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Periodontal Disease and the NHS
This is a Government Information Broadcast! How many people remember those black and white info-commercials from the 50s and 60’s? I hope I’m not the only one! If they still produced them, I’m sure they would include a regular series about what you are entitled to under the NHS. It would certainly include NHS dentistry and ‘A visit to the Dentist’.
It’s odd that in these days of the World Wide Web and the Information Super Highway, patients actually seem to have less of an idea of their entitlement than they did forty years ago. This, I’m sure, is because the situation is so much more complicated. In my experience, not only patients are unsure but even dentists do not always know what the rules are.
When it comes to provision of Periodontal Treatment, patients are getting confused messages from dentists and practitioners are getting sued. As an Expert Witness, 60% of cases I see are Perio-related.
True gum or rule of thumb?
To start with, here is the bottom line. This is taken from the NHS website and is the same information that patients will see.
- advice on preventing future problems, such as diet advice and cleaning instructions
- applying sealants or fluoride preparations to the surfaces of your teeth
- a scale and polish
- marginal correction of fillings
- non-surgical treatment of periodontitis such as root planing.
Basically, everything that is needed to achieve and maintain a good standard of oral health has to be provided within the NHS banding, starting with a Basic Periodontal Examination (BPE) and following the pathways which this guides you through. Here is the ‘rub’, you cannot charge privately to provide any of this through a hygienist. Everything, including the amount of time spent with a patient and an overall good standard of care still has to be provided under those NHS bands, whether it is provided by a dentist or hygienist.
I feel like a man waving a big stick, but you will be liable to litigation if the time required to give patients all the information and treatment is not provided. This includes information on the causes, process and prevention of periodontal disease. Following a BPE, the guidance says the following should occur –
Score 0 – no treatment
Score 1 – Oral Health instruction
Score 2 – Scaling and Oral Health instruction
Score 3/4 – Root Planning or Root Surface Debridement and Oral Health instruction (over several visits to be effective)
Don’t become a statistic
Every year, an increasing number of practitioners are becoming involved in litigation or are falling foul of the GDC. Keep yourself safe by following evidence based pathways in care. We are fortunate in have a periodontal pathway provided by The British Society of Periodontology, if you haven’t got a copy, go to their website and download one to keep handy or use as training material in the practice.
Dr John Shapter – QCS Expert Dental Contributor