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08th November 2013


The NHS Choices website has the following advice for people seeking online help and advice about NHS dentistry. –

The NHS will not provide treatments such as teeth whitening, which you may want to make your teeth more attractive but which are not clinically necessary.

However, if your dentist says you need a particular type of treatment, you should not be asked to pay for it privately.

Your dentist is not allowed to refuse you any treatment available on the NHS but then offer the same treatment privately. Also, any treatment provided on the NHS has to be of the same high quality as treatments provided privately.

After discussing your treatment needs and all the options available to you with your dentist, you may choose to have some general dental treatments provided privately in addition to the NHS treatment. This may be carried out at the same time as your course of NHS treatment. The dentist should discuss the options with you so that you can make an informed choice.

Your dentist should also explain any risks, as well as the costs, of all treatments and should give you advice on how to keep your teeth, gums and mouth healthy.

This is a reminder to us all of the onerous responsibility of working under NHS contracts.  The agreement to provide all treatment required places us in a difficult position both clinically and financially.  Is doing a molar root treatment within your skillset?  If not, how do you meet your responsibility?  Dental Hospitals don`t always take Endodontic referrals and there is no NHS referral system in general practice.  If you try to do treatments that fail due to lack of experience then you are liable to litigation.  Unfair?

Well, yes it is.  However, there are some actions you can take to minimise the issues.  Do a monthly `ring around` the teaching hospitals to see who is taking patients for Endodontic and Perios referrals.  This means you have an option to give people, even it means a bit of a ride.  Encourage a member of your team to develop a special interest in Endo and come to a financial arrangement for internal referrals.   Give patients as much choice as possible rather than restrict availability of treatments – choice expands the possibility of taking better options.

It is really important to give patients lots of information too – and record that you have done so.  Choices, risks, prognosis and costs.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

John Shapter

Dental Specialist

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