/ Health

It’s time for dentists to sit in their own examination chair

More than half the NHS and private dentists we visited in our undercover investigation were rated poor by our experts. Some even neglected to offer basic treatment. Sound familiar, or do you love your dentist?

I don’t know about you, but I think my dentist is pretty fabulous. She’s clear about what she’s going to do, and I can honestly say she’s been a godsend for my poor, much-ground teeth. But I’m no clinician, and I’m relying on her to do a good job – if I’m honest, I’m not sure I’d be able to tell if she didn’t.

So it’s worrying to think that our undercover dentistry investigation might be any sort of reflection on the general state of UK dental practice.

Our dentistry diagnosis

Out of 20 visits across England rated by our panel of experts, 11 were rated poor, with evidence of poor case history-taking, clinical examination and a hotch-potch of inappropriate treatment offered to our undercover researchers.

All of our researchers had dental problems – from gum disease to decay and orthodontic need – and all should have been offered x-rays. So it was a real disappointment to see this didn’t happen in five out of 20 visits. Moreover, five visits lasted less than ten minutes, with two at just a shocking five minutes!

So what’s going wrong in an industry that has two regulators? Is it the NHS contract that’s the problem? Not necessarily – we also saw some poor private dentist visits. Are the standards dentists are working to too broad and woolly? Perhaps – these standards are currently under review by the General Dental Council (GDC).

Our four experts – who work at general dentist and consultant level, as well as having expertise in standard-setting and performance management – were surprised and disappointed by the picture they saw, with only three of the 20 visits rated good.

Improving NHS and private dentists

Sadly, it looks like some patients have been failed, which might leave them with a lifetime of dental problems that could have been prevented.

We want our findings to bring about positive change, so we’ve already shared our results with the British Dental Association (BDA) and the GDC. The latter is studying our findings closely to consider further action and told us:

‘We’re extremely concerned by any evidence of poor standards in the delivery of dental care. All dentists and dental care professionals are required to observe standards, and the findings of the Which? undercover research raise questions about adherence by some dentists.’

Do our dire dentistry findings strike a chord with you, or do you love your dentist?

Comments

My wife and I started to lose confidence in private dentistry when her Denplan contract was increased by substantial sums annually and yet all she required was an annual check-up.I appreciate that Denplan is a different organisation from my dentist’s business nevertheless her dentist was the only point of contact and he could not explain the increases.
We both now pay for treatment directly. About 2-3 years ago our dentist started suggesting that we both required six monthly check-ups when in the past annual check-ups seemed to suffice. This was followed up by frequent chaser phone calls from the dental surgery.
Recently after my check-up I was advised that I needed a scrape and polish from the dentist and eight weeks later a visit to the hygenist. I was given an estimate for the treatment which I am happy to pay but there is doubt now in my mind about whether I need any or all of this treatment.
My dentist is now part of a large national group and I am wondering if each dentist now has to meet an annual income per patient target.

Anthony Kilcoyne says:
16 January 2015

No just different ways of paying – prevention and regular visits is best though, the trouble is the NHS system has ‘quotas’ to send people away for 2 years (so someone can take their slot) to artificially bump-up Access figures, when in reality YOU then miss out on your Annual Oral Cancer check = recommended to spot Oral Cancer (it’s on the increase!) early.

It’s prevention in the widest sense and all these things take time and good staff and facilities and keeping up to date, has high overhead costs.

But again, the most economic and healthy option, is prevention first!

Anthony Kilcoyne says:
16 January 2015

Dear Which,

I believe you are doing another ‘Dentistry’ investigative piece in Which soon – will you be brave enough to criticise those who IMPOSE and LIMIT the NHS Dental system in England centrally, or will you just blame ‘dentists’ again for SYSTEMATIC major failings and lack of prevention strategy in our Society?

Like the NHS Mid-Staffordshire scandal, if you put GOOD people into a BAD system, this has BAD consequences for patients ultimately – as a consumer Organisation, surely you should hold HMG accountable, especially 4 months pre-election ???

You can read how when Dental professionals blow the whistle in the public interest, they still get ignored year after year, as things deteriorate further 🙁

http://www.telegraph.co.uk/comment/letters/11320751/Letter-Rotten-teeth-system-its-time-to-change-NHS-dentistry.html

Yours still concerned,

Anthony Kilcoyne.

Julie says:
23 June 2015

I had treatment for gum disease which my NHS dentist said I needed. I was scared and unable to afford the private treatment of £800. After much deliberation, I borrowed the money from family members to have a course of treatment undertaken. I was surprised how little work he did on my teeth and it makes me wonder if I needed the treatment at all! I have always looked after my teeth even to the point of paying for professional whitening treatment at a cost of £300 a few years back.

col5839 says:
7 December 2016

I had a bad experience, after needing denture, this was carried out in hospital. On my return to my dentist, the dentist pulled apart a small nick I had in my lower gum. It did hurt, but I did not want to show it.This developed into what I later learned was labelled rocking, the denture broke in half. It was repaired and I am still using it now, however the new denture that were made by another dentist within the practice. when fitted on the final appointment which i really feel was too may.Not to mention the cancellations for me. I am registered Disabled and the taxi cost was £18 per appointment for the return trip. I was feeling so low when they did not fit, he grinned and said. Just see which are easiest to suit, this was over a year ago and being honest. I had a lot to put up with health wise, I did contact the Practice Manager, just asking for to be compensated for the taxi fares.She spoke with the dentist and he requested me to come back in. I was feeling no trust in him, he sent his assistant to the waiting room to give me other dentures in a clear bag and that to me was no respect at all. Eating and all is a real issue and I would just like it sorted so I can have some normality.I have learned that the lower jaw is known for problems. That has me thinking, had the dentist never pulled it apart.None of this would have came about and being a dentist, that was the last thing i would have done if i was one. Excuse if this is written a little jumbled maybe to some. I am dyslexic. What shouldf I do ?Thank you for your time.

col5839- from what I can gather from your post, and correct me if I am wrong , your dentist is guilty of MAL- practice , you can get professional advice about putting in a claim against him. Checking up on this I cant figure out why I have to go to the USA to get information on mal-practice in the UK from the Library of Congress , I might not be a USA lover but , give them their due , they dont, censor-block-make it very hard for the GENERAL public to get information. Suing the NHS comes under the Law of Tort but Dentists/GP,s aren’t in this category it seems most belong to a medical defence council and you would need to contact the registered body that regulates Dentists to put in a claim . Believe it or not you can now put in a claim via one of those American type mal-practice companies that now exist in the UK like: http://www.dentallaw.co.uk I am only mentioning that one as it is accredited to The Law Society , I am NOT recommending it , only providing it as a means of supplying you with information I am sure others will give you more help.

susan jones says:
17 October 2017

she is 14. my daughter visits our NHS dentist every 6 months, all of a sudden she needs fillings, now I am sceptical and question the dentist but he says they are needed as she has shadows under her teeth, my 2 other children don’t have a filling in their teeth at all, and they are they all have the same diet etc…. the last dentist she saw said that a particular tooth didn’t need the filling, this dentist says she does, who do I believe? my husband has just returned from the same dentists, his usual dentist was away so he saw my children’s dentist, guess what he needs a filling! so I am now beginning to wonder, NEVER do any of them have a tooth cleaning at any appointments, the only way they can have a cleaning is to see the hygienist, yes guess what that is private, do I trust NHS dentists, the answer is no, and my reason is this, why can one say one thing and another say something else?

My father had dentures made on the NHS, he paid £400 for them, they didn’t fit in his mouth, yet when he complained the owner of the practice basically said tough and gave him his money back, yes guess what the same dentist.

Is dentistry subjective? is this dentist just playing with her teeth, as a victim of the 80’s dentists I received many fillings I now know were not needed and it upsets me that they can play with peoples teeth.

Maybe dentists work should be looked at a little more often. an Ofsted for dentists who can turn up when they like, then if dentists think they are being watched they may think a little before doing unnecessary work or not doing work when they should.

The issue is there really is no regulation, things are not flagged up until you have gone through the dentists complaints procedure and lets face it what dentist will admit to foul play, by then you have a mouth full of amalgam!

Jacquie says:
20 January 2018

I was treated by my local dentist for many years; until the dentist had reached a point where his bedside manner had totally changed when the dentist was taken over by a big chain.

He started charging me separately with my first dental check only lasting five minutes. Just one quick look in my mouth, and a quick dismissal saying I needed to come back and pay separately for x-rays. Then another appointment after that for a scale and polish.

My upper right canine (a crown) was fine, and then a new Romanian dentist insisted I change it because it was five years old. It was so solid, she couldn’t remove it with the normal dental tool. She had to hammer out the crown (without sedation). The noise was horrendous, and I went into shock as it violated my personal safety – I was terrorised. There was no concern by the dentist or dental nurse. She broke off my tooth and it bled heavily. No apologies and sent me home with damaged gums.

Trying to fix it on several visits, being charged every time – I wasted hundreds of pounds because I’m registered ‘hearing impaired’ and with ‘total hip replacements’; these are both ‘invisible diseases’. No-one can see what we have. The crown kept falling out, leaving me with a gap visible to all. I fell into a depression for which I had to be treated, PTSD is not pleasant. At no point did the dentist apologise, but then offered me a new dentist at the same practice for ‘private dental treatment’ to repair the crown which was solid. They left me with no tooth to attach a crown, and didn’t offer any compensation, blaming me as a patient saying that it was a problem with my teeth, when it was them that broke it. I didn’t know who to turn to.

Registering with a new dentist locally; they were disabled unfriendly by refusing to give me an appointment. I couldn’t attend the one I booked because I was in hospital being treated for not being able to breathe; my airways were blocked. I explained that to the dentist, but they discharged me from their list. They didn’t offer any help in finding a new dentist. I’ve been let down so badly, and need a dentist now for my teeth.

Anthony Kilcoyne says:
10 February 2018

Yet another year where Dentists concerns raised in the public interest are continually ignored about centralised mismanagement and huge under-resourcing:
See: https://www.theguardian.com/commentisfree/2017/jan/12/nhs-dental-service-payment-system-tooth-extractions-children
and: https://www.mirror.co.uk/news/uk-news/british-kids-worse-teeth-those-11788170
and: http://www.telegraph.co.uk/news/2018/01/02/dental-crisis-leaves-britain-reliant-charity-developing-world/

Basically what is BAD for Dentists and their teams, is BAD for Patients and public health too – it’s time to realise it’s not the workers, it’s the target systems coupled with more bureaucracy, meaning less time to treat and care for people.

So come on Which, dare you investigate and hold such systems to account publicly, if you are really serious about improving things for the many……???

Yours curiously,

Dr. Tony Kilcoyne
Dental Surgeon.