Should I use a Private Dentist or an NHS Dentist?


In some areas it is difficult to find a NHS dentist. If you are not on a list or have not attended as asked for your ‘check-up’ appointment, you may be put back onto a NHS waiting list and have to consider taking a place at a dental practice offering private treatment. The NHS dentist vs private are set up to provide treatment in a different way. Most NHS funding for appointments appear to be spent on one unit of dental activity i.e. one UDA:- a dental examination, X-rays if necessary and scale and polish. In reality then, much activity is not on restoring teeth or active treatment which is expensive and generally seen as leading to more treatment. The NHS dentist may see themselves as adequately compensated for treating patients who have dental problems that could affect their health and well-being and rather less in the role of responding to patients demanding complicated or complex treatments. The NHS nowadays is aiming to be a more preventive service and is largely populated in some areas by ‘the worried dentally well’.


The NHS dentist is currently paid according to how many ‘units of dental activity’ (UDSs) that are performed and not essentially on the basis of the how many fillings are needed or on other complex dental needs. The patient who is an irregular attendee at the dentist sometimes finds it more difficult to be accepted at their preferred practice on the NHS. They may need to phone the primary care trust who will direct them to be seen in an emergency slot. From the NHS dentist perspective he has targets to meet and would be expected to prefer patients who look after their teeth.


Because of these UDA targets some procedures, those that take longest, or are practiced infrequently would be seen by some dentists as unlikely to be beneficial in the long term if offered to patients and less to the casual attendees. Although the patient would be given options for treatment, in reality these options depend on the dentist ability and willingness to perform a treatment. A general NHS dentist may feel that in their hands, a lack of skill or practice, leading to very little belief in the benefit, longevity of a certain procedure can make it unjustified. Those will most often be treatments that they do seldom, or are not funded by the NHS taking a lot of time to do and have a poor prognosis. These might be items such as some root canals and deep cleaning in complex gum conditions. Replacing a crown (cap) or bridgework that has been in the mouth for some time and is now failing may not be viable to replace or repair by an average dentist and an extraction and denture might be recommended as a realistic alternative.



Compare NHS dentist to private

Dental private practice; Dental practice private: Private dentist to NHS dentist: Private dentist vs NHS.


Private dentist vs NHS may be comparing apples and pears but it is inherent that without units of activity to achieve, a dental private practice vs NHS will give more choices because the patient is charged not by units but the time and costs to do the desired treatment. Therefore, if you compare private dentist to NHS dentist it is rather unfair. A dental practice in private contract with their patient should have skills to offer literally because they have more ‘dental practice private work’ experience and are free of NHS constraints on time and money.


By this we mean the more time they have doing more complex treatment-replacing failing crowns and bridgework or white fillings the better they should be at doing it. To compare nhs dentist to private means comparing two different skill sets.


The NHS dentist may be altruistic doing the more often-essential work, and keeping patients as healthy as possible. The private dentist will gain the skills, training and practice to give time to an exacting restoration, an aesthetically more pleasing smile or refer to his dental hygienist.


One of the additional benefits related to the hygienist dental treatment is that a private dentist will usually require an assurance that the patient knows how and why this advanced work needs good oral hygiene to maintain this more expensive option and it is part of the hygienist job to help with this. So the private patient who has the confidence to ask for a further improvement in their cosmetic look as well as the function of their teeth will need to pay a bit more for these advanced options. This may even include the replacing of some or all of the teeth that have been extracted in the past with implants or a bridge rather than a denture that may be uncomfortable or even intolerable to some patients.


The private dentist has the time, some additional training and experience to respond to the more demanding patient whether it is the look or the feel of the mouth it is part of body image and function that can contribute to improved self esteem.



Dental hygienist NHS

The NHS dentist working in a practice is very unlikely to have direct funding for a dental hygienist NHS style and does a short scale and polish. A dental hygienist dental visit is usually for 15-30 minutes and should include recognising and treating any oral health issues and guidance on correcting them. The NHS dental practice hygienist is not under the NHS contract so NHS patients usually pay for this extra service.



NHS dental hygienist

The dental hygienist, NHS dental practice, unlike the dentist, is not under contract to work for or be paid for by the NHS. They are contracted to work in NHS dental hygienist clinics during training or in hospitals such as cancer hospitals. As you see, in the NHS a dental hygienist is a rare breed! Patients of the NHS dentist who are referred to the hygienist for their expertise are usually required therefore, to pay. However beneficial it is to get extra time for deep gum treatments cosmetic cleaning advice and personalised help with prevention and gum health the dental practice private hygienist works on the same private basis in almost all NHS practices.


Very few NHS dentists have additional funding to pay a dental hygienist and if the patient declines to pay the NHS dentist will do all they can within their skill set and time available. Alternatively they may refer to a dental hospital that may be able to do more complex treatment (often undertaken by students) but at the cost and time of travel for patients as they are usually some distance away.


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