This article if intended to highlight the differences between private dentures made by us and the typical standard dentures that are made on the NHS. The NHS can be a great system for those who cannot afford private options but it does have its limitations. This needs to be discussed as often patients are not aware of such limitations and options should be discussed thoroughly for proper valid consent.
Often patients who have had experience with dentures within the national health service will be disappointed with the result. Dentists must never assume that the patient wants the cheapest option.
In fact, patients are often happier to pay for something if the outcome is better and dentists must always remember this especially when it comes to healthcare. Dentures can play an important aspect of physical and mental health and if you have experienced this first hand you know what I’m talking about.
Patients come to see us for a free assessment and they often ask why this is the case so here are all the reasons:
1. Making a denture takes a lot time and money. The NHS doesn’t pay dentists appropriately and this is where problems happen!
Unfortunately, the NHS pays dentists very little to make dentures – this is often just over £100. Out of this money the dentist will need to pay the laboratory technician to make the dentures which normally equates to £50-£80. This leaves the dentist feeling undervalued and he/she will want to make the dentures as quick as possible in order to minimize the effect on their hourly rate. This typically involves cutting corners. I have seen NHS dentures so many times when they simply do not fit.
If the impression is 70% – a lot of the time, the dentist won’t bother to retake it as they assume it will do. Having to retake the impression adds another 10 minutes onto appointment time and then the dentist has to worry about running late all day. If the dentist is already running late, do you think they will bother to retake the impression if it looks around 60% good? These suboptimal impressions lead to poor outcomes. This is fine if you’re expecting an ok outcome, but if you want a perfect job then you will be disappointed.
Clinical Time spend on average by NHS dentist – 1hour 15mins
Clinical Time spend on average by The Denture & Implant Clinic – 7 hours
*Figures above do not relate on technicians time – only dentists time.
When booking appointments with The Denture & Implant Clinic we always book longer. This is because sometimes we don’t get the impression 100% right the first time around and it allows us time to redo it if needed. Sometime on the odd time its necessary to take it 3 times.
As stated previously, the NHS dentist will need to pay the technician to make the dentures therefore, he/she will generally try to find a cheap technician in order to ensure their hourly rate does not drop more than it needs to.
The technician will then have this same feeling of being undervalued and will economize on the denture as much as possible. Ie – use cheap teeth, materials and try and make them as fast as possible. This invariable leads to cutting corners and a poor quality denture.
What’s more is that the technician and dentist are now trapped in a system that rewards poor quality and cutting corners. This leads to deskilling of them both, which further exacerbates the problem, and it causes a vicious circle.
2. Cutting Corners to make the process economically viable
- Poor quality of teeth
- Poor quality of denture materials
- A denture is supposed to be made by one technician, one at a time – it’s a bespoke medical device. Often, to make ends meet the NHS technician will have a whole stack of dentures to make on their tables which causes them to ‘streamline’ the procedure. This is where quality control goes out the window. He/she will mix a big batch on material and then do them one by one. By the time they have got to the end of the stack the material is half set and they have keep going. Whenever you’re making things by hand its always best to concentrate at doing it one at a time rather than trying to do it all at once.
- Secondary Impressions are not done so generic non-bespoke trays are used
- Bites are not taken accurately
- Bites are not balanced
- Poor quality of impressions
- Poor quality of impression materials
- The cosmetics of the teeth are often not looked at
- The size and shape is left entirely to the technician. As they have never seen you before it’s impossible for them to pick the right size/shape/mould for you which means everyone’s dentures ends up looking the same.
- Poor quality of technicians doing the work. If you are a denture laboratory owner, you will have to employ cheaper unskilled technicians to carry out the NHS work. You simple would not have the funds coming in to pay for high quality technicians.
The list is endless and I have only mentioned the factors that the lay person can understand. If you use cheap materials, cheap technicians, you will only get cheap quickly made dentures back. It’s a surprise if they fit well.
Now, I don’t want to knock anyone down, I am just explaining why the differences in quality arise. The unskilled technicians are good at working within that system and that is a remarkable skill to have in itself and they have provided a good basic level of care to people who need it. But for the people who want a better outcome here is the alternative.
The Alternative to NHS Dentures
Thankfully, there are private clinics around like ourselves that concentrate on quality, regardless of the time and cost that it involves. This leads to much better outcomes and leaves the patient and dentist feeling happy. It means we can use a highly skilled technician who uses the highest quality of materials on the market. This means results are predictable meaning happy patients.
If you would like to enquire about what we can do you for, please call us and we would be happy to assess your situation. We are a dedicated denture clinic and have a dental laboratory and technician on site.
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