Surgery costs Table 5


Procedure


Extractions: bone removal (premolar, molar)


Extractions with surgical flap


Extractions


Extractions additional fee per visit


Extractions: bone remove (impact L3rd molar+div)


Extractions: bone remove


(impact L3rd molar no div)


Number 14


20 43


25 3 3 Cost per


37.85 22.20


7.67 6.50 55.00 46.40 Total =


Cost per patient


Continued »


incurred if a patient were to be referred to a hospital specialist. SDR takes a very simplistic view of the surgical removal of teeth. It would be uncertain at times to predict if one tooth requires a simple extraction or more complex procedure. If the patient has to pay a


fee and is undergoing multiple extractions, it could lead to confusion if it turns out to be difficult. Going further, extraction is very important to prevent further infection and very critical or even life threat- ening if not performed at the right time. So why should the patient pay for it under NHS? Discretionary codes exist


for oral surgical procedures other than extractions. A fee is set by Practitioner Services, usually on prior approval. A dental advisor who may or may not have enough experience


ABOUT THE AUTHOR


Mr. Girish Bharadwaj BDS MDS MFDS FFDRCSI is a specialist in oral surgery. He works at Ochil- view Dental and Oral Surgery, Armadale and Meadowbank Dental Practice, Edinburgh. He is also an associate specialist at the Maxillofacial Unit, Queen Margaret Hospital, Dunfermline.


Email: drgirishb@yahoo.com www.ochilviewdental.co.uk


66 Scottish Dental magazine Total of episodes procedure (£) cost (£)


529.90 444


329.81 162.50 165 139.2


1770.41 21.33


in dealing with complex oral surgery allocates a fee. A long-drawn process for


a simple episode of treat- ment will further cause delays. Routine enucleation of cysts, closure of oroantral fistula or communication and removal of benign lumps in the oral cavity have to be treated under one code with multiple sub divisions. These procedures are routine


and can be performed safely and efficiently in primary care. Any suspicious lesions (within limitations) may be biopsied as well, which can help speed up waiting times for a cancer diagnosis and further management in secondary care.


Oral Surgery Review 20103 South of the border, oral surgery is contracted out to so-called dentists with special interest in oral surgery (DwSi), who are not necessarily specialists. This is an example of how a signifi- cant majority of procedures can be carried out in primary care, thus avoiding unneces- sary delays and problems to patients. A referral from a dentist is


forwarded to a local contracting oral surgery service. PCT pays the specialist or DwSi directly and there is no charge to the patient. We need to be aware that there is uncertainty on


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