Roland Perry wrote:

So if the procedure takes two hours to do properly and with due care
but the NHS only provides adequate funding for 20 minutes, what do
you suggest the dentist does?

In the long term try to ensure that there's not such a big gap. There
must be some sort of trade association to deal with that. In the mean
time I'll take the view that while there may be some gap, one of the
size you postulate is simply a debating point rather than reality.

I can actually give you some figures, since I did discuss this with my
previous dentist. He said that a basic filling in a molar takes at least
40 mins to do properly - he would prefer an hour in some cases. The NHS
provides funding on the basis that the job takes 15 mins.

He said he could just about do a filling in that time, but only by
drilling directly after injecting analgesic, and skipping most of the
thermal insulation and nerve protecting layers of the filling. Basically
clean out the decay, and fill directly, with little time to tool a
decent surface on the filling. The result would be a filling that would
last at most five years, and would transmit even slight temperature
changes to the owner of the tooth quickly and painfully. He also said
that for every NHS job he took on there was about 10 to 15 mins of form
filling to go with it. He put up with doing NHS work for ten years (he
originally worked in Ireland), but then for the last 15 years or so
before retirement he gave up all NHS work as the stress was too much.

Take the money and bodge it?
Decline that patient?
Do the job well enough and make a loss?

Most do the second (ie they decline all NHS patients).

Indeed, which means the NHS is failing to provide any service at all in
most cases.

A conscientious one will do the third.

Perhaps, but you can only do that as an exception rather than a general
rule.

And bad dentists the first.


--
Cheers,

John.

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