Tuesday, August 21, 2018

UK vs US - The Difference at the Dentist


Today, Edith went to the dentist. For those unfamiliar, Edith is Z's doll. She's been in a lot of books, and she's famous (amongst those who enjoy a certain kind of kitsch children's literature), but as far as I know she did not ever go to the dentist before today. None of the books mention that, anyway. That's probably why she wouldn't open her mouth, and the dentist couldn't do anything. We'll have to try again in six months, when Z and E have their next appointment. The dentist is quite kind, so I'm sure she'll give it another go.

I've found that there are a lot of misconceptions and a pretty good deal of incorrect information regarding UK medical care and the NHS floating around amongst Americans, so I thought I'd clear some of this up by writing about our experiences. In addition to Edith sitting in the dentist's chair today, both my children also took their turns, so it makes sense to start with dental care since the details of the visit are fresh in my mind. There are some major differences between UK and USA dental care, so I'll address those.

In the USA, we were covered by dental insurance that we got through J's work. This insurance was an expense shared between the company J worked for and us. By US standards, it was really good insurance. When it came to dental work, exams and cleanings were free, but everything else had a co-pay and a deductible. I got a cavity and blinked pretty hard when I was told how much it would cost to fill it, even with the insurance contributing their bit. I thought I misheard, but...I didn't. Z got a couple of small cavities, and it wasn't cheap. E chipped a tooth, and it was ridiculous. Again, even with insurance covering much of the expense.

On the upside, the dentist's offices we visited were very nice. Mine was in a fancy office building with a fancy elevator. The kids went to one with a beautiful waiting room full of things to do, and loads of toys to choose from after the appointment was done. The children got full cleanings every six months and x-rays annually. It was by a Whole Foods, which was nice. They had excellent iced coffee there.

Here, our dentist's office is above a betting shop. We go up steep stairs, and the waiting room is no frills. I'm guessing the chairs are from 1992, and the desk is a bit worn out. But it's always clean, and the receptionist is kind. They have a small television on, and the kids like that because we don't have a TV at home. There are no toys for them to play with, but someone usually compliments their hair. We don't have to wait long to see the dentist.

Once we are in the exam room, she asks a few questions about tooth brushing habits, takes a look at kids' teeth, tells me what I need to know, and dabs some fluoride on their molars. It takes all of five minutes for each kid. They can have a sticker if they like, but lately they don't want one. We pay nothing; NHS dental care for children is free. This includes orthodontics. That's right - free braces.

If J or I need to visit the dentist, there are different bands for different levels of treatment. Whichever band you reach, that's what you pay, total. So if you end up with treatment that is in Band 2, you only pay that amount. You do not pay both Band 1 and Band 2 fees. And these bands cover multiple treatments - so if you need two root canals, you still only pay one Band 2 amount. It's a flat fee for however much work you need done within that Band. Thinking back to what we paid in the USA, this is amazing. At one point, I had seven cavities that I needed to have filled. I have no clue what that set me back in the US, but here it would cost £59.10. Total.

So to say that I am a fan of NHS dental care would be an understatement. People say things about socialized medicine and rationing care, but this care is much more accessible costwise than care in the US, so to me it seems like care in the US is rationed in a way that care in the UK is not, because if you can't afford to pay in the US, you just can't get dental work done. Here, in addition to the low pricing within the bands I mentioned above, those who are on income support and other benefits do not have to pay.

Frankly, the hardest part was registering with the dentist. Our dentist only takes a certain number of new patients each month, so you have to call first thing on the first day of the month in order to get registered. On the day I registered, I had to dial the number quite a lot before I got through, but once the receptionist picked up, I got registered without issue and had a full cleaning and exam within two weeks. I paid £21.60 - a bargain!

In my opinion, dental care in the UK is superior to dental care in the USA. It's true they do less than is standard for kids in the USA, but we've found that it's not necessary for the kids to have full cleanings and x-rays; their teeth and gums are healthy without the additional care. I am happy with the care we receive and the amount we pay. I am happy to climb stairs instead of going up in a fancy elevator. I am very happy that it is a more equitable system. I will gladly give up new chairs in the waiting room in exchange for quality dental care that is accessible to those who need it - including our family.

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