Let a dental student loose on your teeth… and save thousands

| UPDATED:21:08 GMT, 31 March 2012

Over the past 36 years, Rebecca Enright has needed a daunting amount of dental work – a gold crown on a rear tooth, a porcelain crown over a canine, root-canal work, an extraction and a bridge. And that’s on top of routine check-ups, hygiene appointments and a number of fillings. All this would normally have cost a hefty five-figure sum – but Rebecca hasn’t paid a single penny.

That’s because the 41-year-old, who owns a construction company with her husband Gerard in Solihull, West Midlands, has had all her treatment carried out by students.

At best, many might think her brave – at worst, foolhardy. Yet she is one of a growing number of people being treated by trainees from the UK’s 18 dental schools.

Keep smiling: Rebecca Enright has had her teeth cared for by trainee dentists for nearly 40 years

Keep smiling: Rebecca Enright has had her teeth cared for by trainee dentists for nearly 40 years

‘When I tell friends that my dental work is done by students, their first reaction is that I’m mad – but my teeth look great. I’ve been going to Wigan Dental Hospital since I was five. My mother had a botched job at a private dentist and was referred to the college for repair work. The whole family have been going there ever since.’

According to the British Dental Association, one person in 12 suffers a severe dental problem, but clinics reported last year an estimated 68 per cent of patients now defer treatment for financial reasons.

Fees in Britain are among the highest in Europe, with recent research suggesting a bill for a simple check-up can be as much as 124. In 2008, Citizens Advice found that one in six of the 1,800 people they surveyed had been unable to get access to an NHS dentist in England and Wales.

That same year, about 22,000 people were admitted to hospital for emergency dental treatment, 5,500 of them children.

Perhaps, then, the prospect of a student dentist isn’t so unpalatable after all, particularly given how highly supervised they are.

Professor Damien Walmsley, who is in charge of restorative dentistry at Birmingham University’s School of Dentistry, explains: ‘In the past we advertised for patients but now we don’t need to. We charge for dentures because they are so expensive, but everything else is free. Patients seem to enjoy coming here because they are so well treated and cared for.’

Rebecca says: ‘While other people are paying thousands every time a crown falls off, I don’t pay a thing. The standard of work is fantastic and with the supervisors and professors overseeing everything, I know I’m in the best hands.’

Professor Stephen Dunne, Head of Primary Dental Care at The Dental Institute at King’s College London, says patient numbers are increasing rapidly as more and more NHS dentists refer cases to them.

‘Thecontract that dentists now have with the NHS means that the remuneration for performing lengthy procedures isn’t consistent with thetime and effort spent. They get the same money for several crowns on one patient as they do for just one. We make sure the undergraduates areup-to-date with the latest innovations and techniques, and we have the combined expertise to deal with very complicated cases.

‘Allwe ask is that patients make time for lengthy appointments. A standard dental appointment is about 15 minutes, but with an undergraduate it is an hour. The student timetable is rigid so patients can’t come at weekends or evenings.’

There are 18 dental schools in the UK and all of them need thousands of patients to work on

There are 18 dental schools in the UK and all of them need thousands of patients to work on

But isn’t it riskier having students treat your teeth Not according to Prof Dunne. ‘Student extractions have a very low post-procedure infection rate. Everything possible is done to avoid error,’ he says.

Eric Whaites, Clinical Director at Guy’s and St Thomas’ Dental School in London, says standards are high because students are encouraged to aim for perfection.

‘Students are checked at every turn and have to keep going until they get it absolutely right, so patients end up getting the very best treatment possible,’ he says.

‘There are 18 dental schools in the UK all needing thousands of patients to practise on each year. A degree in dentistry takes five years and the requirements of the students change according to how advanced they are in their studies. While those in their third year need patients who require simple fillings, fifth-year students need more of a challenge. I would have every confidence in having my teeth done by one of my students.’

Anyone can walk in off the street for emergency treatment at a dental school – Guy’s and King’s College Hospital each see about 100 such patients every day. ‘Ideally, patients with dental emergencies should go to their GP,’ says Prof Dunne. ‘If you have no GP or can’t access emergency treatment for any reason, we are the best port of call.’

Patients are assessed at an ‘initial diagnosis unit’. There are no guarantees about qualifying for treatment by a student – this will be dependent on which procedures are being taught throughout the academic year.

Prof Dunne says: ‘Patients will be asked to sign consent for photographs, surgical procedures or the use of clinical notes for publication. Patients are assessed and a treatment plan is then drawn up. If they are suitable, a student is allocated to do the work under supervision.’

Rebecca has been seeing students since she was a child (picture posed by model)

Rebecca has been seeing students since she was a child (picture posed by model)

Schools offer most dental treatments, including the making and fitting of dentures, but tend not to do anything purely cosmetic. You also cannot walk in for a basic check-up.

The need for complex cases is constant. Mr Whaites says: ‘We will do implants in rare instances – perhaps for a patient who’s had an accident or was born with missing teeth.

‘In the case of postgraduates, we have very specific criteria about who we can see. Primary Care Trusts fund the treatment, so we have to go through them – sometimes they say yes, and sometimes no.’

Charity worker Caroline Ffrench-Blake was left with a shattered jaw after being mugged 11 years ago, and she is thrilled with the dental care she has received at University College London’s Eastman Dental Institute after a referral by her dentist.

After Caroline’s broken jaw was reset, she was left with a misaligned bite that, over time, caused her teeth to erode to tiny stumps. Eastman’s postgraduates, who are training in specialist fields of dentistry, were happy to tackle the complex case. The extensive work – including veneers, eight crowns, an implant, fillings and surgery on Caroline’s gums – would have cost more than 20,000 with a private dentist. ‘I couldn’t have afforded it,’ admits the 60-year-old from East London.

Caroline has attended the Eastman at least once a week for two years, but will soon finish her treatment. ‘It’s been slow but I didn’t mind as I was getting the benefit of specialists,’ she says. ‘The student has done a super job. I feel good about myself again. I am lucky to have got such brilliant treatment for no cost. Everything is checked and rechecked.’

Another satisfied customer is civil servant Keith Danvers-Colquhoun, who is in his 50s. He first went to Guy’s Hospital dental school 15 years ago after he was referred for an extraction his own dentist would not carry out. Since then, over about 30 appointments, he has had root-canal treatment, fillings and dentures made and fitted.

‘I have saved a fortune but it’s about more than that,’ says Keith. ‘The quality of treatment is so much better than at a regular dentist. I also enjoy knowing I’m helping the dentists of the future.’