NHS dentist charges

[Peter B]

I am an NHS dental patient. I need a bridge from LR 5 to 7 (6 is missing). My dentist says he won't do this on the NHS because it is a large bridge and if I paid only £198  he would make a loss. Is he allowed to refuse NHS treatment like this? Bridges are included in Band 3 NHS dental charges, without specifying the size or cost of the bridge.
 

[Dental Technician]

In short, no, he isnt. The patients charge is not the same as the amount the dentists recieves, you are partly subsidised by the goverment who make up the difference between what you pay the dentist and what he recieves from his contract amount.
The issue here is the dentists greed and it happens all the time, basically the dentist gets a contract from the primary care trust, the contract allocates points (UDA'S) to the dentist per annum, the dentist gets a set figure for each uda ranging from around £20-£30 per uda. This value of the uda for the dentist is determined by the range and quality of services the dentist provides, so if the dentist offers an excellent service he gets more £ per uda.
For examples sake lets take an average value of £25 per uda
The 3 bands are each allocated a specific points value
band 1 =1 point = £25 for the treatment
band 2 =3 points = £75 for the treatment
band 3 = 12 points = £300 for the treatment
These are the amounts a dentist recieves for doing the treatments which fall into each band, it is more than enough to do most treatments.
The problem for the dentist and much more importantly THE PATIENT is the laboratory bill. out of the fee he recieves he has to pay the laboratory for the cost of in this example (your bridge) which may be £100, by the time he has done the preparation work on your teeth and paid the lab bill he deems it not economic to do your treatment as he can achieve the same amount of uda's by doing a one tooth denture which takes him around 10minutes surgery time and has a laboratory cost of around £30.
This is the reality of the situation and it is the same story for chrome denture frameworks.
They tell patients they are either not available on the NHS or that they simply wont do it, it is wrong, unprofessional and does not put the patient first which is a fundamental principal all dental care professionals MUST do......by law, see  www.gdc-uk.org for all the details regarding rules which dentists must follow and if you want my advice go back explain what you now know and I am sure that if you mention the primary care trust his attitude will change, let me know how it goes.
Dental Technician

[raoulmp]

Peter, There is some truth to what dentaltechnician is saying, however:

1. There are rules imposed by the nhs as to what can be provided under the nhs, and under what circumstances. The biggest one for bridges is that if a denture can do the job, then is what is going to be provided. If the patient refuses to wear a denture, or wants the bridge for cosmetic reasons, then it will be provided on a private basis.

so, basically thr nhs will fund the cheapest simplest option that will solve the problem. it may not necessilarly be the best option. If the nhs were serious about providing good quality treatment/ best options, they would make implants available on the nhs, and fund complex treatments better.

2. People are always complaining of the poor quality of nhs appliances (crowns, dentures, bridges) and wonder why they cant have the more expensive option from the nhs. Until the nhs sort out their funding, and start providing funding for better treatment options, the majoirty of dentists will either continue to supply cost-effective solutions or go private so that they CAN provide high quality appliciances to their patients.

I sympathise with you situation, but it is likely that any nhs dentist will only provide you with a denture.
Have you considered that a bridge will actually compromise your other teeth, you may want to consider implants as an alternative. they last longer and wont involve damaging your other teeth.