Here you will find questions that are frequently put to us here at CDC.
We can’t provide every solution here so if you have a query that isn’t answered, email us and we’ll try to help. Questions are divided into those which deal with administrative matters and those which relate to treatment.
Please call 01670 712 100 or pop in to see us (see our contact page). At your first appointment, you will be asked to provide a detailed medical history.
Please bring a list of medications that you currently take and any other relevant documents that you feel may help. A copy of our medical history form can be found below if you would like to print and complete this at home instead.
We will endeavour to see patients with toothache as soon as possible and we have designated toothache appointments before lunchtime, so an early call is appreciated.
Patients with dental issues outside practice hours are advised to call 111 where the issue can be appropriately triaged with referral to NHS out of hours clinics if necessary.
We offer free cosmetic consultations with our dentist Tom where your concerns and options can be discussed in depth. If you have any questions beforehand, feel free to write them down and bring them in with you.
There is absolutely no pressure to sign up to any treatment on the day and written estimates can be given for you to go home and think about.
At CDC we have a very dedicated team to make sure patient safety comes first.
Current guidelines are adhered to in the strictest ways possible and the surgeries are cleaned thoroughly after each patient.
Cramlington Dental Centre has an NHS contract to see only patients who are exempt or partially exempt from charges for any reason, we also have an NHS contract to treat children up to their eighteenth birthday.
It is important to note that if you are not exempt or partially exempt fropm patient charges under the NHS we will not be able to see you under the NHS.
If you are not exempt or are under 18 years of age, you will be treated under one of our private schemes, our receptionist will explain what those options are, the next FAQ explains more about these.
We have three private schemes available for non-NHS-exempt patients although any patient can join, irrespective of whether or not they are exempt from NHS charges.
1) Basic Care
In Basic Care, you pay for your treatment as you need it, each item has a price and you will given a printed estimate for every course of treatment you attend, should you want it. Basic Care is the truly affordable replacement for NHS treatment and includes most, but not all, of the common items such as checkups, cleanings, fillings and plastic dentures but note that not all items which are were originally available on the NHS will be available in Basic Care, we will advise you if required.
Denplan is a capitation scheme where you pay a fixed fee every month. This covers all routine care but with certain exclusions and exceptions which we explain to you if appropriate. Denplan is the largest capitation scheme in the UK, with 1¼ million patients and has been successfully operating for over 20 years. Denplan covers everything you need for regular day-to-day dental care and you pay neither more nor less whether or not you need no treatment at a checkup or lots of treatment. Denplan allows you to budget your dental care so you know exactly how much your dental care is going to cost you every month.
3) Private Care
For those who want only the best, you can elect to pay privately for all your treatment.
All treatment, from the checkup to the fillings are charged for privately, this means that you only pay for what you get. Treatments are available under Private Care which are not available under other schemes, such as tooth lightening (bleaching) and cosmetic treatment.
Private charges are set within the Practice and the NHS has no bearing on them. However, we set a fixed charge for most “standard” items and a written estimate will be given to you if you elect to have any treatment done privately. Your dentist is able to guide you on what treatment you can have.
Our computer system is capable of producing multiple estimates for different permutations of mixed treatments which you can take away and think about at your leisure. Generally, Private treatment is based upon an hourly rate of £150.
At the basic level, there is no difference. The NHS offers a fairly comprehensive list of treatments (with notable exceptions) which covers most options but there are a few items which the NHS will not cover, such as white fillings or white crowns at the back of the mouth. Generally, treatment done to NHS standard is adequate in all respects but is at a basic level, for example, materials used conform to the basic requirements that they be suitable for the purpose for which they are being used, in other words, they are adequate and acceptable, but are not necessarily the very best quality available.
The main differences between NHS and Private centre on two factors. Firstly, under Private contract, we can afford to use materials which are much more expensive and therefore give a better end result which can last much longer (such as better quality white filling materials which stain less readily over time). Secondly, the dentist can afford to be generous in the amount of time that the he spends doing the work, taking the time needed to get it just right. For example, an NHS set of dentures will do the job, they’ll fit well and you’ll be able to eat well. But they look fairly plain, regular and uninspiring. A set of Private dentures are made with top quality continental teeth, set into the mouth with a great deal of care to get the positioning just right and finished with a plastic which can be tinted and stained to make it look extraordinarily lifelike.
Think of it as the differences between a Ford and a Rolls Royce. The Ford will get
you there, in reasonable comfort and in complete safety, but the Rolls is considerably more comfortable and provides the luxuries that make the journey that bit more pleasant. (Sorry, Ford, we’re not picking on you!)
Many patients are uncertain whether or not to have an injection for treatment.
The decision whether or not to have an injection is by the very nature, a personal one and depends on a number of factors. Firstly, it depends on how deep a filling is likely to be. Secondly, it depends on your age – the older you are, the less sensitive your teeth are. Thirdly, it depends upon your personal pain theshold; some patients can tolerate a fairly high level of discomfiture, others will not tolerate any at all.
Finally and perhaps most important of all, it depends on your personal preference. Your dentist will normally ask or discuss with you if you want an injection before undertaking any treatment.
If you have an injection, you will be numb in the affected area for anything between an hour and four hours, depending on where the injection is.
During this time, you should take care not to bite your lip as you won’t feel it! A tingly feeling often accompanies the wearing-off stage – often prompting a desire to scratch it. This is normal.
Our computer system can generate Estimates on demand with no effort. You will be automatically provided with an estimate if you are attending for the first time or you are having mixed NHS and Private treatment in the same course. If, during the course of work, treatment changes, you may well be given a revised estimate.
The estimate provides a simple breakdown of treatment into basic treatment units. If you would like help in interpreting the estimate, please ask at Reception.
Sorry, but unless you are exempt from charges, you will be asked to pay for treatment as work proceeds. For each payment you make, you will be provided with a receipt, please keep this in case of query later. We do not allow charges to accumulate for payment at the end of the course.
There are standard exemptions in the NHS for patients who fall into certain categories.
You will not have to pay for any treatment if you are;
- A mother who has had a baby within the past 12 months. (note that this is calendar months based on the baby’s date of birth, not the dates provided on an NHS exemption certificate used to obtain free prescriptions etc).
- Under 19 and at College or Full-Time Education (not University)
- On Income Support
- Receiving any of the various Tax Credit derivatives
- Receiving Disability Working Allowance
- Receiving Jobseeker’s Allowance
- Hold a Certificate for Full Exemption, HC2
You will be asked to pay treatment costs up to the specified amount if you hold a
Certificate for Partial Exemption, HC3 – the amount is specified on the certificate.
There are no exemptions for Private or other non-NHS charges.
If you have genuine difficulty in paying your charges, you can submit a claim form, HC1, to the Department of Social Security. They will then make an assessment of your ability to pay (NOT US) and will issue you with either a Certificate for Full Exemption, HC2 or a Certificate for Partial Exemption, HC3. Please bring this certificate with you when you attend as we have to record its serial number in our records.
If you are unsure about your exemption status, we will charge you privately for all your treatment until such time as you can produce evidence of exemption or partial exemption. Obviously, if you are become exempt or partially exempt after that, you can receive your treatment under the NHS.
Cosmetic Dentistry is a term loosely applied to treatment which is not strictly necessary to secure oral fitness but nevertheless, the patient and the dentist feels might be highly desirable for cosmetic reasons. Such treatments might include white fillings or white crowns at the back of the mouth or any other type of treatment which might be considered more luxurious than the basic NHS option. Talk to your dentist about these options, he will tell you if such a treatment is suitable in your circumstances.
If you are a patient of the Practice and you have attended recently, telephone the Practice as early in the day as possible and you will be offered an appointment to be seen within 24 hours. In extreme emergencies, you might be told to come straight in and be prepared to sit and wait until a dentist is available to see you.
If you haven’t been in to see us recently, still telephone the Practice as early in the day as possible. It is our policy to see anybody in pain the same day if we canbut if you are not registered with us, you may not be seen until the following day, depending upon available appointments. We do not normally turn away patients who are in pain.
Patients who are not registered with the Practice, that is patients who haven’t received a course of treatment recently, may have to pay privately for any emergency treatment. Subsequent treatment after that can be NHS if you are exempt or partially exempt.
Our practices belong to Emergency Out-of-Hours schemes, run respectively from Ashington (for the Cramlington Practice) and Newcastle upon Tyne (for the
Gosforth Practice). These schemes offer cover for when the Practices are closed, that is, from 6pm to 8am weekdays, all day weekends and Bank holidays. Telephone the Practice and you will hear a message from our answering machine which provides the number to be telephoned in an emergency. This number is currently the NHS Direct number 0845 4647. A trained operator will take you through a sequence of questions to ascertain the nature and severity of the emergency and if necessary, she will arrange for the duty dentist to telephone you back to discuss the problem.
Please note the following important points;
- NHS charges apply at all times if you are not exempt.
- You will be expected to travel to the Treatment Centre (at Ashington or
Newcastle), the service does not come to you nor will you be seen at the Practice.
- The dentist will make a decision as to whether or not to see you, not NHS Direct.
- Our Gosforth, Newcastle upon Tyne practice does offer emergency treatment directly from ourselves under Private contract only. Telephone the Gosforth practice (0191 285 4182) to obtain the mobile number of the dentist on duty. A standard minimum turnout fee of £65 operates (dependent of the time of day) and any treatment costs are charged privately on top of that.
At the current time, the cost of a simple NHS checkup is £15.50 but this applies only to patients who have a Certificate of Partial Exemption from charges.
A simple, uncomplicated extraction costs £42.40 on the NHS but this applies only to patients who have a Certificate of Partial Exemption from charges.
If you have never been seen by us before and you are not exempt, you may be treated privately on your first visit for an extraction. The cost is £42.50 for a simple extraction and you will be told this price before the treatment is done.
Sorry, but the answer is Yes! Don’t ask us! Ask the Government. Under current arrangements, all patients pay for their treatment unless they fall into either an exempt class of they are on a low income.
If you are a pensioner and you are on a limited income, ask for Claim Form HC1 at Reception as you may be entitled to assistance with charges.
Denplan is a low-cost insurance-type lookalike capitation scheme in which a patient pays a monthly premium and in return, receives all treatment at no additional cost (with certain specified exceptions). It is proving to be increasingly popular. Denplan, the company, is owned by PPP and this, in turn, is owned by Axa, one of the world’s two biggest insurance companies. Denplan is the oldest established capitation system on the market, having been established in 1986. There are about 5000 dentists throughout the country registered as Denplan practitioners covering over a million patients. The big benefit of being covered by Denplan is that there are no sudden and unexpected charges when treatment is needed, you are effectively spreading out the charge over an extended period by paying monthly. Most patients like this arrangement as it allows them to budget their expenditure more effectively.
We offer Denplan cover for those who wish. It is a requirement of entry into Denplan that you are dentally fit at the time of registration and so you will be required to complete all outstanding treatment first, either Privately or on the NHS as appropriate.
Denplan offer their own website at www.denplan.co.uk.
Depending in the circumstances, you may be able to have a white crown at the back of your mouth on the NHS but there is no reason why you shouldn’t have one, if you wish, outside ofthe Health Service. The NHS will still pay for metal crowns at the back of the mouth, we supply crowns made of a non-precious (no gold) metal alloy but they do have a rather brassy colour to them. Whilst they may be made of all-metal, they are still fully-functional.
As an alternative to a metal NHS crown at the back of the mouth We offer a quality and style white crown at £325 per crown. Such crowns are built to a much higher standard of finish and incorporate shading and tinting to give them a very lifelike appearance. Speak to your dentist.
The study and treatment of irregular or crowded teeth is called orthodontics. Our practice always makes a quick assessment for every child seen at each checkup visit for general orthodontic problems. If your child appears to have a problem developing, we will tell you when we see him/her and advise you accordingly. Treatment may either be by simple extractions or by using a brace, depending on the nature of the problem. Your dentist will always advise when he discusses this with you.
Orthodontic treatment is not always appropriate for minor irregularities and your dentist might advise that NHS orthodontic treatment is not available for certain conditions. If the irregularity falls below certain measured criteria, it might be
possible to do the treatment privately, speak to your dentist.
As part of the orthodontic assessment, your dentist will assess if there is enough room for all your child’s teeth to come through. If there is not sufficient room, he may well advise that some second, or permanent, teeth are removed to make way for the remaining teeth. If they are not removed, your child may well end up with too many teeth for the space available may will end up with irregular and misplaced teeth.
Every tooth has a nerve, or pulp, which runs down inside each root. This very sensitive piece of tissue becomes inflamed if the tooth decays and this is what causes toothache. If the tooth isn’t treated, the nerve eventually dies and can subsequently abscess. The object of a root filling is to remove the dead or dying contents of the root canals and to fill the canals with an inert root filling material.
This is a complex procedure and often takes two or more visits to complete. After the nerve contents are removed, any pain present usually resolves and the tooth becomes symptomless. One of the side-effects of nerve removal is that the remaining tooth becomes fragile and liable to fracture. It’s rather like a dried stick fracturing readily, a green stick bends and absorbs forces. A vital tooth does deflect slightly under forces and can take most strains but a dead tooth becomes brittle and breaks readily if stressed, often losing a cusp. For this reason, your dentist may advise you that the tooth should be crowned after root filling.
Under NHS Regulations, you cannot have an NHS root filling followed by a private crown in the same course of treatment. If your tooth requires a root filling and a crown, we have a special discounted price to cover this, your dentist will explain this to you at
If a tooth is grossly broken down either because of decay or because a large piece has fractured off, the dentist may decide to crown it. A crown (often referred to as a cap) is an artificial tooth made from porcelain and/or metal alloy (in days of old, gold!) and which fits over the top of the original tooth. Obviously, before a crown can be fitted, it is necessary to prepare the tooth by trimming a little off from each surface to make room for the crown. The dentist will then take an impression of your mouth (and tooth) and this is then sent to a laboratory where the crown is made. The finished crown is cemented onto your tooth at a second visit.
If the tooth to be crowned has already been root-filled, the dentist may affix a post into the roots of the tooth to act as a foundation on which to build the crown.
Your dentist can only examine those areas of your teeth which are readily visible in the mouth. He cannot see, for example, see between your teeth where decay usually starts. Nor can he see under fillings or inside the jawbones where the roots are. Xray pictures are used in these cases and quite often reveal problems that were never suspected beforehand – a prime example being impacted or buried wisdom teeth.
There are no hard and fast rules regarding taking of XRays when a patient is pregnant as circumstances vary. A balance has to be made according to how vital it is to have the XRay taken against the potential risks involved to the baby. In general, it is relatively safe to take XRays after the first three months of pregnancy. In the event that an XRay is necessary during a pregnancy, we would normally cover the Mother’s abdomen with a lead apron to protect the baby. However, overriding this is the patient’s personal consent – we never take an XRay against a patient’s wishes. If you are concerned about XRays and pregnancy, please talk to your dentist.
Most new patients have a large panoral XRay taken. This shows all the teeth in both jaws and is very useful to assess buried or impacted teeth.
Our practices conform to guidelines laid down by the National Radiological Protection Board and all of our XRay units are monitored annually by the NRRP to ensure that they conform to the necessary Regulations.
It is an unfortunate fact of life that many patients just do not have enough room in the jaws for the teeth they have been allocated! Of this happens, one or more teeth may well fail to erupt or try to erupt into a poor position. In the case of the wisdom teeth, which are back teeth that come through between about 18 and 25yrs old, the teeth may end up half-erupted, in a poor position, or completely buried. This is known as impaction. Your dentist may advise that these teeth should be removed and you should discuss this with him.
Plaque is a sticky mixture of carbohydrates (sugars), bacteria and food debris which builds up insidiously on teeth. The bacteria in the plaque then ferment the sugars, this generates small amounts of acids and it is this which causes decay. In addition, the presence of plaque around the gum margins causes an inflammation of the gums called gingivitis. Over a long period, gingivitis will slowly destroy the gum tissue and inevitably, loss of teeth due to either infection or loosening. For these two reasons, dentists recommend that you have your teeth professionally cleaned on a regular basis. For most people, this means twice a year concurrent with checkups.
If plaque is allowed to lie on the teeth for more than a few days, it starts to crystallise into a hard substance called tartar, or calculus. Calculus cannot easily be removed with a toothbrush and must be removed by a dentist or Hygienist with suitable instruments. Calculus is always covered with a thin layer of plaque and therefore must also be removed regularly.
Hygienists are specially trained staff who have taken and passed both the Dental Nursing examination and the Hygienist Certificate. They are qualified to undertake a range of activities which includes Scaling and Polishing and Dental Health Education. In addition, they are allowed to administer some types of injection to numb a tooth and apply fissure sealants.
We make maximum use of our Hygienists as they are a valuable asset to patient care, all patients who need a Scale and Polish are referred automatically for an appointment with the Hygienist after they have seen a dentist first for Examination. Hygienists are NOT allowed to see patients without the patient first having seen a dentist, so please don't ask.
At each visit, the Hygienist will normally complete a Scale and Polish and then spend a few minutes with the patient explaining any Oral Hygiene instruction that may be relevant. This could be how to brush your teeth, showing you where you are missing areas or where plaque is collecting, or even dietary advice to Mothers for children. In addition, they may recommend a particular toothbrush of Oral Hygiene aid to help you keep your teeth in perfect condition - we sell an extensive range of branded brushes and aids at prices well-below supermarket and shop prices.
Everybody’s teeth collects plaque to some extent. And almost everybody has deposits of tartar or calculus on the inner surfaces of the lower front teeth even when it is not obviously visible. Even if you think you clean your teeth to perfection, most patients comment that they can feel the difference after a Hygienist’s scale – this demonstrates that a cleanup has actually done something!
A veneer is a relatively new treatment which involves sticking a thin layer, or veneer, of porcelain onto the front surface of a tooth. Veneers are used when a tooth is badly discoloured due to medicines taken in early life or for other reasons.
The major advantage of a veneer is that it can dramatically improve the appearance of a tooth but involve only the minimum of preparation or loss of natural tooth tissue. If the veneer is lost or damaged, the original tooth remains almost unchanged underneath and can usually be re-veneered fairly easily.
It should be noted that veneers are glued to the tooth surface and they can be damaged or broken quite easily. They shouldn’t be used for stripping wire! Er, come to think of it, teeth generally, shouldn’t be used for stripping wire.
When your dentist looks in your mouth, he is not just looking at the dentures. Sadly, the occurrence of oral cancer, cancer of the mouth, has risen in recent years and unfortunately, it is a difficult cancer to treat. However, if caught early, the chances of treatment being successful are greatly increased.
Your dentist will look around your mouth when you attend for a routine checkup. We believe for most patients, that it is necessary for full denture patients to attend only yearly. Additionally, your NHS registration, if you are registered under the NHS lapses automatically under NHS rules after fifteen months. Having a checkup every twelve months always ensures continuity of registration.
People used to think of baby teeth as a disposable asset. Dentists believe that it is as important to maintain baby teeth as it is for second teeth. They serve a number of important purposes beyond the obvious. Their continuing presence in the mouth helps the jaws to grow correctly in order to be ready to receive the second teeth in due course.
Additionally, if they are lost early, the spaces that they originally occupied in the arch tend to close as the remaining teeth on either side drift together so that when the second teeth try to come through, there is not enough space left.
And who wants to see a child with a row of black stumps?
You can, but not on the NHS. The NHS will not pay for white fillings at the back of the mouth unless you can demonstrate an allergy to mercury supported by a Consultant Neurologist’s report to that effect. For the vast majority, then, this means, NO.
However, there is no reason why you can’t pay privately to have white plastic fillings done. Discuss this with your dentist, he will be able to advise you of the prices involved and the suitability of any individual tooth for such a filling.
White fillings start from about £25 and go upwards, depending on the size and position.
NO! There has been much discussion and a lot of deeply-felt argument has been propounded that the presence of mercury in amalgam fillings is harmful in the long-term but there is precious little scientific evidence that mercury in fillings does any long-term damage.
Mercury amalgam has been used in fillings for over 100 years. One would have reasonably thought that if there was a serious risk associated with this, then it would have come to light before now. Current scientific thinking by the World Health Organisation is that the environmental risks associated with mercury is a far greater problem than the presence of mercury in peoples’ fillings.
The problem is that it is possible to measure traces of mercury from fillings for an extended period after they have been placed and, by extension, also to measure traces in the blood and body tissues. At issue is the source or origin of this mercury. As there are many sources of dietary mercury and mercury compounds, principally fish, it cannot be assumed that all mercury found in the body must therefore come from fillings. The most important consequence is whether this low level of mercury is harmful in any way and this is the link that remains unproven. Today’s sensitive tracing techniques can detect almost any compound – the question is whether these levels are clinically significant. The majority opinion is that they are probably not.
A lot of people have made all sorts of outrageous claims that their fillings have caused all sorts of obscure ailments, varying from making them fat (honest!) to causing cancer.
The main claims seem to revolve around general wellbeing but there is little evidence that any of these claims stand up to detailed scientific investigation. The following website gives a good account of the current line of scientific thinking regarding mercury and dental fillings;
There is much research into this problem being carried out at present, both the Government and the WHO have programs. If you have any concerns regarding then use of mercury fillings in your mouth, then talk to your dentist.
Although we try very hard to get it right all the time, there are always odd occasions when things seem to go wrong. In common with all practices and in conformance with Regulations, we have an in-house Complaints Scheme, operated via our Complaints Manager, Angela.
If you have reason to believe that something isn’t right, always speak first to the person with whom you have been dealing, dentists included. Don’t be afraid to ask questions – we would never refuse to explain anything reasonable that you don’t understand or that you are unhappy with.
If you are still unhappy or you feel that you would rather talk to someone different – perhaps to get a different slant on the problem – ask to speak to Angela.
You will be given the opportunity to talk to her in confidence and she will try her utmost to mediate and explain any queries raised although it must be understood that she is not qualified to explain the minutiae of clinical decisions.
In the event of your problem still not being resolved, you have the right to make a formal complaint to the Primary Care Trust if you registered under the NHS and your complaint involves treatment provided under the NHS.