An investigation by The Times newspaper has found that thousands of people are losing their teeth because its more lucrative for NHS Dentists to remove them that to save them. Regulators say dentists were extracting teeth to avoid offering complex treatment, for which they are paid the same by the health service. The investigation also found some dentists earn almost £500,000 a year, as the system rewards them for seeing as many patients as possible.
Many dentists claimed the equivalent of over 60 check-ups per day, in what has been described as an unethical approach to patients. The upper limit of patients seen for a dentist is said to be 30 a day. Reforms introduced a decade back meant dentists are paid about £25 for every “unit of dental activity” (UDA) that they carry out. Each check-up or examination, is counted as one UDA, tooth extractions count as three alongside fillings and root canal work, regardless of how long the treatment takes. NHS figures seen by the paper show around 30 dentists were paid for more than 15,000 UDAs last year, the equivalent of about 60 appointments a day over a working week. Ten dentists were paid for more than 18,000 UDAs, amounting to £450,000. It’s said dentists routinely weigh up how much time and treatment a patient needs against a desire to maximise earnings.
The warning comes before a disciplinary hearing next week of the dentist responsible for the biggest patient alert in NHS history. Desmond D’Mello, 62, treated over 20,000 people, who were later called for HIV and hepatitis testing after he allegedly failed to change gloves or clean equipment between appointments in a bid to see as many patients as possible.
The president of the British Endodontic Society of root canal specialists, Mike Waplington said “There is an incentive from the system and some dentists may say to patients ‘I can take this tooth out simply’.” It is estimated more than two million teeth were taken out on the NHS last year as many dentists feel more comfortable taking teeth out, only 277 out of more than 40,000 are registered as specialists in root canal work. Figures show least 2,000 dentists claimed for more than 8,000 UDAs, equivalent to the limit of 30 check-ups a day.
Co-founder of Saving Teeth Awareness Campaign, Trevor Lamb said “The public are too quick to accept that teeth should be removed. They are unaware of the alternatives and some dentists exploit this. You wouldn’t go into A&E with a broken arm and expect it to be amputated.”
The General Dental Council say they cannot act because there is a lack of professional guidance which allows dentists to claim that extraction is a legitimate option. The council’s chairman, Bill Moyes said “I’m sure that if patients had a full understanding they’d be quite appalled”.