As somebody who has spent around $5,000 on dental work over here in the US - this thread is like a slap in the face
We still have to pay for major work.
Dentist's - Rip off
- Thread starter Ciphon
- Start date
We still have to pay for major work.
I had a private dentist very local who was telling me that I needed a Root Canal to save one of my five remaining molars in my lower mouth. Was told it'd cost £300 each session for 2 sessions, not including a crown which would cost another £250. OUCH.
He put in a temporary filling along with some meds to sooth the inflammation back in around December, I've been back once in March to have the temporary one re-done while I still make up my mind. Have had no pain since then, but I need to do something about it.
However, back in March I found out about a new surgery that was taking on NHS patients locally, I managed to score an appointment 4 months after they opened which I've just been to. The dentist was quick, to the point and efficient (German, figures!), he seemed good though. He x-rayed my mouth and had a good look around, agreeing that I need a root canal on the one tooth, all other fillings OK. I was chared £11 for that appointment and quoted £114 for the entire root canal, £50 for the crown. Booyah.
He put in a temporary filling along with some meds to sooth the inflammation back in around December, I've been back once in March to have the temporary one re-done while I still make up my mind. Have had no pain since then, but I need to do something about it.
However, back in March I found out about a new surgery that was taking on NHS patients locally, I managed to score an appointment 4 months after they opened which I've just been to. The dentist was quick, to the point and efficient (German, figures!), he seemed good though. He x-rayed my mouth and had a good look around, agreeing that I need a root canal on the one tooth, all other fillings OK. I was chared £11 for that appointment and quoted £114 for the entire root canal, £50 for the crown. Booyah.
You get what you pay for...if you are happy to go along with this NHS treatment then by all means that is your choice, but FYI I am a dentist and here are some facts which you ought know about before you have NHS treatment.
1. A lot of NHS practices simply cannot afford to do proper root canal treatment (RCT). Ask yourself why some can and some can't...something has to give...often that is the quality.
2. It is both a legal, regulatory and clinical requirement to use rubber dam whenever a root canal treatment is carried out. Is your dentist going to do so, or are you going to risk having noxious chemicals or worse a small sharp instrument down your throat. Not to mention opening up the inside of your jaw to the microbes in your mouth via the root canal if rubber dam is not applied.
2. It takes at least 90 mins surgery time to carry out a proper RCT. Average breakeven costs for a dental surgery (ie before the dentist makes any money is around £100 per hour). You do the maths!
3. Proper RCT equipment is specialised..ie they shouldn't be using the same drill as they use for your other fillings-except at the start and finish. This equipment costs several thousand pounds.
4. Regulations and good advice states that root canal instruments can only be used once-there is a theoretical risk of prion transmission (CJD). Modern techniques use around £50 worth of SINGLE USE equipment. Is your dentist doing this or using the same equipment as for previous patients-albeit sterilised.
As I say you get what you pay for, but it's your choice.
Soldato
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Apfelbaum I figure whoever sells you protaper files and sold you your protaper machine well and truely ripped you off.
Single use yes, (only as some chump released interesting data regarding trasnmission) but you should be able to buy files cheaper than £50, even with VAT.
Some of us are forced to do RCT on the NHS, as our patients simply can't afford anything else, but we have strict policies regarding single use for any endodontic materials, but I would disagree with you regarding the 90 minutes surgery time.
Single use yes, (only as some chump released interesting data regarding trasnmission) but you should be able to buy files cheaper than £50, even with VAT.
Some of us are forced to do RCT on the NHS, as our patients simply can't afford anything else, but we have strict policies regarding single use for any endodontic materials, but I would disagree with you regarding the 90 minutes surgery time.
I know what you mean. I went to have a check up on the 27th of July. My birthday was on the 20th of July (Turned 19). I was exempt from fees if I was in full time education (Which I am) and age 18. So because I turned 19 7 Days before my check up I had to pay 
But still my xrays only cost £19. That was the full cost of the check up (Teeth count .... normal stuff + Xray)
Normal NHS Dentist.
/Johnathan
But still my xrays only cost £19. That was the full cost of the check up (Teeth count .... normal stuff + Xray)
Normal NHS Dentist.
/Johnathan
.
Hikari Kisugi I'm guessing you are an associate who earns 45/50% of gross regardless of overheads and direct costs. Of course, you are right it shouldn't be 90 mins, it should be longer. Here is my timing for RCT-if you can give me your own timings, I would be very happy to share the secrets of your success. Please feel free to shave some time of my own if you can find it anywhere.
Surgery prep 5 min
Full radiographic assessment from pressing button to reporting 2 min (longer if further assessment required or non-digital)
Diagnosis inc pulp testing etc 5 min
Proper discussion and treatment plan 10 min dependant on patient needs etc
Rubber dam prep & placement 5 min
Proper canal access 5 min
Full entry tapering-normally with full set of Gates-Gliddon burs 3 min
Access full length of canals and assess lengths with apex locator 10 min
Proper instrumentation of canals 30 mins minimum if irrigation is to be effective
Radiographs 2 min (longer if non-digital or needs adjustment)
Proper obturation 10 min
Full coronal seal as per current teaching with resin-bonded material as crown core/white filling 10 min
Further radiographic assessment 5 min
Surgery clean and turnround 5 min
These timings assume that everything including anatomy, patient needs, core, etc goes according to text book...if you don't book a contingency time then you are doing yourself and your patients a disservice and/or you don't mind keeping everyone else (staff/patients waiting inordinate amounts of time).
With regard to cost of equipment if you ever have to pay to set up your own surgery...I think you might be in for a shock-remember you don't just buy the equipment and plug it into a socket-it needs to be powered, and serviced and drained etc.
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Associate
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I was at the dentist this morning. Check up, polish, x-ray for £14.50. Taken bang on time. Gotta love the NHS.
Ps
Hikari Kisugi;
So you regard people who research into cross-infection and protection of patients' lives as "chumps"...astounding from a healthcare professional!
And while undoubtedly proper dentistry is not cheap, and paying a lump sum for quality healthcare is certainly difficult and occasionally impossible for a patient, the statement "our patients simply can't afford anything else" is meaningless. On what do you base this? Do you mean that they, understandably, choose the cheaper option (albeit with greater risk of failure, or worse) and then, again understandably, choose to spend their money on other things, cars, holidays, clothing, hairstyling, entertainment etc? Who can blame them, but do you think they would still do this if they were fully aware of all the facts-as I have quite clearly laid out? Do you not think that offering payment options or insurance to allow your patients access to the things I have pointed out might be in their interests?
I would still love to hear your timings for a root canal treatment if you can do it properly in less than 90 minutes.
.Well, if that was the case, surely she would have recommended the filling instead? They would have generated a lot more income that way...
And as always, if you don't want to pay the premium then just go NHS (and take the downsides that go with it).
Soldato
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Well, your RCT time seems to start from your diagnostic steps, rather than a treatment step. I just ponder how you manage to know people will need a 90 minute appointment for treatment with RCT when you haven't diagnosed the issue, and as you say 'if you don't book a contingency time then you are doing yourself and your patients a disservice'. I'd remove your initial timings for the treatment as they are clearly diagnosis, and most of these won;t result in an outcome of RCT.
What system are you currently using for canal instrumentation and obturation? Personally, after I open and flare using an SX Protaper file, then apex locate, then instrument prior to obturation. It would be a rare occasion now i would use gates gliddon burs, especially a full set, unless you're working on an upper incisor, but I thought we were speaking of molar work.
As for your other barb regarding what people spend their money on, they are offered a full range of treatments in all case, even NHS exempt, so they can have a private molar endo done if they wish, yet to see anyone accept the offer when they can have it completely free.
I'd agree with you that RCT isn't cost effective on the NHS, but then neither is crown work unless doing multiple units or denture work, but when you sign a contract you sign to offer people their choices.
Finally, the 'chump', a person demonstrated the theoretical risk of prion tranmission, in light of this, entire health service policy for dentistry was changed. If the evidence was looked at in its entirely, a different result might have been applied. From what I recall, the evidence was based on mice and hampster (maybe gerbil) models, and has since been extrapalated to incorporate sailva tissue and extracts and gingival tissues. It would suggest that handpieces are as likely a source as files, yet one is single use the others are not. They've introduced a halfway house policy, as a knee jerk reaction to a problem that may not even exist, yet they still encourage the placement of amalgam....
I am trying my best to remember the chaps name, as I find it hard to call him anything bar chump, as thats what a microbiologist friend who met and discussed things with him referred to him as (privately of course, not professionally)
So i would like to rebutt your comment
'So you regard people who research into cross-infection and protection of patients' lives as "chumps"...astounding from a healthcare professional!'
As that isn't my viewpoint at all, its what you assumed from my use of a single word. Glad you allowed me to clarify. Hopefully you won't be as astounded in future.
So you diagnose for free! I don't. Still care to share your timings?
And your argument about cross-infection control is what exactly? What has amalgam got to do with it? Who are the "they" that encourages its use? I'm not prepared to gamble with my patient's lives so I am quite happy that my knee-jerk reactions are still fully working. A knee-jerk has traditionally been a sign of good health and hopefully will continue to be so.
As for your use of the "single" word "chump", are you suggesting that it has somehow become a positive and has suddenly lost the clear negative meanings that it has had for decades?
Whether you personally agree or not, you are breaching guidelines if you re-use your instruments, and single use instrumentation involves a significant cost.
they are still better than mechanics though you can take your car in they do some work replace something and then it turns out that wasnt the problem , your down a few hundred quid and they need to try to do something else!
my dad has some garage fix the same problem 4 different times before they eventually fixed what was wrong.... clowns i swear
Free extensive check-up, 2 xrays and a plack and tarter removal total £14 I'm with you, you have a good attitude; my dentist is much the same, always erring on the side of caution.
I recall having spent almost 2 hours once having RCT on my lower third molar (at least I think it's a 3rd molar!, lower back), on account of strangely shaped roots? (is root the correct term?, anyway..), he went on and on with the beeping hook thing, and I recall having an xray or two during, or something like that, it's been a while..
Anyway, end result - root removed, everything filled nicely, zero complication since. It's never been a problem to me, and so it was worth the time, and the cost.
I've had a fair bit of dental work, and I'd rather a strict dentist who's primary interest is level of care, rather than a visible consideration for cost/overheads, getting people in and out the door, etc.
I go, he plays nice music, nothing's rushed or hurried, it encourages confidence; which is bloody important when there's a guy cutting your gums or drilling your teeth (and you don't happen to enjoy either..). It costs more money, but you do get what you pay for. IMO anyway, it's just part of a different approach to dental care than I've experienced with the 3 NHS dentists I've used. I'm not a dentist, so I'm talking purely from the perspective of a patient.
I've just paid £1800 for two new crowns a a tiny bit of restoration work. These are my front teeth, the last time I had one done was by a NHS dentist, it was awful, huge size, wrong shade and didnt match my veneer at all. I decided to go private and have both front teeth done.
So far I have my temporaries on and had a 1 hour consultation with the two guys who will be making my new crowns, i'm really pleased with what they have come up with, they look natural and you won't be able to tell that I had crowns at all.
For me it's worth spending the money on getting decent teeth.
So far I have my temporaries on and had a 1 hour consultation with the two guys who will be making my new crowns, i'm really pleased with what they have come up with, they look natural and you won't be able to tell that I had crowns at all.
For me it's worth spending the money on getting decent teeth.
Man of Honour
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Got my last unscheduled xray for free from mine.