Medieval dental care under Britain’s NHS

When I was growing up, my father was a teacher with a lousy salary and lousy benefits.  The only good thing he had was his dental plan.  It was a wonderful dental plan.  Provided that we got our teeth cleaned and checked twice a year, it would pay the total cost of any dental work needed.  (And, unsurprisingly given the careful maintenance our teeth got, we never needed fancy dental work.)  One of the side benefits of the plan was that it got me in the habit of making regular visits to my dentist to keep my teeth up to par.

Going to England for my junior year abroad didn’t change that habit.  About half way through the year, I decided that I absotively, posolutely needed to get my teeth cleaned, even if I had to pay out of pocket for the experience.  While visiting a friend in Surrey, I managed to get an appointment with her dentist.

The tooth cleaning I got was, to this spoiled American, surprising.  First, the dentist did it himself, as opposed to a technician.  He explained that, since people didn’t get their teeth cleaned, technicians weren’t trained in the task.  He had been trained at dental skill, he said, but his skills were rusty.

And rusty they were.  If you’re like me, you’re used to a very thorough cleaning:  gum measurements (to check for recession); a careful scraping of every surface; sonic assistance on the scraping, if need be; a gentle scrub with that polisher doo-hicky and some abrasive paste; and finally a good flossing.  When I leave the dentist, my teeth are so clean you can eat off of them.

In England, all I got was a less than gentle scrub with that polisher doo-hicky and some abrasive paste.  That was it.  That was what past for dental hygiene.  It became apparent to me why British teeth have been a long-standing American joke.

Despite (or perhaps because of) Britain’s national health care system, British dentistry apparently continues to be a century or two behind America’s.  Today’s British news informs us that Britain’s dentists pretty much treat tooth problems as they’ve been treated for thousands of years:  they pull the tooth. Indeed, it seems that, when it comes to dental care, the only difference between British dental care today and British dental care in the 1850s, 1750s, 1550s, and ever further back in time, is the anesthetic:

Thousands of Britons are having teeth needlessly pulled out, it was claimed yesterday.

The number of extractions has soared by 30 per cent in four years, according to figures obtained by the Liberal Democrats.

The party claims this demonstrates how much dental care has deteriorated under Labour, leaving thousands missing out on treatment that could save their teeth. More than 175,000 Britons had their teeth extracted under general anaesthetic in 2007/08, up 40,000 on the 2003/04 figure, a parliamentary answer revealed.

Figures show thousands of people are having their teeth pulled out needlessly when they could have been saved

Of these, 44,300 were aged between six and 18 and 14,200 were under five years old. LibDem health spokesman Norman Lamb said: ‘The extraordinary number of people needing their teeth extracted under general anaesthetic could well be the result of the appalling access to NHS dentistry.’

He pointed the finger at the general difficulty in finding a Health Service dentist since the Government introduced a ‘botched’ contract in April 2006.

Designed to increase access to NHS dentistry, the deal actually saw hundreds of dentists leave the NHS.

The number of patients seeing a dentist fell by 1.2million, leaving thousands without the treatment that could have stopped their teeth getting so bad that they had to be pulled out.

But dentists’ salaries have soared by 11 per cent since the change – to an average of more than £96,000.

Mr Lamb added: ‘The dental contract was supposedly designed to improve the situation, but the staggering rise in tooth extractions proves the massive failures of thisbotched initiative. The crisis in NHS dentistry is one of this Government’s most shameful legacies.’

Although the rate of extractions increased throughout the four-year period following April 2003, it gathered pace after the new contract for NHS dentists was introduced.

You can read the rest here.

As I read it, aside from Britain’s generally laughable dental standards, a huge government error has doomed millions of Britain’s to medieval care. That’s what happens when you have one provider, and the provider screws up. There are no alternatives. There is no marketplace to adapt and provide. Everything simply collapses.