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Dentistry

The current state of NHS dentistry

In 2003 a new dental contract was introduced the purpose of this was to produce a better dental service to benefit both dentists and patients.

However it would appear that major problems are arising with the new contract from not only the dentist’s point of view but also the patients. The dentist’s salary is now  related to the production of units of dental activity (UDA) which like the old system of payment is related to the number of fillings, extractions, etc. provided,  but dentists believe that all that has happened is instead of a salary based service like Doctors they have exchanged one treadmill for another.

From a patient aspect, although the new three bands of fee payment are much easier to understand, it often means for a simple routine procedure the patient is paying far more than they were previously.

Of deeper concern is that the fact treatment is tending to be skewed as under the new system the dentist gets the same UDAs for complex treatments (i.e. root canal treatments, bridges, etc.) as for providing extractions and plastic dentures. There is no incentive therefore for more complex and time consuming treatment to be provided, indeed there is a disincentive as if targets are not reached the dentists “salary” will be reduced by the primary care trust who now hold the purse.

This situation is likely to get worse in 2009 when the contracts are reviewed by the Primary Care Trusts (PCTs), and large numbers of dentists are likely to leave the NHS , as the  Primary Care Trusts are likely to  give NHS contracts to those dentists who can produce the most UDAs for the least money. This will affect the quality of dentistry provided.

Those patients that have difficulty accessing NHS dentists should approach their local PCT who hold lists of NHS dentists in their area.

In the future patients may need to consider private treatment, either via direct payment to the dentist, or many dentists now have capitation schemes whereby dental treatment is provided via a monthly payment dependant on the condition of the patient’s mouth.