Back in April 2007 I wrote that a decision to make endodontic files and reamers single use was going to spell the end of root canal fillings on the NHS. It is with sadness that I read yesterday that a government report on the new dental contract (introduced in April 2006) has seen a 45 % reduction in root canal fillings provided on the NHS. This has been matched by an increase in tooth extractions, a massive reduction in the number of crowns provided and an increase in the number of dentures provided.
Clearly this is not all due to the decision on endodontic files but the introduction of an extra cost of up to £45 per case for a treatment that the dentist receives £46 for is going to have an impact! (Interestingly the cost of endodontic files has gone up 25% in 2008 alone).
The government report provided a damming review of the new contract and predicted further deteriorations in the service if changes were not introduced. Unfortunately it is clear that the decision on how to treat a tooth is now, more than ever, based on strict financial conditions put upon the NHS dentist and these may not serve the patients best interests. Now if you hear that your tooth cannot be saved, perhaps you should ask “Can it not be saved at all? Or can it not be saved on the NHS in a way that the dentist can still earn a living and provide for his/her business/family/employees?”