Controversial but, would you support dental bandings increasing by 100% if it meant better access and registration?

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SneezlesForNeezles@reddit

No. Dental services should be included within standard NHS care, which means no charge at the point of delivery. The teeth are part of the body and have a huge impact on health and wellbeing. The charges should be completely scrapped and NHS dentistry properly funded.

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minipainteruk@reddit

Eyes too.

I know some stuff is covered already but I find the thought that people can be struggling with their eyesight but cant afford glasses really awful.

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xBruised@reddit

Please can you explain this to me? I’m feeling really naive.

From my understanding, people who are on benefits (for example, low income), and children are eligible for free eye tests and some unbranded glasses are free. A lot of companies (every one I’ve worked in except agencies) offer subsidised tests/glasses up to a fixed amount.

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Greenmedic2120@reddit

That’s correct, free eye tests are a thing for those in certain groups. Children’s glasses are free I believe, not sure about those in benefits. However I imagine they’re only free up to a certain amount (eg, £40) and anyone with a complicated prescription can quickly rack up the costs, especially if they require bifocals or verificals for example. The latter examples don’t apply to children of course, but there are a lot of adults it will apply to.

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MessageSelfdestructs@reddit

Bifocals or varificals are also subsidized though...

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Greenmedic2120@reddit

Lens thinning isn’t, which for certain prescriptions is basically compulsory.

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MessageSelfdestructs@reddit

Lens thinning is a modification you do to make something look nicer.
When someone else is paying for your stuff, you should be satisfied with what you're getting, and realise that you can't get the best.
If you want to get thin lenses, get a job and pay for getting the lenses replaced with thinner ones.

"which for certain prescriptions is basically compulsory"

It isn't though...

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Greenmedic2120@reddit

It’s not just for aesthetics, if you have a large prescription the lens doesn’t fit in the glasses well and can weigh them down a lot too

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Apsalar28@reddit

My eye sight is so terrible that I qualify for free eye tests. My glasses cost about £500 and that's with the cheapest frames available. The NHS voucher for my prescription is £94.

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annabiancamaria@reddit

Complex lenses (strong prescriptions, varifocals etc) can cost hundreds. I am talking about the actual lens, not the frame.

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minipainteruk@reddit

Yes, you are right in that people who are on certain benefits are eligible for free eye tests and some people can get vouchers to help with the cost of glasses.

But if you don't meet the criteria for the free eye test or vouchers for glasses, you have to pay out of pocket, and that might be a struggle for some people.

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mikpgod@reddit

If it was properly funded there wouldn't be a problem. But there's no money, as a country we're pretty much broke.

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Single-Position-4194@reddit

But if you look at the total spend on dentistry over the last forty or so years, it probably hasn't changed that much - in fact it's probably more now.

What has happened is that people cast about for an NHS dentist in their area and if they can’t find one, they go private if they can afford it which is more expensive than the total spend on an NHS dentist would have been.

So it turns out that saving money by introducing a contract which underpays dentists for their work is very much a false economy.

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Odd_CivilServant@reddit

Opticians are free for those low income.

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Spicymargx@reddit

No I wouldn’t. Dental care is healthcare. I don’t agree with the current system as it is.

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connectfourvsrisk@reddit

Yes. Especially as we know dental health is directly linked to overall health. Poor dental health is increasingly believed to be a risk factor in other diseases. Not just correlation but direct causation. Successive governments have dropped the ball on this by somehow thinking teeth were something that could be ignored or just treated as cosmetic.

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Spicymargx@reddit

We also know the link between poverty and poor dental health. We need to be doing what we can to get the nation’s health in better shape without it becoming a luxury only the rich can afford.

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connectfourvsrisk@reddit

It’s such bad planning.

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Single-Position-4194@reddit

Yes it is.

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SWVsuccess@reddit

You call the GP and he prescribes medication. Cost around let's say £15-£20 including all expenses. That's a five minute phone conversation.

You walk into a dental clinic, there's a dentist, dental nurse, other staff, chair expenses and material cost. Xray, machines, filling materials, they're all very expensive. The instruments they use to look into your mouth goes through 3 step decontamination. And that happens whether you need a filling or not. If it's touching your mouth, it's going through the process. That takes money.

Anyone who says dental care is same as healthcare is just bad at math. It's simply not worth it for a dentist to treat you according to NHS costs.

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Spicymargx@reddit

I am not suggesting that the overheads in dental care and general practice are equal. Hospitals have even more overheads but we don’t pay for them at point of use. I believe all forms of healthcare, including dental care, should be free.

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Single-Position-4194@reddit

Exactly.

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Single-Position-4194@reddit

What is ridiculous at the moment is that dentists don't get paid any more for working on several teeth than they do for one tooth (a consequence of the 2006 dental contract). A lot of them quit the NHS is frustration.

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AnonymousCapybara72@reddit

Wait til you hear about GPs. They get paid a fixed fee per patient per year. They get the same amount of funding for Ahmed, 22, who visits his GP for a checkup once every two years, as they get for Doris, 90, who sees her GP twice a week for help managing her 20 medications for her 10 chronic conditions, her various tests and specialist referrals, or sometimes just for a chat because she's got fuck all else to do.

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connectfourvsrisk@reddit

I see your point but to be honest Ahmed isn’t using the NHS appropriately by having “check ups” every 2 years from his GP. They’re not appropriate for an otherwise health adult with no underlying symptoms. Over 40 you might get offered a routine basic check every 5 years. But Ahmed shouldn’t be wasting his or the doctor’s time and resources like this.

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User-1967@reddit

And then there’s people like me who’ve probably been to see their GP once in the last 20 years

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Single-Position-4194@reddit

You wouldn't get past the receptionists in my practice if you just came in for a chat 😄 You get triaged rigorously concerning why you're there.

That having been said, I've spoken to more dentists online than doctors, so probably know more about the challenges of dentistry.

The cost of equipping and maintaining a dental surgery is astronomical, and the fees the NHS pays dentists simply don't cover it.

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amytee252@reddit

Thank you! I once read the dental contract and was shocked at how screwed over dentists are. I think if more people were aware of things like this, they'd have a bit of sympathy. It's actually costing dentists a lot of money sometimes to do NHS work.

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Single-Position-4194@reddit

Yeah, I've spoken a lot of time on Twitter over the last few years talking with dentists about the challenges of their profession and why they left the NHS and went private (if they did). Without exception their opinion of the way they've been treated by successive governments is extremely poor.

I find it hard to believe their either the Blair government (who created the 2006 contract), or subsequent governments who made negligible changes to it, listened to dentists at all - it was a stunning act of political negligence on their part.

And of course it's the patients who suffer if they can't find an NHS dentist in their area or a private one they can easily afford.

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Worth_Gap4226@reddit

If the bandings were £50, £150, £500, how much would that impact the NHS in terms of providing better access and service?

I'm in a position where I'd be able (and willing) to pay more if it means a tangible benefit to others, rather than being wasted in the 'ether'. But if increasing the bandings means that there are more people who would struggle to even pay the massively subsidised minimum, then I don't really see a societal benefit to that.

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Single-Position-4194@reddit

I've spoken to a number of dentists online and it's the very fact of the banding that's the problem; under the NHS contract they're paid according to the type of treatment they're carrying out, not the number of teeth they are working on.

It simply isn't sustainable; my worry is that we've gotten so used to that being the way things are done that we don't question it, even though it;s only been that way since the 2006 contract 9so twenty years).

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33backagain@reddit

Private dental insurance costs me £15-20’per month. That two check up, two hygienist appointments per year, and all work included when/if needed. That’s pretty much the same cost if you just had two check ups and private hygienist through the nhs. NHS isn’t much cheaper that private today (as long as your looking after your teeth).

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tyger2020@reddit (OP)

What private dental is that?

I'm gonna call bullshit here, most private dentists at best will give you a 10% discount on any treatment even if you're paying 30/month.

None of them offer 'all treatment included' for £180 a year.

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Single-Position-4194@reddit

It certainly sounds like a fantastic deal. Implants included (if required) and all? Crikey I'd go to a dentist like that if I knew where there was one locally.

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33backagain@reddit

Denplan. I pay for the whole family and forget who is charged what, but that’s about it. Go look it up.

Gemini says: For someone with decent teeth, a Denplan Care package will typically cost between £18 and £30 per month (averaging around £220 to £360 a year). However, because Denplan Care is a comprehensive comprehensive-care plan rather than a standard insurance policy, the exact price relies heavily on how your specific dentist sets their rates.

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amytee252@reddit

Last time I went for a checkup, the dentist asked me to open my mouth, he said all looks good, and that was literally it.

Prices have changed actually. They were frozen during covid, and then went up. I have to pay for Band 3 treatment at least once a year, and it's gone up by about £100 in the last decade.

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MrReadilyUnready@reddit

Complain. That's not an acceptable standard of care.

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Intruder313@reddit

Band 1 is very expensive when I often:
1. Sit in the waiting room for 15m
2. Sit in the dentist's chair for 1m

They don't even include the Scale and Polish anymore

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throwaway4477229@reddit

Dental work (and eye care) should be included FOC on the NHS. That they aren't is disgrace.

We could increase access by allowing dental hygienists and therapists to be used for routine checks and basic treatments. This would mean dentists are free to do more complex work and the hygienist/therapists can make full use of their training.

Their training is shorter than dentists so faster (and cheaper) to increase capacity too.

The NHS should also include scale and polishes - preventive care is sorely neglected and costs is a massive barrier. My NHS dentist does no cleaning as part of my check-up so they can push their private services.

2 NHS checkups and 1 private clean a year is £10 a month and if you're low income, but not low income to qualify for any benefits, that is £10 you may not have, especially as it isn't evenly spread out - my clean and checkup was just shy of £100 in one hit.

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mida0137@reddit

No. I’m going to have 5 root canals with a year. Getting a crown for each tooth costs Band C which is £332.10 which I can barely afford for 1 tooth.

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Kudosnotkang@reddit

I’d rather it was means tested rather than doubled across the board .

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33backagain@reddit

Around 1 in 5 people in the UK have private dental. Most of those that can afford to pay more already do. And it’s not really that expensive to get private dental (£15-20 per month).

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Kudosnotkang@reddit

Ok so those who ‘cannot pay more ‘ probably would be really screwed by a price doubling .

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Danglyweed@reddit

Im in Scotland so a scale and polish is included at every visit free of charge. I'd absolutely pay some sort of fees, speaking as someone with terrible teeth after i broke one (my upper front ffs) in labour and had to pay thousands for an implant.

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Only_Appeal_5403@reddit

Also in Scotland I always get charged for a scale with my nhs dentist. He only sees me once a year now too 😕

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Danglyweed@reddit

My man Andrews a fucking gem then

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Only_Appeal_5403@reddit

Where he at 😅

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Danglyweed@reddit

Borders town beginning with P

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tribordercollie@reddit

Absolutely not.

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NochMessLonster@reddit

I think £27.50 is actually incredibly reasonable for guaranteed 6mnth/yearly check ups and X-rays.

I would pay more, but I wouldn’t want it to increase so that those with a lower income can no longer access it. Perhaps it should be a sliding scale based on your tax bracket? I’m sure that’ll be a wildly unpopular opinion.

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33backagain@reddit

Something like 1 in 5 people have gone private already. A lot of those in higher tax bracket’s are already paying more.

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namegame62@reddit

I think I would, tbh, if it meant an expansion to services. Ever seen private dental insurance costs? It's like £15 a month at my local dentists, and that still doesn't cover everything.

If the band pricing + NHS dental contract means that dentists don't take NHS patients and services are private-only anyway - which is true in many areas of the country - the point is moot.

If I can pay £150 to the NHS on Band 2 but also NHS dentistry is more available and I can get, say, a white amalgam molar filling as standard (should I need one), I'd probably say yes.

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Low-Captain1721@reddit

It would make little difference to NHS dentistry availability as from a dentists point of view the difference between what they can get from providing private treatment & what they would get from NHS contacts as so vast.

Unfortunately the clauses of NHS dental contracts make them not viable in today's commercial market.

There is but a few NHS dentists in our city & their service is dire. My bro in law eventually got an appointment with one and he was given inappropriate treatment. He then had to go to GP to get follow up medication which the dentist should have prescribed (he was actually lucky here as many GPs wouldn't do this as not their responsibility).

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WDW1997@reddit

I don't agree with it as it is anyway. Either we have free healthcare (at the point of service, I know it's not "free"), or we don't. I'm fortunate enough that when I had a £300+ bill for a crown I needed, I could afford it, but I imagine there are people who can't afford it. If we didn't have the NHS, we'd have health insurance to make sure we're covered for things

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PurchaseDry9350@reddit

No. It's expensive enough as it is. Dental care should be on the NHS free at the point of use.

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The-Smelliest-Cat@reddit

Probably, although I've forgotten NHS dentists exist anyways. The nearest to me is over an hour away (the three NHS dentists in my town have all turned private), and it would cost about £20 in transport costs to see them, not counting the whole day off work for it.

If there was a way to tempt more private dentists into being NHS dentists, that would be great.

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