Hi,

This may be quite long winded but I want to provide as much detail as possible.

During my childhood I was registered with an NHS dentist and attended
my appointments, nothing really out of the ordinary except it was
noted that I had a problem with enamal wearing off my teeth. This was
put down to fizzy drinks.

When I was approximately 20 years of age I missed an appointment and
was "struck off" - I am 23 now and havn't visited a dentist since.

Lately I have become concerned about the cosmetic appearance of my
teeth, there is very little enamal left and as a result my teeth have
eroded considerably, some teeth have eroded down to the root.

I realised that I needed to do something about this and visited a
private dental practice. After several consultations, x-rays and
impressions the dentist has provided me with a treatment plan and
quotation. Below is a direct quote from the dentist which comes to
some £12,000 pounds. My question is should I have to pay this or
should it be provided by the NHS, also what is my best course of
action. And finally is the quotation reasonable for the work which
needs doing.

I hope someone can give me some good news, if I have to pay for this
is is equivlent to about 6 months salary and I really cant afford it.
If I dont do it i'll probably have no teeth at all within the next 2
years.

***DENTISTS QUOTE***

"Dear Ben

It has been a pleasure to meet you at our practice in recent times and
discuss your dental problems and needs. An interesting case!

The initial examination revealed that you are fit and well, and a
non-smoker. You do not take any prescibed medication routinely.

Your principal concern is the loss of tooth tissue and the poor
appearance of your anterior teeth.

Periodontal Condition

The bone support for your teeth is good. Your plaque control was
initially inadequate but folloing treatment with your hygienest *****
********* this has improved to an acceptable level. Pocket depths were
seen to be below 3mm

The "fizzy drinks" in your diet were seen as a principal factor in
your present dental condition.

Occlusion

A class I occlusion with severe loss of tooth tissue in all areas.
Slightly more noteable in the upper than the lower arch.

The upper right 1 is root treated but otherwise all teeth exhibit
vitality. However teeth at upper right 2 and upper left 1 & 2 will
require root canal treatment because of severe loss of tooth tissue.

In order to restore the missing tooth tissue, all teeth will need to
be restored using porcelains, resins and in the case of the second
molars, gold.

You have seen the models showing how your teeth would look when
restored. There would be benefit in restoring the upper anterior teeth
with laboratory constructed temporary acrylics whilst the posterior
teeth were reconstructed in porcelain. This would allow adjustments to
be made on the acrylic prior to porcelain fabrication.

You expressed a wish to organise your treatment over approximatley a
year. Whilst this is possible is does increase the cost slightly
becuase of the need for some long-term provisional restorations.

I will give you a costing based on long-term provisional restorations,
but there may be savings to be made depending on the need for these
items.

Each porcelain restoration costs £400.00 and these will be required at
upper right 6,5,4,3,2,1 and upper left 1,2,3,4,5,6 and lower right
6,5,4,3,2,1 and lower left 1,2,3,4,5,6 (total of 24 teeth at £9,600)

Root canan treatments at upper right 2 and upper left 1 & 2 are £215 each (£645)

The anterior provisional restorations are £50 each. These would not be
needed at lower right 3,2,1 and lower left 1,2,3. They may be avoided
in all areas but we must maintain contact on both front and back teeth
at all times. The the short term (weeks), this can be done with
composite at no extra cost. In the longer term (months) this will
require provisional restorations. Gold onlays on the 4 second molars
are also £400 each (£1600)

Following treatment you will be required to wear a shield during
sleep. This is to protect your dentistry from a common clenching
habit. This will be provided free of charge.

I understand the commitment this represents, both in time and
financially. Please contact me with any queries you may have.

Best Wishes and Regards"

**END QUOTE**

Dentists here in the UK are very expensive unless you can get someone
to take you on a National Health patient. Even then they are expensive
but the pricing is more controlled.

Note: There is no obligation for any dentist take take you on as a NHS
patient. However, sometimes some do. It's worth shopping around.

Especially if you can't get taken on as a National Health patient, it
is even more important to shop around.

Gold inlays? Wow that's really over the top!

But, not being a dentist, I wouldn't know what is reasonable for a job like that.

Good luck,anyway.

As the comment above says, no dentist is obliged to treat you on the
NHS. Dentists, like GPs, are essentially self-employed practioners who
do contract work for the NHS. The have, like GPs, a right to refuse
treatment to you if you miss appointments, and they can remove you
from their register almost at will. There is no way the NHS will pay
for this ludicrously expensive treatment. What is more, the erosion of
your teeth is not to do with not seeing a dentist so much as your
apparent lack of care for your teeth. It is perfectly possible to
maintain superior dental health without seeing a dentist for many
years if you look after your teeth well, using common sense and the
skills you should have been taught at school.
In sum, while I am neither a lawyer or a dentist, it doesn't seem that
you have any case against either the NHS or your dentist.
As the commnter above says, shop around.
Hope it works out.

I am not a dentist.

I do not think you will get all the restorations done on the NHS, and
certainly not gold. What sounds like essential treatment is the upper
right 2 and upper left 1 & 2 root canal treatment.

If you want an NHS dentist you should contact the Primary Care
department at your local Health Authority. They should be able to put
you into contact with a dentist who will treat you on the NHS, but it
may not be local to you. Note that NHS dentists cannot mix NHS and
private treatment in the same programme.

Another option might be to go abroad for treatment. Hungary has a good
reputation and some surgeries there offer travel, accommodation and
treatment inclusive packages.

Owain

Wow, Owain ...

Going abroad!

What an excellent idea!

Everything now seems to be cheaper outside the UK.

Hi Ben,

Dentistry in the UK is incredibly expensive.
Apart from going abroad, you could look for a Teaching Hospital, and
be a 'guinea pig'.

Being a 'guinea pig' is okay for some things, probably even simple
dentistry, but for root canal .... Not for me! I'd rather go to India.
Quite good dentists there too apparently, but further away and outside
the EU of course.

Owain