A painful dental check-up

RuthEmery's picture

 No one likes going to the dentist. It’s never comfortable opening your mouth (‘Wider please,’ they say. ‘Open wider!’) and having every single tooth prodded and scraped. Not to mention the unlucky ones who get the pneumatic drill experience of having a filling and their mouths stuffed with cotton wool as they gasp and gulp and blink tears away.

And what about the nauseating clinical smell of the dentist; the patronising talk about how you should floss every day; the scolding about how even sparkling water and fruit juice can damage your teeth?

Factor in the difficulty of finding NHS dentists and scary stories of dental malpractice and it’s no wonder there’s an intense fear of going to the dentist.

Much of today’s society is just not bothering to get their teeth checked. This summer it was revealed that a third of people in Sheffield have not seen an NHS dentist in two years and more than a third of people in Barnsley - 38 per cent - have also not visited an NHS dentist.

Well, I’ll put my hand up and confess that I didn’t see a dentist for a whopping seven years. From age 16 to 23, I didn’t once sit in a dentist’s chair. Probably something to do with my children’s dentist not accepting me anymore and A-levels and university getting in the way of me taking the time to find a new dentist.

You’ll be pleased to know that I am now getting annual check-ups. But one experience with an NHS dentist has left me far from pleased.

Four months ago I went to my dentist in Elephant & Castle, London, for a check-up.

I was told that I needed two, maybe three, fillings. She then told me that she couldn’t do all the work on the NHS.

Now, the NHS stipulates very clearly that if an NHS patient is accepted at a dental practice (I was accepted  at the surgery 16 months prior to this incident), then all dental work must be done within the NHS bands, and paid for accordingly.

For ‘two or three’ fillings this falls under Band 2, which is a flat charge of £45.60. ‘This covers everything listed in Band 1 [exam, diagnosis, scale and polish] plus any further treatment such as fillings, root canal work or if your dentist needs to take out one or more of your teeth,’ says the NHS guidelines.

I knew my rights, so I argued with the dentist, saying all the fillings should be done on the NHS and I should pay £45.60 for this.

She responded by saying that the treatment would ‘bankrupt’ them if it was all done on the NHS, and that she would only do one filling on the NHS, the rest would have to be done privately (incurring additional hefty fees).

I wasn’t sure what to do. If I walked away and found another NHS dentist, I’d have to pay them £16.50 for the check-up anyway, and then a new fee of £45.60.

So I went back to my dentist a week later to see if I could reason with her again. This time, she’d changed her tune. She told me that she’d do the one filling today, and the other filling was small and could be done in three months time. So the dentist would then pocket another £45.60. The third filling? ‘No, you don’t need a third filling. Just one today, and one in three months time.’

To this day, I’m still disappointed in myself that I eventually agreed and had the one filling, and didn’t instead get straight on the phone to my local primary care trust (PCT), exposing this malpractice.

I didn’t go back to that dentist for the second filling. I have now moved so I found a new NHS dentist in Hackney, which was recommended to me by a friend.

I went there last week for a ‘check-up’, knowing that I’d need a couple of fillings. My nice new friendly dentist asked me when I’d had my last check-up, which meant I ended up regaling the whole story as she was surprised that I’d had a check-up just four months ago.

There’s no other way to describe it, but she was horrified. ‘That is completely illegal! This is what gives dentists a bad name!’ she squawked. As well as chastising me for having snacks between meals and drinking too much alcohol, she also told me off for not reported it to the PCT, and not using my job as a journalist to expose her.

So here we are. The letter to the PCT went in the post later that day. And here’s my story for everyone to view online. I’m not going to name the dentist (I might later when I hear back from the PCT), but I would like to warn everyone about their rights when it comes to NHS dentists.

You could even take along a copy of the pay bands, which can be found on the NHS website, to the dentist. And if your dentist isn’t playing ball, ask to speak to their colleagues. If they all seem intent on flouting the NHS rules then contact the PCT as this is one dental practice that needs to be urgently investigated.

Oh, and so what treatment did my new dentist tell me I needed? Three fillings and a crown. 

Ruth Emery is deputy editor of Money Observer, Moneywise's sister publication

Your Comments

I had not visited a dentist since i was about 15 always brushed minimum twice a day and never ever had tooth ache or any other mouth problems (apart from normal stuff like the odd ulcer).
When I was 29 I visited the same NHS dentist my girlfriend at the time used just to please her as she thought I really should have a check up and join a dentist.
The dentist told me i needed fillings which shocked me she told me i only needed very small ones, but when she was drilling she was really forcing the drill it was as if there was no rot im no expert but I would have thought if I had genuinly needed fillings wouldnt my teeth have been easier to drill?
To this day I dont believe I needed fillings and since having them I have experienced tooth ache and sometimes discomform when eating ice cream and sometimes when drinking a hot drink or eating a sweet, needless to say I will not be going back to any dentist unless its a genuine emegency

My partner had some problems with her dentist recently - they gave her a denplan assessment (as we wanted to know what band she would end up in) however after telling her it would cost over £250 a year, we decided to stick with NHS and they turned around and said that she couldn't stay on NHS. Spoke to the local PCT who said there is nothing they can do about it.

When I go to my NHS dentist for a checkup they never give a scale and polish like they used to do but they always recommend that I see their hygenist, which of course is private and with a fee of £35.00 to £40.00.

Should I insist that the dentist does the scale and clean?

My dentist is on the panel which looks at dental fraud, so who do I complain to? I only have two teeth on top and 5 on the bottom row, and wear a denture. An exam only takes a couple of minutes, but he just makes up a price each time for looking-??
about £100. How can I check this is right? He also only takes cash - no cheques or credit cards!

You may wait quite a while for a repy from the PCT.

If you had been private your problem (no matter what) would have been sorted with in weeks not months, http://www.dentalcomplaints.org.uk/ is the website. It is run by the General Dental Council but as a seperate entity so there is no conflict of interest.

If the problem is not sorted via phone calls and face to face discussions between your dentist and yourself (surgery complaints proceedures), the last and ultimate option is for the complainant to ask for a meeting with the dentist and trained panalists from the DCS where the panel will listen to both sides of the problem and they will come to a none binding resolution, the meeting is none legal and is informal, out of thousands of complaints received by the DCS, there has been very few panels, this shows how well the DCS early resolution procedures are.

9 times out of 10 problems are caused by misunderstanding and using the Dental Complaints Service, as a third party aids a quick resolution.

Seeing NHS dentist for over 20 years and the service has deteriorated dramatically. They now use substantial overseas trained dentists and reluctant to do work. Always excuses.
Had check up April and complained about a tooth. Just said they would keep a watch on it. Had cost of check up to pay. I also see the hygienist, trying to be proactive about my teeth care, another £35+.
Had to make additional visit as tooth giving jip. Dentist still only saw the tooth and offered tablets, prescription charge over £7 + checkup cost of dentist (june 21st).
3 weeks later tried to get an appointment for the tooth to be extracted as playing up and difficult to brush as sensitive. My dentist, no appointment available and no one else would look at doing an extraction only another checkup ( £17). Declined. First available appt was 4 weeks later.
Waiting and spending money on asprins. Appt will be another £17 and I bet he only looks at it.
So it will cost me the equivalent of 3 checkups, 1 extraction, 1 prescription, at least. Plus all the time off work and travelling and parking.
Been paying my N.I. for over 40years.
Sucks - will it would if it was not so tender.
As the dental practice is the only NHS one locally available and they are not proactive, the first thing to go will be the hygienist.
Doesn't anyone want to look after not just my teeth, indirectly my health
The dental practice has a large number of dentists.
Would go private if coukld trust them to do excellant job at reasonable price.

I regret to say that in my experience, I'm 70, most dentists are interested in money more than in dentistry. That is unfair to the one or two excellent and honest dentists I have been treated by in the past. Some ,many, dentists do work that is not needed and also refuse to do work that is needed because, in their view, it does not pay them enough, despite the fact that Full Contract NHS dentists are OBLIGED to perform the whole works. Fact is, the average dentist earns more than the average doctor. Many dentists are screwing well over £100,000 out of the NHS, and some several hundred thousand pounds - after they have paid their business costs. Their are good honest dentist out there - unfortunately there is an awful lot of the other type.

Sadly, I've heard all these stories - and variations on a theme before. As with any profession there are and always will be rogues. We try to flush them out but it's a never ending battle. However could I point out that the situation referred to in the article relates only to England, here in Scotland we have an entirely different contract for NHS dentists. Problems still occur not along the lines described.

When the dentists joined the NHS about 1954 they visited my school and drilled for gold. That is all the kids had fillings and I personally had 20. When visiting a French dentistv in Canada and without specking he looked in my mouth and said 'You come from the UK'-he told me he could tell by the fact most expats from the UK around my age had been drilled 'for gold' that is gold for the dentists. Do I trust the dental profession ?

When the dental profession joined the NHS around 1954 they visited the schools to drill for gold. Many years latter when in Canada a French dentist looked into my mouth and told me I came from the UK, that was without me talking.He told me most UK expats he saw about my age had a tremendous amount of fillings due to the dentists drilling 'drilling for gold' at schools when they joined the NHS. Do I trust the dental profession???

I am frankly shocked by this piece.

Whilst I agree that the first dentist should be reported to the PCT, can I just point out that MOST dentists are not fraudulent and try to treat people as well as they can in a difficult and usually thankless job.

The lack of NHS provision in some areas is not the only reason why so few people attend their dentist regularly. Hatchet pieces such as the first two paragraphs are completely unnecessary and only serve to further deter people who are nervous from what in some instances could literally be a life-saving checkup.

My advice to the author is to be more responsible in their reporting (oh and look after their teeth better too ;) )

The government has changed all the fees that the dentists can get, and reduced them considerably, there used to be a time when if you were on benefits you could get a crown or a bridge but not now, I have been told I must pay privately for them. I had a denture and was treated very rudely when it would not fit properly, and I insisted on them correcting it, I was then met with well if you get a private denture we can do it good. It is all wrong. Dentists are ripping us off because the government has reduced the fees they can claim.

I never visit the dentist either until a few weeks ago when I had a definite problem. The dentist was private (recommended by a friend) but I had no time to look for the fast-diminishing NHS variety. He charged £40 to look and then a week later did the two fillings he said i needed. It cost another £216. I still had pain and told I needed the nerve out which I did as it was all getting too much . . that to my surprise cost another £210. I was told everything would be fantastic thereon . . no pain, no problem etc etc. NOT TRUE!!!!!! Invited to go back for further checks but I got upset as had spent about £500 already so the dentist saw me for the cost of the xrays only . . that was £18 . . . These dentists knew I had Multiple Sclerosis and I had mentioned I have no family help or support . . I have now been left with a large chunk of my savings gone and still in pain with no idea of what to do. The dentist's final comment was to see how it goes & then i'd have to go to a hospital dentist . . but to leave it for one to two months. I feel deszperate and so sad that this is allowed to happen.

I doubt whether someone on a private Denplan contract is unable to leave and register with another NHS dentist ( if they can find one).I am aware that some dentists have both private and NHS patients but I think most of these have gone wholly private.
If you write to the manager responsible for dentistry at your local PCT explaining the facts you should get better information , and as most PCT's have a dental patient waiting list you should be able to get an local NHS dentist without too much delay.
Many PCT's have board meetings at which the public may ask questions, so this is another way in which you could clarify the local NHS dental availability situation.Check this with their website.

One thing you seem to be missing is that each and every examination is where the practice "accepts" you - the fact that they did a course of NHS treatment yesterday is no guarantee that going back today gets you NHS. 16 months ago would have meant your registration had lapsed even under the old system. However when the governmebt introduced it "brave new world" it removed registration as well.

Would you go to Tesco's and expect them to allow as many trolleys as you like for £45? So why expect as many fillings as you like for £45? (Actually £29 since £16 is checkup etc). Like it or not, dentists are businesses same as any other and if they don't bring in enough money to cover bills and staff wages then they go bust same as any other.

There is a counter argument however, that the dentist involved was willing to accept you FOR THIS COURSE as NHS and then, yes, has to play by the rules. But all that will happen then is that less dentists will be willing to accept NHS patients. Which, as your other articles show is exactly what is happening! Get on to the government and ask them to pay what it costs to run a dental practice. Private prices are not "extortionate" they are what it actually costs to do a filling whilst complying with a never-ending increase in legislation and costs. To expect dentists to then do freebies for NHS patients is where the problem lies.

I'm afraid Ms Emery's experience is not unique at all. Dentists on the NHS are 'fiddling' the system. It is unethical. It is a scandal of huge significance for the dental health of our nation. The new contract offered to dentists in April 2006 has been a total disaster. The new NHS dental practices which have opened up since then have been telling their dental employees to ignore treatment that are needed, but only do one filling or extraction per visit. They then ask the patient to return in 3 months or more, so that they can charge the Band 2 scale of £45 once again for another filling/extraction. If you need more, then they just ask patients to come back in another 3 months, and guess what, they will only do one filling/extraction and charge patients a further £45. Absolutely appaling. Write to your local PCT now.

I got into my dentist after having to reapply lapsed member. It is a dentist/emergency pain clinic you can say that again. I had a denture plate & waited 8 weeks when my last one was made it was done in 1 week it broke so i had to go out which affected my confidence im a 32 yr old women. my new lady dentist was polish. Who was not at all smpathetic with my needs very rough & didnt listen to what i was sayin she had no time at all rude wasnt the word it was always an ordeal. I complained to the receptionist very politley and asked to exchange to the other dentist in same practice and said i never got my teeth cleaned & polished & id like another appointment with new guy. I was told to come back in 6 MONTHS eh! "why"? i needed work as soon as. so i was flabbergasted i didnt go back i now need 8 fillins atleast i only needed 2 back then I need to change dentists i dont have alot of faith now my teeth have deteriorated, but i know there are good dentists ive had one/two in past.But im upset cos they made me feel bad i had phobia with dentist till i met the good one. that horrible dentist only seemed to be interested in paying or customers in bad pain wanting teeth out or pain relief they take too many patients on greedily & dont treat you with respect, in this day & age its terrible ive paid my tax's There needs to be more help its not right but who cares enough to do anything that can actually do something. & sombody backing the dentists yeah fine there are some but dont say the prices are not extorsionate im on benefits due to bad health, i get £77.46 weekly for bills, food travel to live i cannot afford £1 a week N.H.S are ment to pay. or if we all could go private we would & noone would have this hassle. ARGH! some people dont even know they are born saying we should pay what about WE CANT! thankyou for reading to me rantig its this problem that has affected the past year in a very negative way.

I had "avoided" the dentist for about a decade, but was forced to go by broken and painful tooth. Believing that its almost impossible to find an NHS dentist these days I attended the dentist my wife and children use. He is a private dentist but I was still shocked when he wanted to charge me over £700 for 3 fillings and a root canal. I made up an excuse for not booking another appointment. I called NHS Direct who were able to give me a list of the NHS dentists accepting patients in my area. I had the work done by a very nice lady dentist and it only cost me £46.00.

My dentist decided to go Private a couple of years ago. Rather expensive so my wife registered us with a new NHS dentist.some months ago.
A few weeks ago we both had our first checkup with the new practice. My wife was very pleased. Me, not so sure.
I took my upper and lower titanium plates with a few teeth on both. In order to show the new NHS dentist  and to explain that one of my teeth on the bottom that the plate grips around  had lost the filling and a chip of the tip of one side was gone. This made no difference to how the bottom plate was held. Just that the middle of the tooth was gone.
So the dentist (Chinese) looked at the hole. I showed him how my plate fitted to make sure that he filled the tooth taking into account the clip of the plate would have to it over the newly filled tooth.
The dentist said he could fill the tooth but I would have to have a new plate and said it would cost £300 +. I was surprised to say the least. Here was a newly qualified dentist and not able to fill the tooth taking into account the existing plate!  By the way my false teeth are only used on occasions when a steak is tough.
Since the tooth in question was not causing a problem at the moment I said I would leave it.
So a few days later I made an appointment with my Private Dentist. He did a check up. Saw the hole and of course he knew that I had  false teeth. He went ahead and filled the tooth making sure that the plate still fitted.
Guess what? My bill was £35.00!  No injections were required as the tooth was more or less dead,
Should I have spoke to the PTC regarding my experience. There is a strong  possibility that the Chinese  dentist is going to rip off his new customers.

  Wow it seems like everyone has a story to tell when it comes to finding a decent NHS dentist you can trust or being given dodgy treatment by both NHS and private dentists. 

As one of you correctly guessed, it has taken a long time for my local primary care trust (PCT) to send me a response. I still haven't received a reply...

Regarding scale and polish, this should come under the NHS fee (so, included in the £16.50 if it's just a check-up, or in the £45.60 if you're having fillings/root canal). However, many dentists like to refer you to their hygienist which you will have to pay for separately, often between £30 and £50, where you will get a more thorough treatment as they floss each tooth individually. You are perfectly entitled to refuse this service and ask for the basic 'scale and polish' from your dentist though. To look at the charges and what is included in each NHS payband, go to this page: www.nhs.uk/chq/pages/1781.aspx

Finally, for those of you who feel the service you received was not up to scratch, then you should write a letter to your dentist or complain to your local PCT.

You should also look into switching to a different dentist. It often hits the headlines about how difficult it is to find an NHS dentist, but I've never had a problem - maybe that's down to living in London and a little bit of luck. To find a nearby NHS dentist, go to the NHS website (www.nhs.uk) then on the left-hand side you'll see 'Find and choose services'. Type in your postcode and click on dentist. Then it'll come up with the dentists closest to your home. By clicking on each one it'll reveal whether they're accepting new NHS patients or not. Alternatively, you can call NHS Direct, as Mark Stammers who replied to this blog did, on 0845 4647 and they can give you a list of dentists in your area that are accepting new NHS patients. Let's hope you get a positive experience like Mark did! 

Twelve years ago, I had a heart valve replaced following Endocarditis. I was told that I needed to see a dentist regularly. Being a full-time wheelchair user and unable to stand or walk, it took me eight years to find an NHS dentist which was accessible and which would accept me.

Recently, I have had real trouble with my front teeth. Eventually, the dentist said that they would have to come out and be replaced with a partial denture which would also replace some missing back teeth as well. He took an impression, charged me nearly £200 and told me to come back in a couple of weeks for a 40 minute appointment for the extraction and the fitting of the plate. I have to take antibiotics prior to dentistry to reduce the risk to the heart.

Two wees later, dosed up on 3g of Amoxycillin, I arrived at the dentist. Once under local anaesthetic the extraction started. It was difficult and painful. both teeth broke while being pulled and the removal of the roots did damage to the gums and soft tissue. I could feel the dentist shaking as it got more and more 'hairy'. After 40 minutes was up, I was told that 'fortunately the teeth are out just as your NHS time is up' and I was hustled out onto the street in my wheelchair, shaking, shaken and feeling weak, dizzy and sick. I was given, as I went, the denture in a plastic packet - and that was that! No fitting, no advice on care of the extraction site, no pads or tissues to deal with the bleeding, nothing!

After a minute or two to try to recover, I went back in and asked the receptionist about the denture and the care of the site. I was told I would need another appointment with the dentist - he couldn't see me then as he had a private 'cosmetic' patient 'and you are only NHS' I was told! I was offered an appointment for six days later!! I left in disgust.

The plate is useless. It needs adjusting and the front teeth are too long so my teeth no longer close. At the moment, i have abandoned it altogether until I can find a dentist to fit it correctly.

Basically, i was assaulted, injured and left in a worse state than when I started but I have no say..... I'm 'only NHS'!

This sounds slimilar to my experience. Like yourself I hadn't been to the dentists in a very long time, and as is always the case, the back of one of my molars chipped off and I was left with a massive hole and in a lot of pain.

I went to an NHS dentist (any I could find out of desperation) and it took 4 separate visits and 3 payments of £45 to get a root canal and get it sorted. Not only that, but 3 months later the filling she'd used to rebuild the tooth came away and I was back in pretty much the same position I started only £135 poorer. 

I now know my rights and have written a letter to my local PCT in the hopes that others won't suffer the same extortion and bad practice that I did. 



Your story doesn't surprise me....in fact nothing surprises me when it comes to dentists. I was given extensive and expensive treatment that i later found out i didn't really need and I am now trying to claim for compensation.

As much as I love the descriptive detail of your post it has put the fear of God into me as I need see a dentist soon. I think its very difficult these days getting treatment on the NHS. It is probably worthwhile getting a dental cash plan to pay for a percentage of the cost. I think the best plans at the moment are by SimplyHealth and WPA, have a look at these plans first as there are some really bad plans out there!

It's extortionate when you earn £746 per month for full time work and you pay tax also would you not agree? maybe the government should fund dentists more, but hospitals are under-funded and they still manage.

Check up for health is very necessary part of work because a sound mind is remain in sound body if we are ill and how can we work very well so that dental check up is very needed .

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