Hot Topics in Dentistry: MMIs- part 1
Updated: Jul 12, 2021
Tell us about your understanding of dentistry in the NHS. Do you think dentistry should be performed by the NHS for free? Why do you think NHS dentistry costs money?
Costs are divided into 3 bands:
You pay Band 1 for emergency treatment.
ie dentistry is not free, unlike most other areas of healthcare in the NHS
Dentures were actually the first areas of the NHS to cost money as by 1951 the NHS was running out of money.
It's pretty impressive if you know the 3 founding principles of the NHS (founded in 1948)
Available to everyone
Free at the point of delivery
Based on clinical need rather than wealth
You could also mention about the importance of dentistry with regards to both physical and mental health and therefore should be more accessible? Additionally, the NHS does not provide cosmetic treatments despite its potential impact on mental health.
However you could argue that maybe it is justified for dentistry to cost money since many dentists are going private so this could be a financial incentive for dentists to stay.
Also dentistry is inherently expensive due to the advanced training dentists require, the costs of high quality materials as well as sterilisation and infection control
Tell us about your understanding of UDAs.
Why do you think so many dentists are going private?
Tell us about your understanding of NHS dentistry
UDAs or Units of Dental Activity is a measure of how productive dentists/practices are.
Every NHS dentist/practice is given a certain number of UDAs to satisfy by the government- treatments will give a dentist a certain number of UDAs. A dentists or practices are financially penalised if they do not satisfy the UDAs.
Does not take into account education
Disincentivises preventative work
Extracting a tooth and conserving it would give the same number of UDAs but extraction is much easier
It's higher 'value' to do more fillings and extractions
Incentivises dentists to take on patients who require shorter courses of treatments
Disincentivises taking on high need patients
One filling can have the same number of UDAs as five fillings, a root canal treatment and extraction (3 UDAs)
In order to satisfy UDAs, appointments are required to be rushed to get through a huge backlog of cases.
Obviously this is sub optimal for various reasons
Best interests etc
In 2016, a BDA survey showed that 93% dentists believed UDAs where standing in the way of treating patients in need
Also 70% feel that contracts are limiting their ability to take on new NHS patients
Leads to a lot of pressure on NHS dentists
NHS dentistry fails to see 55% of the population.
30% decrease in income for dentists over a 10 year period
Charges of treatment over the past 5 years has increased 4x faster in England compared to Wales
1/5 patients delayed treatment because of the cost
Many resort to DIY dentistry
How has the pandemic affected oral health and dental care?
Link to how there is already a backlog of dental patients and problems with NHS dentistry/contracts
Even more pressure on NHS dentists
Immediate consequences of increase in anxiety and uncertainty
Dentists had to close during first lockdown
How important is dentistry? Physical and mental health.
ICU beds taken up
Oral cancer patients
Patients in hospital at risk of COVID
Outpatient consultation affected
Appointments cancelled due to pressures on practices but also uncertainty/anxiety
Lots of air powered tools in dentistry
Spread the virus
Close contact with mouth
Harder to do video consultations, unlike GPs
Gingivitis, periodontitis, oral cancer asymptomatic in early changes so regularly check ups are important
How has/will Brexit affect healthcare/dental care?
How has Brexit affected staffing?
Brexit may lead to a shortage of nurses
Impact on patients:
Source of comfort and worries
Integral in patient care
Especially patients with COVID who can't see their families
Impact on doctors:
Like extra workload
Significance of the aging population
High demand for healthcare
People keep teeth for longer
Age related diseases
But shows the NHS is doing well as people are living longer
Border disruptions and delay
Higher tuition fees for EU students
See part 2 for use of amalgam, fluoridation and the sugar tax.