.
The field should be kept dry, and preferably not below the gumline.
I would never promise that a filling would last ten years, but many do, the main reason fillings fail is secondary decay, most often due to food traps, and sugars in the diet.
One advantage of composites is they can be repaired, so if a cusp fractures or a bit of tooth beside breaks off, you can genrally repair in white without having to take the whole thing apart.

It's something like £55 for band 1 + band 2 NHS treatment which covers all the initial check-up and the fillings you need doing during so it's considerably cheaper than private.

Thanks for your thoughts on them, that's very very useful. Given you yourself are having them replaced with composites that sounds like a pretty good endorsement. Being able to repair them sounds like good future proofing too.

When I was younger I used to have very good teeth, never had a filling until I was ~12 or something but now I seem to have them pop up all the time. The irony is I used to eat lots of sweats, sugary drinks etc when I was younger and now I hardly ever do and seem to be worse off for it.

I've mostly had composite lately on the NHS for some reason - most recent said she was going to use amalgam on a back tooth but then did composite - did say something about it being better due to having to replace a current filling on the same tooth at the same time or something though.

That sounds like the sort of dentist you want .

 

[Pho]

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

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!

 

[Pho]

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?