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Scores of patients are being forced to pay for private dental treatment because of a continuing lack of NHS dentists, a large survey suggests.
Almost a fifth of NHS patients have gone without treatment because of cost. Others are even resorting to extracting their own teeth after the largest shake-up of NHS dentistry in 50 years. According to the Government’s own estimate, more than 2 million people who wish to access NHS dental care are unable to do so. In April last year, ministers introduced a new dental contract, which aimed to increase access and simplify charges.
But the Dentistry Watch survey conducted by Patient and Public Involvement (PPI) Forums throughout England suggests that a majority of dentists believe that the quality of patient care has declined since the changes and that huge problems remain in finding dentists who will accept NHS patients. For example, when a new dental practice opened in Portsmouth in April hundreds of people queued around the block to register.
Between July and September this year 5,212 patients and 750 dentists were asked for their views: 78 per cent of private dental patients reported abandoning the NHS because either their dentist stopped treating NHS patients, or because they could not find another one who would.
Of those patients not using NHS dental services, 35 per cent said it was because they could not find an NHS dentist close to their homes. Only 15 per cent claimed it was because they believed they could get better treatment. Six per cent of patients said they had treated themselves, including extracting their own teeth, because they were unable to get treatment.
The arrangements under the new contract have been criticised by dentists as a crude, target-driven system, which does not encourage them to treat complicated cases or take on new patients.
Of the dentists surveyed, 45 per cent said that they were not accepting any more NHS patients and 58 per cent said that the quality of care patients have received since the introduction of the new dental contracts has got worse.
Nearly three quarters said they were aware of patients declining treatment because of the cost. However, 93 per cent of patients receiving NHS treatment said they were were happy with the treatment provided.
Sharon Grant, Chair of the Commission for Patient and Public Involvement in Health, which organised the survey, said: “These findings indicate that the NHS dental system is letting many patients down very badly.
“It appears many are being forced to go private because they don’t want to lose their current trusted and respected dentist or because they just can’t find a local NHS dentist. This is an uncomfortable read for all of us, and poses serious questions to politicians.”
Commenting on the findings, the British Dental Association said that the survey highlighted the “serious concerns” about the impact of reforms to NHS dentistry in England.
Susie Sanderson, chairman of the association’s executive board, added: “The new contract has done nothing to improve access for patients and failed to allow dentists to deliver the kind of modern, preventive treatment they want to give.”
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hi i have spent alot of time in the dentist but now i have come to a point where i have let things go because of cost for repairs i need i am at present supergluing a filling in my font tooth every other day i have got to a point now that i am embarassed to smile would realy apreciate some advice many thanks
rob edwards, wolverhampton, england
people think dentists went private only to make money, well why did they not do that in the many yearspreviously. the reason they went private is because the nhs system is totally underfunded and it affects the dentists ethics.im a dentist and i can tell you so much but listening to some of the comments, i think most of you have already made up your minds.
what people forget is teeth are part of your health, if you valued them, you would spend your money on them and not on a trip to get a suntan.
if you are lucky to get a good ethical dentist like me, u are one of the lucky few but remeber tou get what you pay for.
lastly you cannot take your own teeth out withou leaving in the roots which means the pain wont go away, we are educated professionals, leave it to us.
bill, london,
Yes - and I did a good job too. Half of my upper right molar fell off so I was left with a large jagged bit that obviously had rot in it. I used pliers to break of the top and then filed the tooth down. Very comfortable result and still have some tooth left. I refer you to Woody Allens article "If Dentists were Impressionists!"
Christopher Stuart Brighton
Chris Stuart, Brighton, UK
Kevin Murphy of Birmingham - dentists are not failed doctors - they have a completely different training! Indeed doctors who want to become dentists (many) have to study for the whole 4 year course! (having already done 5 years at medical school to qualify as a Dr).
In fact, dentists have much more potential income than doctors because of the possibility of large amounts of non NHS work. They have always been much richer than Drs, because they are not almost entirely beholden to the NHS which keeps rates low.
Mr Brown should learn the lessons of the dental fiasco - encourage private provision in medicine and watch GPs follow the dentists - he will finally have to pay market sized rates for these highly trained professionals who take enormous responsibility - then watch costs escalate!
sarah, york, york
My Dad pulled my tooth out with a pair of pliers when I was 7.
Terrified me at the time but at least my tooth ache stopped.
Phill Barlow, Wirral, England
I think a lot of dentists in the West Midlands will now have Kevin Murphy's name written down somewhere!!
Toothsmith, Nth Yorks, Nth Yorks
I was quoted an exorbitant amount for 2 fillings so I bought a tube of Tooth-Fil and did it myself. Perfect and all for less than a fiver!
Alan, Chigwell, Essex
I have had a permanent inlay fall out. It basically needs to be stuck back in position. No NHS dentists available, so took a private consultation. Would charge about £450 for a new inlay (cast, mould etc). Can't afford it, so tried to buy dental cement over the internet, however, only temporary stuff available in the UK (not even ebay; guess it must be prohibited - no wonder people use super glue, even though it's supposed to be toxic to the tooth. Anyway, managed to get a bit off a friend who lives abroad. Am now looking for instructions on how to mix the stuff. Hopefully will get suitable info and will then cement the thing back into place. Luckily no deeper cavities or even this would not be possible.
Sanjay, middlesex,
I moved to Taiwan a couple of years ago and have been amazed by the standard and availability of dentists here. I can count at least half a dozen dental clinics within walking distance of my home in Taipei, all with excellent facilities and dentists generally trained in Japan or the States. I could walk into any of them and have an appointment the following day at the latest. Treatment is very reasonably priced and virtually nil when you're signed up to the national health insurance program (premium about ten pounds a month.)
Don't know what to suggest for the UK though - perhaps we need a new wave of Polish dentists?
Charlie, Taipei, Taiwan
Feel strongly about this one then Kevin?
Damian, Reading,
100,000 pounds a year should be enough for anyone trained at public expense to provide a social service. Of course the culture of naked greed for which we can thank dear Baroness Thatcher's governance, now dictates it is not nearly enough and so called professionals must have five bedroom houses, plus a weekend home and perhaps a cottage in Tuscany, high end cars, thanks Clarkson(two of course) and send their kids to private schools.
Thanks to celebs and the insane media everybody who can screw the maximum cash out of the rest of us will do so.
Sense of duty - forget it!
Teachers and nurses work far harder than dentists and get far less pay.
billcarr, turku, finland
after paying £40 for a very loose tooth to be pulled years ago I vowed never again. Now I've only got 12 teeth left after pulling my own for 10 years. Unfortunately, I've not got the skills to make myself a set of false gnashers so I'll have to stump up for a set of gnashers from a dentist. Grrrrrr!
richard lord , worcester,
I had to go to the dentist after being in some pain for several months and had to have two root canals. This cost me £1001 i have to go and have hygienist appointments regularly which are £50 a time and also a check up is £50 a time. Just found out I have to have another two fillings which is costing me £250 then have to have my root canals crowned which is a further £900 which leaves me in a right financial state before i can actually sign on to a Denplan as no NHS dentist would take on any more patients. I do not earn enough money to afford this and have credit card debts because of it (and i never wanted a credit card but this was the only way to fund this and stop the pain). A friend of mine also has problems with their teeth and has been contemplating pulling his own tooth as he cant afford to take the time off work to go to the dentist let alone pay for it!! I think it is completely extortionate and have no idea how people think we can afford this plus the cost of living.
Hannah, Reading, England
Ah! Now I understand when visiting your very beautiful country I aint seeing any smiley faces.
robert, vancouver, bc
I agree with most of the comments made. I have two further points.
First, Dentists know they have a captive local market hence going private forces the people around to pay. Naturally, they will then be paid more than any NHS contract. If this was a normal business, it would be refered to the monopolies commission. We have paid for Dentist's education and now they bleed us dry.
Second, the current government has done nothing to stop this flow to the private sector, seeing it as a way to reduce health expenditure - much the same way they have invested little into Council sports facilities allowing the private sector to pick up the market.
I for one am angry with Dentists, by running for the money and abusing the situation the govenrment has created. They have degraded their profession and put the nations dental health at risk.
Adrian James, London,
Kevin! since april 2006 a patient is NOT registered with his dentist. I would like to tell you that the dentists DID NOT WANT this last "Reform" in the dentistry. The old system was severely underpaid, but it worked (sort of). The Government forced the dentists into accepting the new systen. Unfortunately for the patients and the dentists it is extremely badly constructed. Have you heard about the added funding for Dentistry? NONE of the money has reached the "grassroots" ! It has all been spent on new "managers" etc. We talk millions of pounds every month! If that money was given to the Clinics, everybody would have an NHS dentist and receive quality dentistry!
Jan Pultr, Georgetown, Grand Cayman
TO ROARKE:
My wife is a hygeinist here in the States. I assure you her skills are no 'con'. Its commendable that you have the natural talent to clean your own mouth. However many people dont bother. The discomfort they feel after a cleaning is their own fault for either not brushing regularly or at all. She is highly trained and very professional. I know of 2 occassions where she idenitified oral cancer in patients, possible saving their lives. I doubt your kit has tools for that.
joe, myrtle beach, usa
My last dentist appointment was a complete joke. and a complete waste of my time and money. My dentist couldnt speak English (fluent Polish though) and through the school girl assistant i was advised my teeth need to be cleaned by a hygienest and another appointment made and 35quid lighter. I didnt need a dentist to tell me this.
When it comes to work being required they also cannot be bothered, especially if it is near there lunch break!!
On the other hand, Ive had fantastic treatment in Bosnia of all places and was charged less than seeing a hygienest!!
Scrap the NHS, what a waste of money and lower our taxes!
Alan, Dublin, Ireland
The "hygeinist" is the biggest con of all, I bought a DIY dentistry kit from my local chemist with all the tools, and descale and gently clear my gum line to perfection every few weeks. I still go for regular checkups, but even my dentist comments on how clean my gum line and teeth are, completely tartar and scale free. Saves me £35 twice a year, plus I do a better job, completely free and with no discomfort , swelling or infections afterwards. And because I do it more regularly than if I left it to a hygeinist, my gum health is permanently good.
Roarke, Wembley,
About 7 years ago, I had a permanent brace fitted to the inside of my lower teeth. The brace was intended to be there for the remainder of my life. A couple of years after the treatment finished, the brace became loose and one of the wires began to cut into my gums. I was no longer covered by the 1-year after care service and couldnât afford the cost of the remedial work. So I used a pair of pliers to remove the brace completely. It took a couple of hours and caused a fair amount of pain but I had no choice.
I donât know what Iâd do if I had something wrong with my teeth or gums that wasnât cosmetic because Iâm not rich enough to afford the treatment Iâd need and not poor enough to get it for free.
Alan Thomas, Ruislip, UK
People have been pulling their own teeth out for decades - I have heard these stories over 20 years ago when NHS dentistry was free for many folks. You the public have been paying for NHS dentistry at the point of delivery for years too. It has not been free for decades, unlike your doctor. And dentists are not failed doctors as a badly infomed "expert" above states - I never wanted to be a GP and still don`t. That is 50 years ago not today. One interesting fact you might like to know is that the fees paid to dentists on the NHS are pretty much the same in real terms as they were in 1948. So if you want the same dentistry of 1948 thats OK but you won`t be able to get it because modern dentists use much better cross infection contoles, local anasetheics, materials and staff than they ever have. And that costs MONEY. Govt has NEVER funded this.This is why so many GDPs have been FORCED to go private. Purely to keep their own business afloat. Both shades of politicians should hang their he
Andrew Adey, Wolverhampton,
It is known worldwide among dentists that the quality of the British NHS dentistry is one of the worst in the world. Workmanship, materials used etc. All this because the fees are so low. Yes, we pay all pay tax. But do people know that each tax payers contibution to the NHS is one of the lowest in the EU? You get what you pay for! And do not forget, we all know how to avoid getting decay and gumdisease! it is simple!
Brush more, eat less crap!
Jan Pultr, Georgetown, Grand Cayman
after twenty years my crowns are now crumbling off , leaving sharp edges.
i regularly attempt to smooth them off using a diamond file purchased from a tool shop
john borg, london, england
If you're going to change a system it makes good sense to carry out pilot studies where all the proposed new systems can be tested. Surprisingly, this was done, unsurprisingly, (let's face it we're talking about the DoH here) the results of the pilots were ignored and an untried and untested system imposed upon dentists and public alike. The British Dental Association tried to tell the government the system was fatally flawed and the DoH (perhaps HoH -hard of hearing - would be appropriate here) refused to listen. Barry Cockcroft (Chief Dental Officer), a reasonable fellow, having taken the Queen's shilling, became, and continues to be, nothing more than a mouthpiece for a policy which has singularly failed the public. It is embarassing to watch him arguing that the emperor has magnificent new habilliments when it is becoming clearer by the day that it's all hanging out!
The GDC - whose job it is to protect the public - remains silent - too many gongs to surrender perhaps?
Bill Q, Derby,
My 73 year old father pulls his own teeth out with pliars whenever they get to the rotting stage. But then, he doesn't value them. He could never be bothered to learn how to care for his teeth and gums properly and has spent the last sixty years gorging on lard, salt and beer.
I've spent the last fifteen years paying extortionate amounts to put right all that the NHS did wrong to my teeth in the 70's, and now wouldn't go near an NHS dentist if paid to do so.
Alice, London,
It is a disgusting state of affairs that one cannot get NHS dental treatment anymore in the 21st Century . WHY has this suppose Labour Government ( I don't think that they are actually Labour at all as they sure as hell do not look after the workers, only themselves) let the NHS deteriorate to such as extent ?.
I live in Woking, a town with population of 80,000 or so and there is not even 1 NHS Dentist here. All the Surrey PCT does when you complain is say that it is the Government's fault etc etc. You know, all talk no action to cure the problems.
So when Labour got into power 11 years ago it sang the song "it can only get better" , well Im sorry but that sure is not true as it has got far far worse.
Shame on this Government and shame on it for bringing the true values of Labour into disrepute.
John, Woking, Surrey
We pay tax. We pay for a National Health Service but somehow teeth and gum deiseases are not covered by our National Health Service. Everybody at the point of need should be entitled to teeth treatment on the NHS. The current situation is a national disgrace. I feel i want a refund of my taxes. I feel that i have been conned. It seems teeth are exempt from our NHS why?. Why are people silently putting up with this sham? Sort it out Mr Brown and sort it out now. As for Dentists, you have betrayed loyal patients some of whom have been with you for years registered for NHS treatment and all of a sudden you decide you are going fully private. Shame on you and you Professional body for not sorting this out. The truth of the matter is most Dentists are faild Doctors who have seen how well the Doctors and GP's negotiated big pay rises but Dentists professional body failed to do the same for Dentists. Shame on you for holding patients to ransome.
Kevin Murphy, Birmingham, United Kingdom
The British Dental Association SHAME ON YOU. In 2007 we have people people at home pulling out their own rotten teeth with household pliers because your members are holding the public to ransome. Why? because you failed to get the deal you wanted from the Government. I have not spotted a POOR dentist yet. Dentists have done huge damage to themselves in this selfish action . The word Dentist is now a dirty word.
Kevin Murphy, Birmingham, United Kingdom
We pay tax. We pay for a National Health Service but somehow teeth and gum deiseases are not covered by our National Health Service. Everybody at the point of need should be entitled to teeth treatment on the NHS. The current situation is a national disgrace. I feel i want a refund of my taxes. I feel that i have been conned. It seems teeth are exempt from our NHS why?. Why are people silently putting up with this sham? Sort it out Mr Brown and sort it out now. As for Dentists, you have betrayed loyal patients some of whom have been with you for years registered for NHS treatment and all of a sudden you decide you are going fully private. Shame on you and your Professional body for not sorting this out. The truth of the matter is most Dentists are failed Doctors who have seen how well the Doctors and GP's negotiated big pay rises but Dentists professional body failed to do the same for Dentists. Shame on you for holding patients to ransome.
Kevin Murphy, Birmingham, United Kingdom