What are differences between NHS and private dentistry?


Many patients are confused about the difference between private and NHS dental treatment so we have outlined some of the differences below. The common assumption is that private dentistry is more expensive but this may not always be the case and usually the service and treatment outcome you receive is better and unrestricted.

Private

    • Cosmetic treatment is not available on the NHS. This means the materials/treatments which produce the best appearance are often not used. Private treatment will always give you the best possible functional but also cosmetic result.
    • You are able to have private appointments at anytime a practice is open including in the evening after 5pm or on Saturdays and sometimes Sundays
    • Private treatment gives us complete freedom to provide the very highest standard of treatment and materials. We have no funding restrictions and focus purely on quality of the treatment.
    • Private work such as dentures, crowns, bridges and implants are usually sent to different private laboratories where named experienced technicians hand make the item. In our case we have used the same award winning private dental laboratory and technicians since 2005. There is also usually more flexibility in returning items from a private laboratory quickly.
    • Appointments are longer to allow plenty of time to complete your treatment at a more relaxed pace.
    • Certain treatments are not always available on the NHS eg. dental implants
    • Tooth whitening is not usually available on the NHS
    • With private treatments you can request your treatment to be performed by a specialist and be given quick and easy access eg. a difficult extraction
    • Orthodontic treatment for patients over the age of 18 is usually not available on the NHS and invisalign is usually not offered on the NHS
  • Your dentist will discuss your treatment options and costs and give you a written estimate before you commit to any treatment.

NHS

    • NHS patients are treated with the same care as our private patients though the government does impose some restrictions and fixes the patient charges nationally.
    • Treatment needs to be functional on the NHS and not for cosmetic reasons
    • NHS treatment is designed to be cost effective for the tax payer and each NHS clinic works to a fixed NHS budget so naturally this means more cost effective materials and laboratories are used
    • We must follow government guidelines for recalling patients which may mean you may not be entitled to a check up or clean as often as you want.
    • NHS cleaning is designed to ensure gum health and treat what is clinically necessary eg gum disease and not to specifically remove all stains or for cosmetic reasons
    • Appointment availability may be limited. You may not be able to get appointments outside school or work hours. You may also not be able to see more experienced dentists or specialists who choose to work outside the NHS
    • The government imposes limits on the amount of NHS treatment each practice can provide and the contracts are usually Monday to Friday 9-5. Once a clinic reaches its NHS limit they may not be able to offer any more NHS treatment until the next financial year.

There are NHS clinics which will have contracts to provide emergency services on weekends and Bank holidays.

    • Some treatments are not available under the NHS at all or in certain cases eg. cosmetic treatments / dental implants or certain preventative treatments eg. fissure sealants for low decay risk patients
    • Tooth whitening is usually not available on the NHS
    • Hygienists are usually not funded by the NHS
    • Specialist referral on the NHS may not always be available and you may have to be placed on a waiting list if accepted

Your dentist should always give you a choice of NHS and private treatment options to enable you to make a choice which is right for you. You should then always be given a written treatment plan so you can see the treatment required and likely cost of treatment. In summary NHS dentistry is designed to be functional, whereas private dentistry is usually functional and cosmetic. Each treatment plan is individual and it is best to discuss with your dentist the available NHS and private options.

How to prevent tooth decay?

Although widespread, tooth decay is one of the most preventable health conditions. As long as you look after your teeth well and visit your dentist regularly i.e. every 6 months, you should be able to prevent tooth decay. Did you know that the children of most dentists have none or very few fillings? If you know what to do you can prevent fillings.

If you are unsure as to what tooth decay is and its process please read our previous blog.

There are also some changes you can make to your diet to minimise your risk of tooth decay.

Tooth decay is more likely if your diet is high in sugar. It is also far more likely if you have a higher frequency of sugary snacks in a day than if you have a high dose of sugar in one sitting. Cutting down on sugary food and drinks, particularly between meals or within one hour of going to bed will decrease your risk of decay. The best time to have a sweet food is as a pudding immediately after your main meal.

Effective tooth brushing i.e. brushing for 2 minutes twice daily with the correct technique and fluoridated toothpaste can also contribute towards reducing incidence of tooth decay. An electric brush is usually better at cleaning your mouth than a manual toothbrush. In addition, flossing is an important part of oral hygiene. If spaces are bigger you may need special small interdental brushes(tepee) rather than floss. It removes plaque and food particles from between your teeth and under the gum line – areas a toothbrush cannot always reach. You should clean between your teeth at least once a day with floss and then also visit a hygienist to have anything you have missed removed. A dentist and hygienist can give you personal tailored cleaning advice to help reduce your risk of tooth decay.

Straightening your teeth eg. via orthodontics can also help you to keep your mouth clean and reduce your risk of tooth decay. Your dentist can also perform fissure sealants, which is a simple pain free way to smooth the biting surface of your molar teeth. This reduces the amount of plaque building up and therefore reduces your risk of decay on one of the most prone areas in the mouth. Ask your dental professional for more advice.

What is tooth decay?

You may also have heard it called dental decay or dental caries. Over time, symptoms of tooth decay can include:

  • toothache
  • pain when eating or drinking
  • visible discoloured spots on your teeth

If left untreated, a build up of plaque could lead to complications of tooth decay such as gum disease (gingivitis) or a dental infection. Regular dental checks can help your dentist spot signs of tooth decay early and identify any cavities (holes or damage in the teeth). Tooth decay is much easier to treat successfully in its early stages, sometimes without the need for an injection.

Causes of tooth decay:

Your mouth is full of bacteria, which combine with small food particles and saliva to form a sticky film known as plaque, which builds up on your teeth.

When you consume food and drink high in carbohydrates (sugary or starchy), bacteria in plaque turns carbohydrates into acid. Over time, acid in plaque begins to break down your tooth’s surface. Left untreated, plaque can completely destroy the outside of the tooth and expose nerves inside.

decay pic

Once this happens, you will have toothache. When a deep enough  hole is created in your tooth by this process you will need to have this restored with a filling.

So you are more likely to get tooth decay if you don’t clean off the plaque ( brushing twice daily/flossing) or if you have a diet high in sugar. Your dentist/hygienist can analyse your diet and also advise on how well you are cleaning as well as other factors to assess your decay risk.