Britain’s teeth aren’t that bad – but what of their rotten history? | Hacker News Reader

Britain’s teeth aren’t that bad – but what of their rotten history?

theguardian.com

23 pointspepys20 comments

What is rotten is overcharging by dental practices. The NHS fee structure is extremely simple [1], yet because people do not research the charges, receptionists are able to easily mislead people.

Often the dentists do NHS and private work and they either tell flat out lies such as "that's not covered on the NHS", and/or suggest their brother/sister/best friend does the work privately) or just makes up random fees.

http://www.nhs.uk/chq/Pages/1781.aspx?CategoryID=74

I don't know why this is being downvoted, this is completely accurate for the English NHS where the UDA system is used (Northern Ireland and Scotland have a different fee per item system).

Many English NHS dentists encourage patients to return for multiple treatments instead of doing all the work in one treatment.

I'm not sure what you mean, things are charged by the course, no?

http://www.nhs.uk/NHSEngland/AboutNHSservices/dentists/Pages...

>You will not be charged for individual items within a course of treatment. Depending on what you need to have done, you should only ever be asked to pay one charge for each complete course of treatment, even if you need to visit your dentist more than once to finish it. A course of treatment is finished when your dentist considers good oral health has been achieved.

Have I misunderstood what you meant?

I'm guessing that was GPs point, that receptionists and doctors will happily fail to inform patients of this, and rather make separately charged appointments.

While I haven't been to the dentist yet, after living in UK for a year I can testify that the bar for cheating or misleading customers is very low.

As an example, taxi drivers usually pick a longer route than necessary, sometimes driving around the whole city. Especially if they perceive that you are not local.

Yes, that was exactly my point. And you are right abut the bar being very low! It drives me crazy

A record of the work done will be on file, have you taken this to the CQC or regulatory body?

I appreciate the onus is on me to provide evidence, and you've perhaps interpreted my comments as personal experiences only. I was referring to of cases of people I know - at least 3 instances this year alone - and I was not saying that every practice overcharges everyone.

However I myself have not been ripped off by an NHS dentist - mainly because I am aware of the bands. I would certainly take it further if they tried to.

I guess I'm finding it just surprising, I've never experienced anything like that, nor have I ever heard of it from anyone I know. I know plenty of people inside the NHS too, as well as simply many people who will have used these services. I'd have expected to see more problems if there really was a "very low bar for cheating customers".

There are regulatory bodies specifically for dentistry as well as for the NHS and sales and advertising. I would heavily suggest that they report this, there seems to be places to do so and I consider this an extremely important issue to solve if it's happening.

I'm not saying you're wrong, just that your friends experiences are so vastly different from my friends.

Odd, I've never experienced anything like that with the NHS, nor heard of our from anyone I know. There will be a full record of your treatment so this sounds like a very risky thing on the part of the practice.

I thought it might be that many practices are both NHS and private and you can have some things covered but get some private work done at the same time.

I can't comment on the taxis much but all will be regulated with the local council so that would be a point to start a complaint. My only note is that some cities like Liverpool or Manchester can have major congestion which needs avoiding, as well as (particularly on Liverpool) seemingly insane one way systems.

Uber and some other local versions send you a receipt with a map of the route taken which you could complain with.

Consumer protection laws are pretty strong here. I can dig out mode specifics if it'd help.

Missing teeth is one thing but British orthodontics are far less commonly used than in America. America also has a far higher negative stigma against gaps or unstraight teeth.

They ARE that bad. Anecdata perhaps, but come on - Americans really do have whiter teeth. At least the "privileged class" does. Downvote me to hell if you like still, I have lived both in UK and US for a decade and yes it is true, British teeth are nearly as bad as Japanese teeth (who don't use any flouride in their toothpaste, and it shows by the age of 40 or 50)

Is whiteness really a good indicator?? My teeth aren't particular white but 25 years and I've never had any work needed on them. I know plenty of people with really white teeth who have had more fillings than I can count.

Anecdotally, I'd say there's a correlation, but I too know plenty of counterexamples.

Hollywood white teeth == healthy?! How? To me they look bizarre, do normal Americans really have teeth like that? (serious question)

I'm an American with $10k or so into Orthodontia to make my teeth straight (I had gaps that were a big self-confidence issue for me) but no, seeing someone with insanely bleached white teeth definitely stands out in my head and always looks strange to me. I think there is a pretty big line between Hollywood White and Smoker Yellow.

To give a perspective, if it's needed, when I was in middle school (6th-8th) just about every single one of my friends at that point had either had, or was currently wearing braces of some sort.

I've now had braces 3 times (Invisalign actually) because my teeth won't stop moving. If I go a few days without wearing a retainer (I wear it nightly) they look different. A month or two without (I've lost the retainer before) and I'm going for round 4. Not sure if this is a genetic thing, or what, my cousins and sister have had the same thing happen, but I know plenty of other people who have never worn their retainers and barely had any movement.

"Braces" culture is interesting. I grew up in the rural southeast of the US, and while braces weren't unheard of they were uncommon. I have friends from new england who reported the opposite - most children, even those from poorer families, had braces.

Driving to the orthodontist was a major pain for my parents, so maybe that had something to do with it. They had to take off work early, pick me up at school, take me to the Ortho and wait around for an hour while the braces were aligned - EVERY month. I'd imagine it's even more of a pain for those in rural areas who have less options. The orthos next to schools made out like bandits. But my parents were also Military, so maybe that's just my experience.

https://www.youtube.com/watch?v=ECgQjZYAGqs#t=9m49s

As a British person I find the joke quite amusing, and it's always something that's commented on when I'm in the states ("your teeth are pretty good for a brit", that kind of thing).

I think on the whole it shows a gap in expectations between the US and the UK. As nations we have a different view of what is 'normal'. I often think that my US friends look like they're wearing dentures, because their teeth are (in my eyes) unnaturally perfect. They look strange to me. If as a nation you expect that level of perfection in teeth, then everybody else who has 'natural' teeth are going to appear to have bad teeth.

It's clear why we're in this position (both nations), and it's entirely to do with the way our dental care is funded (privately in the US, publicly in the UK). Our system clearly targets just issues, whereas the US system also has a focus on cosmetic.

I think that's slowly changing in the UK, people are willing to pay some of their own cash for dental treatment, but there are still probably very few people (relatively) who pay for dental plans.

I don't know what the figures are for NHS/Private but I've been wholly private for 15 years or so. I don't think it's that uncommon?

The emphasis with private practice is very much biased towards prevention. My experience with the old NHS system was entirely the opposite.

I am of the generation where NHS dentists were paid per filling. I don't know how the system works now but I'm in no rush to find out.

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