How does your dentist charge you?

I've given up hygienists! My teeth and gums are generally good apart from a bit of tartar build up behind the front ones and the dentist used to deal with that as part of the check up. But now it means a visit to the hygienist and a bill of £48 as they're private. It seems a bit over the top for five minutes. So I've decided to just treat myself every five years or so.

A previous, long term, private dentist began to ask for a deposit before any appointment, whether for checkup or treatment. Treatment requiring a number of visits was billed in stages. Hygienist appointment had to be fully paid at the time of booking. We had always received excellent treatment there so didn't query it, assuming a general change of approach. When we moved to a different surgery on the death of our dentist we found this way of charging was thought to be unusual. We moved house and location and were able to register with an excellent NHS dental practice, there is no charge until treatment is finished.

I ve never been charged upfront and I ve had a number of NHS dentists over the years and always paid after the treatment Hiw can you pay upfront as you don't always know what's needed I went in for a simple extraction ( I thought) and ended up with 6 months treatment which I haven't yet been charged for
You can easily move from one band to the other within the treatment so paying upfront can't be a possibility surely ?

That story of the woman refused repayment of an overcharge would make me very wary that the surgery is about to fold,
A few years ago we were overcharged by direct debit for something and when I rang to complain I was talked into having a couple of months with no charge and a reduced charge for the next few, I agreed and the company went bust days later.

I had a checkup at my dentist and asked them about charging. They charge after the checkup for that and any necessary treatment all at the same time. They confirmed that the treatment was with the practice and a change of dentist half way through the course would make no difference. DiL is composing her complaint - about the treatment as well as the cost - with lots of bullet points!

My private practice charges you after you have had the treatment.

Most relevant to this case; after an implant I had a severe allergic reaction to the mouth wash I was given. I went back to the surgery the following day and the dentist dropped everything to check that it was an allergic reaction and not a problem with the implant. I had a full set of x-rays and photographs were taken of the state of my swollen bruised face.

It was made clear that I would not be charged for all this care, which occupied the dentist for nearly an hour.

Thanks All. I've Googled PALS and passed the link to DiL. I think she will complain because of the attitude of the administrator. That and our overhearing a patient at reception trying to get her money back for an hygienist visit which had been charged twice. She failed. They acknowledged the payment had been taken twice and said they couldn't refund but she wouldn't be charged next time! Next year!

My private practice has its charges on display too.

I think the only notice it had when it was NHS was how much you'd be charged if you missed an appointment!

As I said, most dentists don't charge upfront but are entitled to and by signing the NHS form you are agreeing to pay upfront if asked to.

All NHS practices are required to have an up to date list of charges on display. They should also have their complaints procedure on show too!

Same here ( as Eloethan.) Never paid upfront.

Sounds a bit dodgy to me - even if it's not, for the sake of good patient relations and in the specific circumstances, any decent dentist would waive the fee.

I wonder if the dentist who has left carried out the treatment properly in the first place. Leaving a position without another one to go to might suggest that she was not up to the job.

I go to an NHS dentist which very clearly lists the cost of each procedure, and which never asks for money upfront. I think I would change dentists.

Patient Advice and Liaison Service but follow Janea's advice as she knows.

Ana dentists are usually self employed but are paid a percentage of what their NHS contract is worth, unless they own the practice, or what the practice charges are for any private treatment.

That sounds mad! Surely the dentists are employed by the practice, or are they all self-employed, in which case the first dentist will have made off with your DD's first payment when she left!

I've never heard anything like it...

The practice acknowledged that she had already paid for a filling she hadn't received but that she had to pay again as she was now assigned another dentist -who was very nice, efficient and gentle today and DiL is happy to stay with her.

(What's PALS Kitty?)

The filling was a different tooth. She was charged up front for the check-up, x-rays, extraction and filling but it wasn't itemised, she just had a till receipt. I suppose this could have been because she was a new patient. The practice obviously knew the dentist was leaving in two weeks. According to the hospital the abscess may not have shown up on the x-rays as it was draining freely - the dentist did say that she thought the exiting filling in the extraction tooth was being pushed out by the abscess! (DiL did say she had a nasty taste in her mouth!). It was difficult for the Administrator to sort out as the notes were far from complete. I think the dentist was rushed out because it had taken so long, so she had people waiting. A swab was put in but removed before DiL left the room - much too soon according to A&E. Oh, and yes, this is NHS.

nfk Ask for an explanation from the practice owner (the senior dentist) and voice your concerns.
Quite aside from the double charging, they seem to have serious customer service issues.
You may not get anywhere with that approach, as it may be that the practice is owned by a corporate body and no-one within the practice takes responsibility.
If that's the case, take it as high up as you can, either with the corporate body, the NHS or the GDC, who regard 'misleading patients' very seriously.

gemmamag it certainly isn't the case that it's standard practice to Xray before any treatment is carried out.
Nor is it usual to prescribe antibiotics before extracting a tooth with an abcess.

I think the filling was in a different tooth - no way would she be returning to get one in a tooth extracted a month before. However, I am surprised that the one extracted wasn't Xrayed first.

They do try not to give unnecessary Xrays these days. I don't get Xrays for run-of-the-mill fillings. If I did my mouth would glow in the dark by now.

What I can't understand is why your DiL had a filling in the first place!. Did she not have an X-ray as this is standard practice before any treatment is carried out. The abscess would have shown up and antibiotics prescribed and patient told to go back a week or so later when the abscess had cleared up.

I use a private dentist but no way would I have paid the second time although I understand that the fee was waived.

If I were your DiL I would make a formal complaint to the head of the practice but I would not sue them.

At our NHS dentist you pay for your check up and any work found to be needed when the check is done, so yes you pay in advance for fillings etc.
I would say that you pay the practise and not the individual dentist, so her contract was with the business - therefore she had already paid for the filling.

If you sign for NHS treatment Ana you are agreeing to paying upfront however, most dentists won't charge unless they suspect that the patient will make appointments and then not return.

It's not clear whether she was charged for the extraction and the filling first time round. They should ask that specific question. Most treatment would have a 'guarantee' period - NHS or private.

Excess bleeding is not necessarily the fault of the dentist.

Dentists (under normal circumstances!) have to give 3 months notice.

Nfk and/or her DiL could contact their local PALS or Healthwatch for further advice - and a new dentist!

Asking her to pay a second time for the same filling WHICH WAS NOT DONE is double charging. If she paid for the extraction once, they will have a record of it, and if the originaldentist recorded her work it should be clear that the appointment was a disaster and the filing never got done. even ifit had been, when I get dental work done, I "sign up" for a set time and anything needing redone within that time is free.

Plus, any remedial work she needs as a result of the complications of the original extraction are the responsibility of the dentist who did it or the head of the practice. There will be an A&E record of the emergency treatment she received, the cause of it, and the date.

Perhaps the original dentist left abruptly because of the standard of her work (and record keeping) and the practice head is wary of admitting too much responsibility in case your DiL takes it further and sues for recompense for the pain and trauma she received? In fact, given the result of her "treatment" they should be falling over themselves to be nice to her.

I suspect she needs to find a new dentist.

My dental practice is Private and I've never been asked to pay up front. Never was when it used to be NHS either!

I'm sorry your Dil (and you!) have been through the mill like this!

Is she an NHS patient Nfk? If she is, I would think that the first dentist was not the contract holder - that would be the owner of the practice - so I imagine that the NHS charge should cover the whole treatment. NHS charges are payable up front.

I would think that the practice would have known that the first dentist was about to leave.

Don't know if there are rules about private work.
It seems reasonable to leave it a while to heal before having any treatment.