Thursday, October 05, 2006

Smile!



Damn I forgot. We can't smile, we're British. Dental care in this country has gone down the toilet. In the last year it seems, to us on the frontlines , that the crisis is deepening. No-one can register with an NHS dentist, private dentists often require that the patient's entire family join a 'dental plan', and some stipulate that only the 'dentally fit' may register. Yes you read that right, only people who don't need a dentist can get one.

A good 40% of my calls on some days are dental. I speak to people who need to register because they've moved house and have unregistered with their previous practice, or people with snapped teeth, or sudden toothache.

I need to register with an NHS dentist in my area. Can you help?

Well I'll try. Firstly the tools available to us are, for the most part, no different than those available to you, dearest reader. We used to be able to search for which dentists were currently registering certain types of patients, ie. on benefits, under 18 years of age. Now we can only search for the nearest practice to your home postcode. So I go here:
http://www.nhs.uk/England/Dentists/NearestSearch.aspx
I'll type in your postcode and try to locate a dentist that will register you. This is problematic for several reasons.


  • They've crippled the search to return a maximum of 25 results. In a densely populated area this is useless, as all 25 are likely to fall within two miles of your address. I suspect this is so we can't say "The nearest I can find to you is 63 miles away" We used to be able to tell people the truth, we can't now. This makes them even angrier. Some people are so desperate they'll drive 20 miles there and back, some won't go as far as the next street. If they moan about a 2 mile journey my stock response is "at least you don't live in Leeds" (try it on the dentist search applet)
  • Results are ordered by distance from your address as the crow flies. Geographical features such as major rivers and huge mountain ranges aren't taken into account. Sucks for you if you're not willing to swim across the Thames.
  • Results are not grouped by PCT. I might find a dentist in the next street, but if it's not covered by your home PCT you're bang out of luck.
  • Dentists rarely inform us when they stop taking patients, so information is often inaccurate.

If I can't find one within a decent distance then I'll have to give you the Dental Enquiries number for your local PCT. This is a poor solution as they often say "call NHS Direct". Lazy swines.


Owww my tooth hurts. What should I do? I need a dentist!

OK. I'll run through a quick assessment. I'll find out why your tooth hurts, for how long, if you're registered with a dentist, and which painkillers you've tried. Unless there are exceptional circumstances the following will put you to the bottom of the queue:


  • You've had pain (or claim to have had it) for more than two weeks.
  • You haven't tried anything to relieve the pain except crying and calling your helpful NHSD Health Advisor a c***
  • The painkillers are working for you.

If you've got a seriously bad case of tooth-hurty, then I'll be able to find an EDS (emergency dental service) for you. You will accept whatever details I give you. Whining that the EDS is 4 miles away will dump you at the bottom of the steadily growing dental queue. Asking "Are there any appointments sooner/later?" and you get dumped in the queue. It's for emergencies. Threatening me with "I'll go to A&E then!" will merely serve to make me laugh, and trot out my standard response of "That course of action would be extremely unwise, as you have not had an accident, and your pain - although bad, is not technically life-threatening." That threat cannot make me magically summon up a personal dentist for you. In fact, go to A&E if you must, they'll give you two paracetamol, 15ml of lukewarm water, and a card with our number on it.

Sometimes the EDS will require a nurse assessment before patients can be referred, this is usually for services that have very limited availability, and therefore can't see everyone. Please don't bitch to me about this. I don't have the address or phone number of the service, and no amount of whining can get it from me. Speak to the dental nurse, they're very patient and can often give you tips to dull the pain until a dentist sees you, it's their job.


I'm angsty after writing this. I keep hearing from callers that "A&E/my dentist/my GP/told me YOU could treat this!" We can't. They know we can't, and they know that saying that will get rid of you. I even get A&E staff calling and demanding to know why I can't find Patient X a dentist now, and why there's no EDS provision in that area. I really don't have the answer to that. Don't you think I'm tired of speaking to people who fill their own teeth with a Dremel and caulking, or knock them out on a cupboard door to stop the pain, or sick of being abused for everything that's wrong with the NHS?

Instead of asking someone perilously close to the bottom rung, why not speak to the Minister for Health?

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