Ridiculous question... how do dentists work in this country???

[Kingstepper]

Nope
You won't have been accepted as an nhs patient when he/she took you on so no entitlement for them to treat you under NHS.
If you were accepted as an nhs patient then yes the work would be done under nhs regs/prices.
There are obviously nhs limitations in materials used-you wouldn't get a tooth coloured filling on anything past your canines.
Also unlikely to get a hygienist appointment under the nhs -again because the nhs fee is derisory.

Should get a clean and polish if needed under the basic charge, at least in England.

[Kingstepper]

So do you know what you are supposed to do? You actually need dental work done but can’t afford it?

And there is not a single dental practice taking NHS patients…

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Sure you’ve tried them all, seen this? https://www.nhs.uk/service-search/find-a-dentist

[trident-7]

So do you know what you are supposed to do? You actually need dental work done but can’t afford it?

And there is not a single dental practice taking NHS patients…

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You could try your local dental school if you're feeling lucky.

As a junior doctor, what would you advise me to do if I needed a hip replacement urgently because I can barely walk & am woken up with the pain 7-10 times per night, which I am. I've waited over a year for an 'expedited' appointment to see an orthopaedic surgeon under the NHS, after which I might expect to be put on a waiting list behind over 100,000 other patients waiting for a hip replacement? And lets say that I couldn't afford to go private & have the hip replacement on a 6-8 week lead time? What would I be supposed to do?

[trident-7]

Sure you’ve tried them all, seen this? https://www.nhs.uk/service-search/find-a-dentist

I don't see new NHS patients & I'm on there.....

[Kingstepper]

I don't see new NHS patients & I'm on there.....

Think you all are. Checked my area and states dentists who are: -

Accepting new NHS patients
NOT accepting patients
No information in last 90 days

[trident-7]

Think you all are. Checked my area and states dentists who are: -

Accepting new NHS patients
NOT accepting patients
No information in last 90 days

We’re the latter. AFAIK we haven’t been asked

[Kingstepper]

We’re the latter. AFAIK we haven’t been asked

Don’t know how it’s supposed to work but that’s not very useful!

TBH loads like that in my area but were 3 or so who were accepting new patients.

[Wolfman53]

I had an interesting dental experience recently. I have been lucky to have an NHS dentist all of my life. Last year my brilliant dentist relocated and another joined the practice.
Having put up with a mouth full of crooked teeth for my 61 years and never being offered any help I was somewhat surprised to be told that he could definitely sort me out!
Invisalign is the answer apparently and the dentist advised me that my case may be more 'complex' and I would therefore need to see him at his private practice a few miles away.
I appreciate that Invisalign isn't something available on the NHS but the receptionist at my normal practice seemed a little concerned that I was being steered towards the other practice!

Anyway, I have had my preliminary scan and am awaiting a further consultation to see what can be achieved along with a quote and treatment plan.

I would be interested to hear anyone here who has experience of Invisalign good, bad or indifferent and will start a separate thread.

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[watchstudent]

I would write to orthopaedics, refer you to physio and optimise all the other bits that I could. I am sorry if you are suffering with your hip btw.

I suppose I see it as quite different as you would at least be on a waiting list. There isn’t anything else you could do, but you would get your operation. If you had a condition that was going to deteriorate and become dangerous for you then you would get your operation sooner. Plus if you saw a surgeon privately for a consultation you would still have the option of treatment on NHS albeit with a longer wait. The dental situation seems far worse if I couldn’t even get access to treatment when I needed it. In fact, when I think of my patients who live in poverty with their children… it’s a national disgrace. That’s not a dig at you by the way, just the fucked up system.

You could try your local dental school if you're feeling lucky.

As a junior doctor, what would you advise me to do if I needed a hip replacement urgently because I can barely walk & am woken up with the pain 7-10 times per night, which I am. I've waited over a year for an 'expedited' appointment to see an orthopaedic surgeon under the NHS, after which I might expect to be put on a waiting list behind over 100,000 other patients waiting for a hip replacement? And lets say that I couldn't afford to go private & have the hip replacement on a 6-8 week lead time? What would I be supposed to do?

[trident-7]

I would write to orthopaedics, refer you to physio and optimise all the other bits that I could. I am sorry if you are suffering with your hip btw.

I suppose I see it as quite different as you would at least be on a waiting list. There isn’t anything else you could do, but you would get your operation. If you had a condition that was going to deteriorate and become dangerous for you then you would get your operation sooner. Plus if you saw a surgeon privately for a consultation you would still have the option of treatment on NHS albeit with a longer wait. The dental situation seems far worse if I couldn’t even get access to treatment when I needed it. In fact, when I think of my patients who live in poverty with their children… it’s a national disgrace. That’s not a dig at you by the way, just the fucked up system.

I've already done all the things that you said. A 3 year wait for the hip replacement on the NHS (or whatever it proves to be) might as well not be a waiting list for me. I booked my hip replacement to be done privately last week. I chose 8th October. The way it feels today I wish I'd chosen a bit sooner. It'll be £15k well spent...if I couldn't afford it I'd take out a loan.

You're right, the NHS system for dentistry has been fucked up for quite a few years now. Particularly since the UDA system came in. I don't recall when that was but I'm guessing 10 years? (Edit: it was 2006 so 15 years...time flys!). It's a shit system for the public and a shit system for the dentists. It's cheap for the government though & makes the statistics look good. Not surprisingly some patients aren't getting 4 fillings done on one course of treatment. The incentive is for one to be done and the other 3 to be kept under observation. Next course of treatment the worst of the other 3 can be picked off. This makes it look like the tooth decay rate is at a lower level than it really is. Change the system & things might improve.

Call me cynical in my old age plus severe hip pain is making me sound unsympathetic when I accept that it is a real problem for many but at the end of the day this is my livelihood. I'm happy to give patients a good deal...I knocked £100 off somebody's bill today because he reminded me that I'd said I'd do him a deal last time. I'd written that down in his notes when I checked! I don't work for peanuts though & before anybody says that the taxpayer paid for my dental degree, I've paid about a million pounds in income tax since I qualified so I consider that debt paid.

[j0hnbarker]

I've already done all the things that you said. A 3 year wait for the hip replacement on the NHS (or whatever it proves to be) might as well not be a waiting list for me. I booked my hip replacement to be done privately last week. I chose 8th October. The way it feels today I wish I'd chosen a bit sooner. It'll be £15k well spent...if I couldn't afford it I'd take out a loan.

You're right, the NHS system for dentistry has been fucked up for quite a few years now. Particularly since the UDA system came in. I don't recall when that was but I'm guessing 10 years? (Edit: it was 2006 so 15 years...time flys!). It's a shit system for the public and a shit system for the dentists. It's cheap for the government though & makes the statistics look good. Not surprisingly some patients aren't getting 4 fillings done on one course of treatment. The incentive is for one to be done and the other 3 to be kept under observation. Next course of treatment the worst of the other 3 can be picked off. This makes it look like the tooth decay rate is at a lower level than it really is. Change the system & things might improve.

Call me cynical in my old age plus severe hip pain is making me sound unsympathetic when I accept that it is a real problem for many but at the end of the day this is my livelihood. I'm happy to give patients a good deal...I knocked £100 off somebody's bill today because he reminded me that I'd said I'd do him a deal last time. I'd written that down in his notes when I checked! I don't work for peanuts though & before anybody says that the taxpayer paid for my dental degree, I've paid about a million pounds in income tax since I qualified so I consider that debt paid.

I think the example you used about orthopaedics in your response to Watchstudent was a bit of a red herring.

Most NHS consultants, regardless of their specialty, will only be doing around a day per week of private work (if they are doing any at all - most don't). The rest of their time is NHS service on pay that looks poor in comparison with that of our dental colleagues. A new orthopaedic consultant will have spent a minimum of 10 years post-qualification working in the NHS as a trainee, doing days, nights, long days, all in a high intensity environment. You can add 5 years to that for their time spent at medical school. The starting consultant pay for that 15 years of investment is currently £82k.

You will know as well as I that fairly fresh dental graduates, free from the burden of out-of-hours commitments, will be on that kind of money a lot sooner, for a lot less hours per week, with a lot fewer hoops to jump through (think the attrition from core to higher surgical training, MRCS and FRCS exit exams, fellowship years, pressure to research and gain a higher research degree in some specialties etc. etc.). Who would blame them if they are offered the chance by their contractual arrangements to do some private work in between.

Contrast that with dentistry and in my opinion the comparison is unreasonable.

I completely agree that the system itself is at fault, but everyone who walks through the doors of medical or dental school knows from the outset that the work-life balance and remuneration package is so much better in dentistry than it is in medicine. I started medical school in 2009 and CCT next year, and I work an average of 55-60 hours per week with my on-calls. My salary is about £67k. My dentist friend who qualified a couple of years before me works 4 days per week 9-5 in an exclusively private practice (he does my dental work) and earns more than double what I do. He's never worked a weekend or night in his life either!

[The Doc]

I think the example you used about orthopaedics in your response to Watchstudent was a bit of a red herring.

Most NHS consultants, regardless of their specialty, will only be doing around a day per week of private work (if they are doing any at all - most don't). The rest of their time is NHS service on pay that looks poor in comparison with that of our dental colleagues. A new orthopaedic consultant will have spent a minimum of 10 years post-qualification working in the NHS as a trainee, doing days, nights, long days, all in a high intensity environment. You can add 5 years to that for their time spent at medical school. The starting consultant pay for that 15 years of investment is currently £82k.

Average age for Orthopaedic Consultant appointment is 36yrs old(entering medschool at aged 19)
Yes we do private practice, but that's capitalism. It's a remarkably badly paid job for the skills, IQ, hard work and training route.
All my school friends make more money than me, but I'm the happiest I think.
Most of them work south of the Watford Gap.

Although one of my friends owns Porsches worth 3million quid, and he stood next to me when we opened our A Level grades and didn't get enough for Medschool! He was sad then.

[watchstudent]

I think we know we don’t do medicine/surgery for the money!

Similarly most of my school friends are paid more. Wouldn’t want to do their work though. Money isn’t everything.


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[luckyhands]

I think the example you used about orthopaedics in your response to Watchstudent was a bit of a red herring.

Most NHS consultants, regardless of their specialty, will only be doing around a day per week of private work (if they are doing any at all - most don't). The rest of their time is NHS service on pay that looks poor in comparison with that of our dental colleagues. A new orthopaedic consultant will have spent a minimum of 10 years post-qualification working in the NHS as a trainee, doing days, nights, long days, all in a high intensity environment. You can add 5 years to that for their time spent at medical school. The starting consultant pay for that 15 years of investment is currently £82k.

You will know as well as I that fairly fresh dental graduates, free from the burden of out-of-hours commitments, will be on that kind of money a lot sooner, for a lot less hours per week, with a lot fewer hoops to jump through (think the attrition from core to higher surgical training, MRCS and FRCS exit exams, fellowship years, pressure to research and gain a higher research degree in some specialties etc. etc.). Who would blame them if they are offered the chance by their contractual arrangements to do some private work in between.

Contrast that with dentistry and in my opinion the comparison is unreasonable.

I completely agree that the system itself is at fault, but everyone who walks through the doors of medical or dental school knows from the outset that the work-life balance and remuneration package is so much better in dentistry than it is in medicine. I started medical school in 2009 and CCT next year, and I work an average of 55-60 hours per week with my on-calls. My salary is about £67k. My dentist friend who qualified a couple of years before me works 4 days per week 9-5 in an exclusively private practice (he does my dental work) and earns more than double what I do. He's never worked a weekend or night in his life either!

You make a fair point about on the whole, and your friend may well work 9-5 to earn £130k. Also, from that £130k he'll have to pay for his CPD courses,indemnity etc. Already this year I've spent £15k on courses!
I can tell you that to do my job as a dentist (again, working full private) an average day is around 10-11 hours for me. That's getting in at 7:30 and around 8 leaving time as an average. I would say I leave past 9pm probably once a week too. A lot of my bigger cases are booked as the last patient of the day and can run up to 8pm (my record is currently starting at 7:30am leaving at 12:30am the next day) At that point, you've accumulated a sh*t ton of notes, radiographic reports, CBCT reports, lab prescriptions, treatment plans, consent forms etc etc.

If your mate is earning £130k working 9-5 4 days a week,I'm sure there will be a lot of admin work associated. I work 3 days clinically and then other 4 days for admin (albeit I do own a practice) Either that or he know something I don't! (You seem a similar age to me, I might even know your mate!)

[Fitzgeme]

You make a fair point about on the whole, and your friend may well work 9-5 to earn £130k. Also, from that £130k he'll have to pay for his CPD courses,indemnity etc. Already this year I've spent £15k on courses!
I can tell you that to do my job as a dentist (again, working full private) an average day is around 10-11 hours for me. That's getting in at 7:30 and around 8 leaving time as an average. I would say I leave past 9pm probably once a week too. A lot of my bigger cases are booked as the last patient of the day and can run up to 8pm (my record is currently starting at 7:30am leaving at 12:30am the next day) At that point, you've accumulated a sh*t ton of notes, radiographic reports, CBCT reports, lab prescriptions, treatment plans, consent forms etc etc.

If your mate is earning £130k working 9-5 4 days a week,I'm sure there will be a lot of admin work associated. I work 3 days clinically and then other 4 days for admin (albeit I do own a practice) Either that or he know something I don't! (You seem a similar age to me, I might even know your mate!)

Dude, I have been a dentist 21 years and a Prosthodontist 13 of those years. I work 8:30 - 4:30 4 days a week and teach the other (thats a doss day, I mostly drink tea). You really need to work on either your speed or your systems if you are putting in those long hours. There is no way you are doing your best work last thing and late in the evening. I am zapped after a long case, 4 or 5 hours on the drill and its time to call it a day. I found when I was more regimented, cut out the non earning patients and treatments I works less for more money and did far far better dentistry. I know we all have out own way of working, but you sound like you are working far far too long hours, you will burn out.

[luckyhands]

Dude, I have been a dentist 21 years and a Prosthodontist 13 of those years. I work 8:30 - 4:30 4 days a week and teach the other (thats a doss day, I mostly drink tea). You really need to work on either your speed or your systems if you are putting in those long hours. There is no way you are doing your best work last thing and late in the evening. I am zapped after a long case, 4 or 5 hours on the drill and its time to call it a day. I found when I was more regimented, cut out the non earning patients and treatments I works less for more money and did far far better dentistry. I know we all have out own way of working, but you sound like you are working far far too long hours, you will burn out.

Mentally I’m fine as I book quite long appointments to make it so I don’t feel fatigued. Crown preps - 1:30-2 hours, fits 30-45minutes.
Molar endos - x2 90 minute appointments.
Posterior comps- 1:15 minimum.
All under microscope and all under rubber dam (even crown preps)
So as you can see, it’s a pretty chilled way of working. Just long days! I might only see 4-8 patients a day!
I’ve been doing dentistry for 11 years and I can’t work any faster in the way I want to.
Then you’ve got referral letters- once you’ve uploaded all the photographs and x-rays to the letters, reporting your x-rays, your CBCTs etc, im not going home any sooner than 8pm. would genuinely love to hear tips to work faster. (Could DM me!)