Drift from NHS to private dentistry

Check up scale and polish at dentist yesterday, we have been patients at the practice for over 30 years and for most of that time had annual checkup and teeth cleaned under NHS.

Younger generation of dentists now running practice and Scottish dental contract not fit for purpose so dental hygienist now offered as private service, where under NHS service annual hygienist appointment was deemed clinically appropriate I am now told I need one every six months, either my oral hygiene has deteriorated or my wallet is suddenly influencing clinical decisions 

Even more concerning I have had two top front crowns for over 30 years, have a misaligned overbite and grind teeth in my sleep, result is bottom front teeth have been getting worn away for years, now all of a sudden there is a miracle cure to return the smile of my youth and they can realign crowns and add new ones to bottom....but at a price as only available as a private service under the private cosmetic dentistry they now offer.

As a lifelong health care worker this shift in focus horrifies me. I can afford such treatments but where dentistry is a limited resource this is taking clinical time away from treatment based on clinical need to treatment based on want and ability to pay,  not the NHS we thought we had

I know dentists are private contractors and contract part of their time to NHS, but so are GPs, Community Pharmacists and opticians, fear we are heading to American style health care which costs megabucks with poor outcomes (I started my professional career as a community pharmacist, held my own contract to run a High Street pharmacy for many years before moving to work for health board as clinical pharmacist in GP practice then on to NHS management. I also have a masters degree in prescribing science and post graduate health economics qualifications so have a very good understanding of how health care works)

Bilbo, I've not had an NHS dentist for about 20 years. They're like hen's teeth (pardon the pun) in this part of the country. People who can't afford to pay are often in agony and it's a dire situation.

Our very good dentist stopped doing adult nhs stuff about 30 years ago because of the restricted nature of the dentistry he was allowed to perform. We stayed with him because he was a good dentist. When we moved from Gtr Man down here to Lincs we didn’t even try and find an nhs dentist.
It is wrong and very sad. I suppose  insurance can help some, but many simply cannot afford dentistry

The NHS dental service has been underfunded for years. Rather than them being paid for conservation they were paid for piece work, drill and fill, extractions and dentures etc. This was the situation from the inception of the NHS, how payment for dental services were set up. My first dentist that I attended in the 1950s apparently committed suicide.
Mind you in the 1950s and 60s many people had all their teeth removed and had dentures fitted, as did my mother in the 1960s.
It's been a sort of tooth fairy service when she wasn't moonlighting from being Cinderella.

Governments of all political ideologies in the UK have often been more concerned with other more important issues, Thatcher, Major, and that could include their own concern of their legacy in history (Blair), their own "look at me" narcissism (Boris Johnson). In the list of priorities that Governments are faced with, NHS dental services comes very low down, unless that is the media keep running the stories front and centre. The dogs bark and the caravan moves on to a different location that's important to them not you and your teeth.

My dental practice has been private for over 20+ years, and I understand why. You can't have dental care on the cheap. It was never Govertments' priority when the NHS was born or has been thereafter.

You may like to check me out on this :
Dentists enter into a contract with NHS for each new treatment plan for you ie each time you go for a check up - as such you are not "on an NHS list". 
There is no compulsion for the dentist to take you on as an NHS patient at your next "checkup".
If a dentist does take you on as an NHS patient at your next check up, they are duty bound to render you ( ie your  whole mouth)  dentally fit : "period". 
.
In the meantime, you might go down the line, "If it ain't broke, don't fix it!

But if you do want to regain your erstwhile youthful smile, it may be regarded by your dentist as "Cosmetic" treatment - ie not strictly necessary to render you dentally fit. There is a dividing line - though it is a grey area.
.
 Ms Truss had some rumblings - or was it a manifesto committment to sorting the NHS Dentistry disaster?
I can't hold my breath long enough while she implements a "fix".

In Canada the system is similar to the US in that it is insurance based, this does not cover anything regarded as cosmetic and like here that description can be rather blurred. Standards though seem to be very high and appointments are available easily. No complaints about the standard of treatment either.
It might be unpopular, but, seeing both I almost prefer the insurance based system.
At least you know what you are getting, here I have a private dentist and they seem to be selling me the product based on profit, do I really need an xray every year or to visit the hygienist so often when my teeth are giving no problems at all? My last NHS dentist years ago spent the whole appointment telling me how rubbish the equipment was and I felt like I had been attacked with a pressure washer.
Of course I am lucky and can afford it, the help needs to be targeted at those that can't. It would be much efficient and potentially save billions if the UK could find a way so that everyone "paid" but the funding was aimed at those that cant afford it rather than the product itself

We have managed to stay NHS with our dentist but after covid they were taken over by a group practice and won’t take any more NHS work unless you were with them previously.
I had a struggle trying to get an appointment when they first took over and the dentist I eventually saw was absolutely terrible.To her a broken tooth was an extraction or nothing. After refusing treatment from her I saw another dentist eventually. 
I am sure if I was a private patient I would have been treated better.