Thursday, 8 October 2026

Good morning.

Private dentistry took a kicking in the headlines this week.

The underlying research is worth reading.

But so is the denominator.

Plus: a large new look at sedation in practice and a two-year fluoride trial with an interesting split in who actually benefited.

Let’s get into it.

THE DRILL

Both numbers can be true.

Which? published an investigation this week after screening 5,848 consumers.

Around 17% had experienced a problem with private dental care during the previous two years. Which? then surveyed 1,009 people from that group.

Among those who had experienced a problem:

39% felt their treatment was excessively priced.

22% said they paid more than quoted.

26% were unhappy with treatment quality.

And 10% believed their dentist had made a clinical mistake.

Serious findings.

But those percentages aren't describing all private dental patients. They're describing the group who already reported a problem.

For context, separate ONS research found 93.5% of people attending a private dental appointment in the previous 28 days were satisfied with their care. For NHS appointments it was 89.9%.

Different survey.

Different timeframe.

Different question.

The useful conclusion isn't that one study disproves the other.

It's that private dentistry can have very high overall satisfaction while still having a meaningful minority of patients experiencing problems.

And with the CMA currently investigating the UK private dental market, expect considerably more scrutiny of pricing, treatment information and complaints.

QUESTION OF THE WEEK

Researchers followed preschool children for 24 months.

One group received toothpaste containing 1,000 ppm fluoride. The control group continued with their usual toothpaste.

Which children showed the clearest reduction in new caries?

A) Children who were caries-free at baseline

B) Children who already had caries

C) Both groups benefited equally

Have a think.

Answer near the bottom.

PRACTICE OPS

A new British Dental Journal study found 20.6% of responding dental providers in England offered conscious sedation.

Most used midazolam. More than a third used a visiting sedationist.

The more useful finding came from CQC inspection reports.

Recurring problems included:

Evidence of sedation and life-support training.

Patient assessment and monitoring.

Emergency drugs and equipment.

Among sedation providers that underwent routine inspection, 68.1% failed to meet all regulatory requirements. That figure shouldn't be interpreted as 68% of all sedation practices being non-compliant.

But the recurring themes are a decent three-point audit for anyone offering the service.

Especially if the sedationist arrives with their own kit and everyone quietly assumes someone else checked everything.

BREAK THE ICE

Try:

“There are a few things here. Would it help if I start with what I think needs doing first, then we can go through what can wait?”

It gives the patient somewhere to start.

And makes a three-page treatment plan feel considerably less like a three-page treatment plan.

THE ANSWER

A total of 514 children completed the trial.

Across the whole group, children given the 1,000 ppm fluoride toothpaste developed fewer new affected teeth and surfaces over two years.

But the difference was clearest among children with caries at baseline.

Their average dmft increment was 3.1 versus 4.5 in controls.

Among children who started caries-free, there was no statistically significant difference between groups.

That fits an important clinical principle:

the people at highest baseline risk often have the most to gain from prevention.

For UK practice, this doesn't change the toothpaste advice. Current guidance already recommends at least 1,000 ppm fluoride for young children and 1,350-1,500 ppm where caries risk is increased.

Useful study.

Not a reason to downgrade your high-risk patient to 1,000 ppm.

THE LAST RINSE

The curing light battery has one preferred moment to die.

Halfway through the final increment.

Of course it does.