I WAS recently looking at dental practices in Andover on the NHS choices website and noticed there is often confusion about hygienist appointments for NHS patients and I thought it might be helpful to clarify the position.

When a dentist examines an NHS patient they look at the teeth, gums and other parts of the face and mouth and make a record.

The condition of the gums is recorded and this is most commonly done as a Basic Periodontal Examination chart (BPE). The mouth is divided into six areas and each is given a score according to the gum condition. Zero means all is OK.

A score of one means bleeding occurs with gentle probing and this can usually be usually be treated with improved oral hygiene and the dentist needs to explain the problem and solution to the patient. A code two means the gum pockets are no deeper than 3mm but hard deposits, known as scale or calculus, are present on the teeth. Higher scores relate to deeper pockets and greater treatment needs.

Scores of two or more means (according to the British Society of Periodontology) scaling is necessary as a minimum. Under the NHS patients are entitled to have all the treatment they require under the NHS and that means the dentist has to offer the scaling and any other necessary treatment under the NHS. (This also applies to crowns, bridges, denture and so on). A dentist can offer the treatment on a private basis, and in some cases the hygienist services in a practice are only available privately, but if the patient makes an informed decision and elects to have the treatment under the NHS then the dentist has to provide this treatment. A dentist should not tell a patient that they need a scaling and then say it is only available under private arrangements as this would be unprofessional. Clearly the scaling has to be of an appropriate standard, whether NHS or private.

There is a cost element to consider. Band one costs £20.60 and covers an examination, diagnosis and advice and, if necessary, it also includes X-rays, a scale and polish and planning for further treatment. An additional private hygienist appointment could add substantially to this figure. So, ask your dentist for your BPE scores. If any are two or more it means you need gum treatment with scaling as a minimum and this has to be provided under the NHS if that is what you choose.

Any problem, ask about the practice complaints procedure which probably means talking to the practice manager. If you are still unhappy go to NHS choices on the internet or contact the Wessex Area team on 023 8051 3985 and the Care Quality Commission (CQC) would like to learn of the problem.

Anthony Lynn BSc, BDS., Registered dentist