Health: Dentists who drill for gold

Health Check

A DISTURBING photograph appeared in the medical press last month. It showed a queue of people snaking down a pavement in a provincial town. There was a man in a suit, a mother with two children, a lad in a denim jacket - ordinary people from different backgrounds queuing for... the dentist.

A day and a half after a new NHS dentists' surgery opened in Truro, Cornwall, more than 1,000 patients had flocked to register. New patients queued for hours and some travelled from 100 miles away to avail themselves of what is supposed to be a readily available national service.

The destruction of NHS dentistry is a scandal that has gone almost unreported. Ministers claim that there are more NHS dentists than ever, but increasing numbers treat only children and the poor on the NHS. For an adult, paying patient, finding an NHS dentist is difficult everywhere and next to impossible in the south of the country.

For those who fail in the search - or balk at travelling 100 miles to have a tooth filled - a private dentist is the only option. But for many the cost of treatment is unaffordable.

The dentist peers into your mouth, announces what must be done, and starts to drill. As the precious enamel disappears in a whirr of grit and water, the dental practice's bank balance notches up at least pounds 3 every minute.

A new book describes a patient who received an estimate of pounds 58,000 from a private dentist for a "full mouth rehabilitation". That puts Martin Amis's reputed pounds 20,000 bill in perspective. Fees of pounds 100 for a filling that would cost pounds 10 on the NHS are common.

In a market with prices such as these, tooth preservation becomes a critical priority. I am one person who has given up the major part of his dentition to over-eager dentists down the years. Conscientiously visiting the dentist every six months - my first serious error - I was always told so much work was needed that it would trigger the maximum NHS payment. Today, my mouth contains enough amalgam to trigger a bomb scare.

It was, therefore, with a strong feeling of relief that, more than a decade ago, I came upon an NHS dentist with a different, low-key style.

Anne Sherman has practised from the same surgery in Hackney for more than 25 years. Warm, but tough, she understands what too few dentists seem to: that teeth are for preserving, and drilling should be a last resort.

Now she has written a book - a guide to dentistry based on two decades of answering patients' questions - co-authored with her late husband, Barrie Sherman, the writer and broadcaster who died last year.

Like the woman, the book delivers direct, straightforward advice in a plain, unadorned style - and includes the anecdote about the pounds 58,000 "rehabilitation" estimate.

A couple of years ago, after another of my overfilled teeth gave way, I consulted a private dentist in west London about an implant - a false tooth fixed permanently in the jaw - which is not available on the NHS. He spent an hour describing the gadgets in his surgery in a voice as soothing as a physical caress.

When he finally disclosed what the implant would cost - pounds 2,000 for half a molar, plus pounds 1,800 for unspecified restorative work on my mouth - it required a physical effort for me to lever myself up from his chair and say "No".

Now I know how cheap his offer was.

`Complete Family Guide to Dental Health' by Anne and Barrie Sherman (Thorsons, pounds 5.99)