PJ,

I had no idea you were in the UK. Thank you for explaining the process to us. It is most unfortunate that you have to go through so many steps and wait so long to be seen by the specialist. Here in the US.... that waiting thing.... would not be tolerated too well by most Americans, probably because we've never really had to deal with that. Many people here have insurance coverage that requires them to get a referral from their physician or dentist to see any specialist. However in most cases, there is no waiting period and if there were, the paperwork would generally be moved through quickly. Other people have insurance coverage that does not require a referral allowing them to obtain special medical or dental services very quickly.

The only way I could foresee getting you into the specialist sooner is for your new dentist to do the referral now instead of waiting another two weeks. She has already examined you and determined you need the referral. So why can't she do the referral based on her last exam of you?

It must be frustrating and difficult to remain tolerant during this drawn out process, especially when you are living with a physically uncomfortable problem. Gosh, I don't think I could do it!

Please keep us posted. And thanks again for explaining all of that to us....

Bryanna



QUOTE=pjsavvy;839102]Hi Bryanna,

Sorry but I don't quite understand your question re why i'm not consulting an oral surgeon on my own. It might be due to different procedures as i'm in the UK.

Here, there are generally two types of dental practices - NHS funded ones (which are more affordable) and private ones. The private dentists cost far more but generally provide better treatment and a speedier service. Both types are qualified 'oral surgeons' but they will generally stick to common types of dental work such as fillings, root canals and simple extractions.

When a more complex case presents such as roots in the sinus, impacted wisdom teeth, deep cysts etc, the practice will usually make a referral for the patient to see a specially trained oral maxillofacial surgeon based at the local hospitals. These surgeons are uniquely trained in such surgery whereas general dentists are not. They are also able to administer general anaesthesia in a hospital but it is not legal at dental practices.

Thus the routine is for a patient to be evaluated by a dentist at a general practice and if any challenging surgery or further investigation is required, then it gets referred to the specialists. A patient cannot get an appointment with a specialist surgeon directly though, they must be referred by a dentist or GP. Same applies with any surgeons (cardiologists, gastroenterologists, urologists etc), you have to get a referral from your doctor.

I was originally with an NHS dentist but decided to spend extra and go to a private practice as I was concerned with the swelling and discharge. The dentist at the private practice examined me and then advised that she would refer me to the specialists, but only she can do that.

My dentist advised that she will make the referral when I next see her which is in a couple of weeks. I'll then receive a letter from the hospital setting me up an appointment with the specialist surgeons for consultation.

So as it stands, i'm doing everything correctly but will just await my consultation appointment at the hospital. I'm not at all resting on my laurels from bad advice from previous dentists. If nothing was wrong then my palate wouldn't be as it is.

I'll keep you posted how everything goes!



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That was the point I was trying to make to PJ too. Why is her dentist making here wait the two weeks for the referral when she already knows what the problem is?. Why the extra waiting period? The UK must be very different. It just seems there is an extra step in there that could be remedied with a quicker appt. Then there is the issue of how long before she gets into the hospital for the proceedure.
Keep me in your thoughts tomorrow. I will be under sedation and glad of it. #18 is painful today, so I am grateful it only took a few days to get me into the surgeon. I am not nervous this time for some reason. Just happy to know it will be over soon. thanks for all your help Bryanna. I sure hope that doctor sticks around this site to help out. take care, ginnie

Hi ginnie,

I know, it's hard to understand how someone is made to wait so long for an appointment to see a specialist. But perhaps this is the way it has always been in the UK and so the people there are just use to it. I also don't know why there is a delay in the dentist making the referral, but it's up to PJ to question that.

I will most certainly keep you in my thoughts and prayers.... I'm sure all will go well tomorrow and you will be very relieved to be rid of that bad tooth!!

Make sure you check in with us afterwards ;-)

Bryanna

Hehe, it's not as as bad as you may think. Physicians have a 'Two Week Referral' system for anything which is deemed dangerous to a patient. So for example, if a doctor finds a suspicious lump on a woman's breast, they'll be referred under TWR. That means they must be seen by the specialist surgeons within 14 days of the referral.

There is private healthcare which is quicker and arguably better but the NHS is a service funded by the government (the tax payer covers it) and sees that patients get their treatment in hospital free of charge. I have long wondered what the difference is between a US citizen paying health insurance and a UK citizen paying taxes to cover the NHS.


My dentist could have made a referral before now and was happy to do so, but it was just before Christmas and New Year and so was agreed that we would enjoy the holidays before progressing things. I also wanted to look into the possibility of private treatment but have found this to be a bit too expensive. She was kind enough to give me amoxycillin and metronidazole in case anything flared up over the holidays but i've been fine.


That's the strange thing, it's not physically uncomfortable. Yes, the palate is a bit swollen and there is drainage if I compress the area, but if I leave it alone then I wouldn't even know there's a problem! Of course though, I know that there is a problem and i'll look forward to having it sorted out.

Good luck with your treatment Ginnie. I get the feeling you'll be a rather relieved and happy person once it's all done!

PJ,

Well then, that's makes me feel a little bit better

Funny you should wonder the comparison between the US and the UK insurance premiums.....as many of us in the US wonder the same thing!
The overall cost of healthcare insurance in the US is extremely high and the coverage varies greatly from one policy to another. To my knowledge, there is no medical coverage here that will cover 100% of the hospital cost other than medicaid. In most cases, the patient usually has to pay some portion of the bill in addition to a deductible. With medicare, the person usually has a supplemental policy that they pay for in addition to their medicare which is used to pick up the balance on certain procedures. But none of these things are inexpensive by any means.

Is it mandatory or elective to pay toward the NHS healthcare coverage?
Your private coverage... may be similar to here. Are there various policies to choose from or just one?

Sorry for all the questions, just curious how different the systems work!

Bryanna


[/B]

I am almost finished with my dental work. Last appt. is the 12 of next month. all is well and I have my smile back. My son is still working weekends to help me pay my bill off. My oral health is alot better.
There is a young girl posting with some questions. I hope you can help her. She isn't exactly being told the information she needs.
Thank you Bryanna! ginnie

Hi ginnie,

So glad to hear you are almost done with your dental work....and everything is going well.... YAY!!!!!

Thanks so much for keeping an eye out for everyone here..... ;-)

Bryanna

I've just joined this forum, but not sure if it is still 'live'. I really hope so!

Bryanna - your posts have been so informative, and I've spent the last couple of hours reading all the old messages. I feel much more confident with my visit to the dentist this afternoon.

I have had an ongoing 'niggle' with a cracked tooth for 8 years. I have had it refilled twice, and several months ago an overlay was added, but still I have the minor discomfort and reaction to cold liquids. I notice it more when lying down but that could be because I'm not distracted!

I have just had a consultation with ENT because of ongoing sinus issues. I'm referred for an MRI next, as he couldn't find any evidence of sinusitis, but I can feel the throbbing in my upper molar radiating up into my face. I have had repeated sinus infections. I also have post nasal drip.

I now wish to have the tooth extracted, but would it be best to have a cone beam CT scan to check the root/sinus area first? Or will the MRI reveal enough information about the tooth as well as the sinuses?

Fingers crossed you are still around.
Thanks again
Lynney

Hi Lynney,

Cracked teeth can be a chronic problem depending on where and how big the crack is. Sometimes a crown will fix the problem but if the crack is in the root structure, a crown will have no effect on it. Root canaling a cracked tooth does not solve the problem it just exacerbates it. Total waste of money.

If you are having chronic sinus issues... it could be related to this tooth. The fact that the tooth bothers you more when you lay down can be indicative of sinus involvement. What did the dental xray of this area show? Can you post it here?

Bryanna