Sam Lister reports for Dispatches: The Truth About Your Dentist
Going to see the dentist may fill some people with trepidation, but in NHS dentistry there's more than the odd drill to cause concern. During a three-month investigation, we uncovered evidence of a system that often prevents the patient from getting the right treatment at the right price.
We sent reporters undercover to identify common ways in which dentists 'game' the system, while professionals themselves also blow the whistle on concerns about how NHS dentistry has become less about the promotion of oral health and more about the pressures of time, money and an unworkable Government contract.
Reforms brought in five years ago were meant to improve dental health and access to dentistry. They were meant to make life more straightforward for dentists and patients, turning a fee-per-item system into one with three bands of treatment, and three rates for the patient to pay. But while the changes have increased the number of people seeing an NHS dentist, in many instances they have had damaging repercussions. Some dentists have found themselves unable to give up the time for the procedures their patients need, and out of pocket if they try. For some it is now simply a question of working a flawed system as best they can, but as experts and insiders show, the fundamentals of good NHS care and full disclosure are being badly compromised.
Our reporter needed a root canal treatment for an infected molar tooth, one of the most common procedures on the NHS. Despite checking in as an NHS patient, he was encouraged to go privately wherever he went - with dentists waiting until he was in the operating chair before advising that the only option for safe and successful care was to pay far more than the NHS rate. Others warned that going on the NHS would be impossible unless a patient was referred to hospital, or if they went for the extreme fix of having the tooth extracted. None were clear about the prices that our patient should have been paying.
We also visited dental laboratory workers – those responsible for creating the dentures and other dental fittings - who reported how the care of patients is now being compromised by cost cutting. Unregistered laboratory work imported from abroad, for a fraction of the market price, is becoming ever more attractive. But as our programme shows, the safety of such products is, at best, unknown.
The financial pressures show no sign of abating. The ring-fence protecting the dentistry budget was removed in March, and dentists warned that the temptation for health trusts to dip into the dentistry budget will be getting ever stronger. The Government has promised another set of reforms to ensure the quality of dental care – and the outcome for a patient – is what's rewarded. But many fear that with dentistry as hard pressed as it is, little if anything will change. As our Dispatches investigation shows, the rottenness in NHS dentistry is going to be very difficult to remove.