Oral hygiene and England?

This may seem like a silly question but here goes. Last night I watched 'V' for Vendetta, (I absolutely loved it). What I've noticed many times before in movies/TV is that the English are generally portrayed as having ugly rotten teeth. Why is this?

Peace. K*

Because Our dentists are very poor compared to the USA imo because many practices are underpaid (NHS) and therefore there are'nt enough and more and more foreign undertrained dentists are coming over to work in the practice. Yes my dentist sucks and most have (apart from 1) been incompetant. The last time I went in it was like something out of a comedy routine and I swear I'm not even joking here. I'll spear the details for now, but it was very worrying (bleach in eyes etc ffs!) and probably sackable under most circumstances. I think there was a "Horizon" documentary on mal-practice in UK dentists not long ago. I'm sure some UK folks can add more to this though.

[edit on 17-9-2006 by Xeros]

Interesting question (to me at least!).

I'm a British dentist who emigrated to North America about two years ago to go back to school and I requalify in about seven months, I hope.

Anyway - I think the big difference in UK and N.American teeth comes down to the way the health care systems are funded.

UK - was traditionally socialized, so most people had access to simple restorations, like amalgams, extractions, dentures and so on. The more complex treatments, like veneers (to give you nice straight white teeth) the dentist loses money on (at least if he did it in sensible time frames and uses a good technician). Tooth bleaching is completely private, so didn't happen (plus it's illegal at present under EU regs to sell peroxide bleaching kits over the counter at concentrations that work).

US - if you've got the money, you can have whatever treatment you want done.
Of course, if you can't afford it, it seems to basically be 'screw you'.

So, imo - in the UK, the bulk of the population had access to 'cheap and cheerful' dentistry, which kept them dentally fit, if not pretty.
- the US, on the other hand, the economically wealthy has access to 'top drawer' dentistry, and the rest of the population can go hang. Whenever I go into gas stations, or the downtown of a big American city, I see some pretty scary teeth, I can tell you.

I'm still not sure what the more moral system is. NHS dentistry is dead in the water because as it is today, it promotes 'quantity' and not 'quality' - so most UK dentists are going private and following a US model. So you'll see a more American model I guess - the rich will have nice white teeth, and the poor will be left with swollen faces and rotten stumps.

Canada seems to be the sensible compromise - social assistance 'safety net' that covers basic procedures but doesn't pretend to pay for molar endo!

Bet I've bored you to death, eh? Still, one of my pet hobby horses, so thanks for the opportunity to vent!

TD

Originally posted by Xeros
Because Our dentists are very poor compared to the USA imo because many practices are underpaid (NHS) and therefore there are'nt enough and more and more foreign undertrained dentists are coming over to work in the practice. Yes my dentist sucks and most have (apart from 1) been incompetant. The last time I went in it was like something out of a comedy routine and I swear I'm not even joking here. I'll spear the details for now, but it was very worrying (bleach in eyes etc ffs!) and probably sackable under most circumstances. I think there was a "Horizon" documentary on mal-practice in UK dentists not long ago. I'm sure some UK folks can add more to this though.

[edit on 17-9-2006 by Xeros]

Hey Xeros - I'd agree and disagree with you to a point. I think that the dental schools are of about the same quality, where the US/Canada does better is the system of finance - the NHS, like you say, encourages bankruptcy if you take the time to do complex treatment properly. So the guys that 'do well' working the NHS are the ones that can 'crank it out' and do treatment quickly (which doesn't always equate to well).

I got sick of it in the end - you sort of got laughed at if you put rubber dam on a tooth to do a root canal, so I thought 'screw it' and decided to emigrate.

I still say that NHS dentistry is a more moral system - however it's been underfunded for years, and as it is at present I don't think it is tenable. Which is why dentists are leaving.

If you were being conspiracy-minded, you could say that the government is happy with it that way. Why bother getting the flack of cancelling the program? Just blame 'greedy dentists' for going private!

TD

Ah, its just like American films that portray Yanks as friendly, peaceful, honest and always the "hero" type of people :p

Originally posted by TaupeDragon
Interesting question (to me at least!).

I'm a British dentist who emigrated to North America about two years ago to go back to school and I requalify in about seven months, I hope.

Anyway - I think the big difference in UK and N.American teeth comes down to the way the health care systems are funded.

UK - was traditionally socialized, so most people had access to simple restorations, like amalgams, extractions, dentures and so on. The more complex treatments, like veneers (to give you nice straight white teeth) the dentist loses money on (at least if he did it in sensible time frames and uses a good technician). Tooth bleaching is completely private, so didn't happen (plus it's illegal at present under EU regs to sell peroxide bleaching kits over the counter at concentrations that work).

US - if you've got the money, you can have whatever treatment you want done.
Of course, if you can't afford it, it seems to basically be 'screw you'.

So, imo - in the UK, the bulk of the population had access to 'cheap and cheerful' dentistry, which kept them dentally fit, if not pretty.

- the US, on the other hand, the economically wealthy has access to 'top drawer' dentistry, and the rest of the population can go hang. Whenever I go into gas stations, or the downtown of a big American city, I see some pretty scary teeth, I can tell you.

I'm still not sure what the more moral system is. NHS dentistry is dead in the water because as it is today, it promotes 'quantity' and not 'quality' - so most UK dentists are going private and following a US model. So you'll see a more American model I guess - the rich will have nice white teeth, and the poor will be left with swollen faces and rotten stumps.

Canada seems to be the sensible compromise - social assistance 'safety net' that covers basic procedures but doesn't pretend to pay for molar endo!

Bet I've bored you to death, eh?

Still, one of my pet hobby horses, so thanks for the opportunity to vent!

TD

Well, there's PLENTY of people in the UK who have money. The majority of them, in fact. So what are you saying? Those people can't get more dentistry services than the cheap socialized dentistry that is provided to everyone else? Or they just don't want to spend a few pounds extra on a dentist for better oral hygene? Or is the socialized oral hygene already provided to them "just good enough, thank you very much, I'll keep my extra pounds in my pocket and by some chocolates tomorrow". Seriously, is the attitude to go only so far as the soicialized medicine will allow and then that's it?

Well at least we can hear from a UK dentist. I find it very hard to beleive that all dentists go to through the same schooling process, as my (foreign) dentists helper had not got an fing clue what to do when a stand in (foreign) Australian) dentist was there. The stand in almost could'nt believe how incompetant the dentist helper was. She was asking for tools only to be given blank looks time and time again. I could see the embarassment on her face. and I was left like for ages thinking WTF is going on here!!!! you would have to be there to beleive it. Then there were no safety goggles when I had bleach squirt in my eye. She tried to pretend it was water after saying "hand me the bleach" with a worried look on her face and a burning sensation in my eye. P.S It was a root canal afrter an absess (sp?). I could go on with my storys, but I can't trust dentists now, and barely did before. I'm sure there are good dentists out there though.........If you pay the right price (private) lol. Schooling was in NO FING WAY applicable in the last circumstances though.

Thanks for that though TD

[edit on 17-9-2006 by Xeros]

Originally posted by jupiter869

Well, there's PLENTY of people in the UK who have money. The majority of them, in fact. So what are you saying? Those people can't get more dentistry services than the cheap socialized dentistry that is provided to everyone else? Or they just don't want to spend a few pounds extra on a dentist for better oral hygene? Or is the socialized oral hygene already provided to them "just good enough, thank you very much, I'll keep my extra pounds in my pocket and by some chocolates tomorrow". Seriously, is the attitude to go only so far as the soicialized medicine will allow and then that's it?

Hello Jupiter

Yes, but since 1945, people have been used to a system that is 'cheap'. If you pay about $140 for a crown in the UK (which was the NHS cost in 2005 prior to reforms in England and Wales), then people are not going to happy to pay the 'market value' fee of about four-five times that for a private fee. So in answer - yes. Most patients have no idea about the quality of work that goes on in their mouth and want it 'cheap' rather than 'good'. Kent and Blinkhorn - I think - have a text on this, something like 'Behavioural Sciences in Dentistry'.

I would also argue about 'oral hygiene' being dependent on the dentist - we drill things and provide oral treatment. Good oral hygiene (probably more important than us) is dependent on the patient, and is really a function of motivation, and how well you brush and floss. And it doesn't cost anything.

There was certainly an 'inertia' in moving towards private dentistry from NHS dentistry in patients. Now, a lot of patients don't have a choice because NHS dentists don't exist in huge swathes of the country.

When I worked in Glasgow I would strongly argue that about 70% of the population would NOT get treatment if it wasn't socialized because they couldn't afford it. About 30% of my population could afford (and got) high end private treatment. Probably more people in London can afford 'private' treatment, but even in the South East of England there is a large percentage that could not afford it.

The question really is, where does society put a safety net? I picked up three early cases of oral cancer in unemployed smokers living in chronic poverty. If there wasn't a socialized system, they wouldn't have been picked up until a lot later with a much worse prognosis.

As I said - I have no problem with socialized dentistry that is properly funded. NHS dentistry isn't, and fortunately it ain't my problem any more.

TD


[Mod Edit: Tag correction - Jak]

[edit on 17/9/06 by JAK]

Originally posted by Xeros
Well at least we can hear from a UK dentist. I find it very hard to beleive that all dentists go to through the same schooling process, as my (foreign) dentists helper had not got an fing clue what to do when a stand in (foreign) Australian) dentist was there. The stand in almost could'nt believe how incompetant the dentist helper was. She was asking for tools only to be given blank looks time and time again. I could see the embarassment on her face. and I was left like for ages thinking WTF is going on here!!!! you would have to be there to beleive it. Then there were no safety goggles when I had bleach squirt in my eye. She tried to pretend it was water after saying "hand me the bleach" with a worried look on her face and a burning sensation in my eye. P.S It was a root canal afrter an absess (sp?). I could go on with my storys, but I can't trust dentists now, and barely did before. I'm sure there are good dentists out there though.........If you pay the right price (private) lol. Schooling was in NO FING WAY applicable in the last circumstances though.

Thanks for that though TD

[edit on 17-9-2006 by Xeros]

Hey Xeros - blame the EU! One of the fundamental things about it is recognition of qualifications and freedom of citizens to move throughout the union. Odd though - some of the best dentists I have seen have come from Egypt and India, and trained out there. Go figure.

I really think the problem is the funding of the NHS, not the training. You see 40-50 patients a day, you have to work fast, and quality has to suffer. No way around it, other than going broke. The safety glasses with bleach? Very good idea! I always did it, because I was scared of being sued! Other people don't bother. Question is - did you have a rubber dam on your mouth at the time? That's the really important thing with root canals!

If someone can show me how to shorten the link, I'd be grateful!

Link



The 'helper' - do you need the dental nurse? You often hire a young girl (cheap) and train them up. It's a minimum wage business in the NHS I'm afraid - the best girls go for the best positions (i.e private practice) so there's going to be a high turnover

TD

PS apologies for teh length of the link




[edit on 17-9-2006 by TaupeDragon]

mod edit:

Please use this in the post creation window in future to cut down the length of your link, as long url's can alter the width of the page.
Or alternatively you can use: [url=www.urlhere.com]link name here[/url]
A good walkthrough to explain in more detail is ATTN :Image Size Guidelines





[edit on 17-9-2006 by UK Wizard]

Originally posted by infinite
Ah, its just like American films that portray Yanks as friendly, peaceful, honest and always the "hero" type of people :p

You know, I wondered for a sec. that the English are portrayed as such as to seperate'Them' from 'Us'. Like the 'villanization' that's done sometimes to other cultures or religions different from Ours. Thanx for all the info. guys, it's great!