Quality of NHS dental treatment?

Discussion in 'Dental Archive' started by Dominic, Dec 20, 2003.

  1. Dominic

    Dominic Guest

    I have a new dentist, and he seems pretty good. My only misgiving is
    that he always seems to pushing me to go for private treatment even
    though I am an NHS patient.

    Specifically, he recommended two molar fillings should be done
    privately so that he could use white material, as this is longer
    lasting (I am not obsessed with the cosmetic appearance of my teeth).
    A root filling on a front tooth he suggested should also be done
    privately, as the NHS would not pay for enough time or the best
    material for the job to be done properly.

    I don't really doubt him, but of course I am mindful of the fact that
    dentists do have a conflict of interest in this area. And the total
    cost is not insignificant. So I ask with an open mind, what do others
    think about this?

    And is it worth being an NHS patient? Apart from saving me a couple of
    pounds on my checkup, it only seems to entitle me to a small discount
    on inadequate treatments.

    Dom
     
    Dominic, Dec 20, 2003
    #1
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  2. Dominic

    Vaughn Guest

    Hmmm...It sounds like a typical dental plan here in the USA.

    Vaughn

     
    Vaughn, Dec 20, 2003
    #2
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  3. Dominic

    carabelli Guest

    Hillary - 2008

    carabelli
     
    carabelli, Dec 20, 2003
    #3
  4. It's the insurance game.
    "Plan" is the right word. exactly what is the plan???
    In Russia during Communism the workers had to fulfill the "plan".
    if the plan called for a furniture maker to make 40 chairs per day and
    he was incuraged to make more and made 41 he will become the employee
    of the month. But if the next day he made 40 chairs heads would roll.
    It does not matter what the quality on these chairs is, the foreman
    had to count 41 chairs.
    Just a Thought.

    Alexander Vasserman DDS., BS.
    www.smilesbyalex.com


     
    Alexander Vasserman DDS., BS., Dec 20, 2003
    #4
  5. On 19 Dec 2003 18:35:26 -0800, (Dominic)
    wrote:
    Why not? He is baiting-and-switching you from the $2 treatment for
    something better .......

    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 20, 2003
    #5
  6. Exactly what I was thinking ... capitation gets people in the door and
    then the dentist must CONCOCT a better treatment plan or go broke in
    the process!

    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 20, 2003
    #6
  7. Wow! So all the Russians were "sitting down" on the job ........

    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 20, 2003
    #7
  8. (Dominic) wrote in message news:<>...
    Don't know about white fillings being "longer lasting"... (Joel?) not
    from what I've read re. molars, anyway.
     
    outsidethebox, Dec 21, 2003
    #8
  9. And you guys believed we were a threat during the cold war
    wasn't that silly?





     
    Alexander Vasserman DDS., BS., Dec 21, 2003
    #9
  10. Say it isn't so!!!!

    news:xqQEb.495331$...
     
    Florida Hygienist, Dec 21, 2003
    #10
  11. Yup, it was actually the Eskimos that had all of the ICBMs .......


    That's spelled icy BMs ..........



    On 20 Dec 2003 22:46:40 -0800, (Alexander
    Vasserman DDS., BS.) wrote:
    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 21, 2003
    #11
  12. White fillings have good longevity ........... 15 years ... 20 years
    .... maybe more. They have not been around as long as amalgams, but
    they have come a long, long way.


    Joel

    On 20 Dec 2003 19:35:06 -0800,
    (outsidethebox) wrote:
    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 21, 2003
    #12
  13. Aaahh... cheers Joel, it can be hard to know which sources of
    information to trust sometimes, everyone seems to quote different
    life-spans and different advice on when fillings should be replaced,
    which can be pretty confusing for the consumer.
     
    outsidethebox, Dec 21, 2003
    #13
  14. Only replace when new decay is evident, or for cosmetic reasons, if
    you prefer the white look to the dull metallic look.


    On 21 Dec 2003 10:26:28 -0800,
    (outsidethebox) wrote:
    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 21, 2003
    #14
  15. Who says four years ......?


    Re: Quality of NHS dental treatment?
    Date: Sun, 21 Dec 2003 21:04:28 -0000




    white fillings on back teeth have a much shorter
    average lifespan than 15-20
    years.
    they average 4 years at the back of the mouth with
    amalgams lasting double
    this time. that is what the evidence says.
    on molar teeth as a direct restoration amalgam is
    still the most long
    lasting and if you dont care about aesthetics then
    this is the way to go.
    if you are a registered nhs patient and your dentist
    suggests a treatment
    can be done better privately, as appears to be the
    case with the anterior
    root canal treatment then you can compain to the
    health board as this is
    breach of contract.
    what he is saying is that he is prepared to do the
    work under the health
    board but it will be of poor standard. if that is his
    philosophy then he
    should resign from his nhs contract and go purely
    private.
    if you accept the fee then you must do the treatment
    to the best of your
    ability.
    the general dental council are very interested in
    dentists like yours.
    i hope this info helps





    *******



    On 19 Dec 2003 18:35:26 -0800, (Dominic)
    wrote:
    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 21, 2003
    #15
  16. It should be to the standard of health.

    Also posterior composites last longer than 4 years.
    I have patient with ones done 7+ years and counting.
    the study you mentioned may have been done with older composites or
    when the techniques were not fully ironed out.



     
    Alexander Vasserman DDS., BS., Dec 22, 2003
    #16
  17. Dominic

    david Guest

    because you have patients with posterior composites lasting greater than
    seven years is irrelevant.
    i have a post crown in my mouth which has lasted >20 years. it does not mean
    that the average lifespan of a post crown is therfore around 20 years. with
    your logic it does though.
    in an age of evidence based dentistry you have to go by the facts.
    there has been no study that suggests that the average lifespan of a
    posterior composite approaches anywhere near 15-20 years.
     
    david, Dec 22, 2003
    #17
  18. I flip a coin ........

    --
    Joel M. Eichen, .
    Philadelphia PA

    DISCLAIMER FOLLOWS:

    *********

    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    STANDARD DISCLAIMER
     
    Joel M. Eichen D.D.S., Dec 22, 2003
    #18
  19. madiba wrote:
    Yeah, I've seen some. Most of them show significant wear and significant
    incidence of recurrent decay. However, these problems have been addressed and
    the penalty in terms of mechanical properties (when compared to amalgam) has
    continually decreased. The penalty hasn't disappeared, though. Case
    selection and careful technique are still important in restorative care.

    Steve
     
    Mark & Steven Bornfeld DDS, Dec 22, 2003
    #19
  20. What's the story with amalgams that have been placed in the absence of
    decay 15+ years ago (as a result of dentists taking advantage of
    certain insurance schemes, not in the US, I should add)? Should they
    still be replaced? Or can you just leave them in?
     
    outsidethebox, Dec 23, 2003
    #20
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