It’s the most gruesome image accompanying the allegations that there’s a crisis in dentistry provision in the UK.

Mark Cowley is a furniture restorer from Wisbech in Cambridgeshire. After travelling long distances to get temporary procedures done, and having suffered the cracking of his tooth, he decided to take matters into his own hands.

He picked up a pair of mole grips, plier-like tools, and pulled the offending tooth out. “I just got a bit desperate and this tooth was waggling. There’s no pain in it now.”

His friends and family do “get a bit squeamish” when they hear about his DIY dentistry. But what do the experts advise about tackling your own gnashers?

Professor Liz Kay, dean of the Peninsula Dental School in Plymouth, stresses that anybody who is able to pull out their own teeth probably has extremely advanced periodontitis, a collection of diseases that cause the loss of the bone supporting the teeth.

Robert Jagger, senior lecturer in restorative dentistry at Bristol Dental School, says cases of people with periodontitis removing their own teeth are not unusual.

“It can sound absolutely horrendous, but in the case of periodontitis, one of the things is that they become very, very loose. It has been reported very frequently over the years. You could get some pain but I don’t know if there’s a greater risk of infection [than in a dentist's surgery].”

Of course, if you mess it up, leave a fragment of a broken tooth remaining, and you risk abscess and infection. And, as Prof Kay, points out, the complex anatomy of the head means one doesn’t want to be messing around in there for fear of doing something exceedingly bad.

However, while pulling out a waggly tooth is one thing, the reports of people who have used powerful household glue to put a crown back in place are not good.

“It is a very foolish thing to do,” Prof Kay suggests. “If you superglue it and there’s any problem you are going to lose the tooth.”

And if you’ve done a procedure in a permanent fashion and put your crown or filling in the wrong place, you are not likely to notice until it’s too late to get help.

“There are more insidious dangers. Things may appear to be OK but the filling is still leaking,” Mr Jagger adds.

At the other end of the DIY spectrum are the dental first aid kits, provided mainly for tourists and recognised as an option for emergencies by dentists, which contain the tools to deal with a dislodged filling or crown until you get back to civilisation.

A kit might contain zinc oxide powder and eugenol, effectively clove oil. Mix it together and you can improvise glue for a crown, or a filling. It can hold for a few days at least with the dentist removing the material and doing a proper job.

As a “very, very temporary measure” such kits are “useful” for people on holiday, says Prof Liz Kay.

Jenny Lees, managing director of Dentanurse, says her firm has doubled the sale of kits over the last five years, and suggests they are being used domestically as people cope with long waits for NHS dentists.

Sticking a crown back in place is safe and simple as long as people read the instructions. But they should do it themselves.

“Legally you shouldn’t get someone else to do it. If someone else does it for you they are breaking the law by practising dentistry.”

“It’s like making custard, as long as you read the instructions you are fine,” she says.

Rose Matthews, 24, found herself left in the lurch and needing the kits when her dentist stopped a procedure midway and told her it could not be completed on the NHS. Being unable to afford the fee, she endured an 18-month wait for NHS treatment. The hole in her drilled-out tooth was tackled using a kit once a month.

“It was quite difficult and quite painful and because I couldn’t do it properly the walls of the tooth were starting to break away.”

But despite the less than ideal solution, it was a lot better than plan A.

From:
http://news.bbc.co.uk/1/hi/magazine/7045263.stm

Health Direct feels that the plight of people needing urgent dentistry is both distressing and unnecessary.

On April 02, 2007 Health Direct posted: Labour’s dentistry health reforms ‘have failed’

Radical Labour Government reforms to improve patient access to NHS dentists have failed, it was claimed today. The charity Citizens Advice said there is “huge inequality” in access to dentists in England and Wales, and urged action to deal with “dentistry deserts” in many areas including some parts of Hampshire and Lancashire.

It claimed two million people are forced to put off treatment or go private because they can’t find an NHS dentist.

Susie Sanderson, chair of the BDA’s executive board, said: “When the Government is failing to meet even its own success criteria for the new contract, then it’s time for urgent action.

“We now have a reductive, target-driven system that is failing both patients and dentists. The future of NHS dentistry is becoming increasingly fragile and we need action now before it shatters altogether.”

On April Fools Day in 2006 Health Direct warned- The saddest April Fool joke of all- D Day for Dentists- 1,000 dentists expected to quit NHS in contract row.

Unfortunately, not an April Fool joke but an exodus of about 1,000 dentists from the NHS in England was predicted last night by the chief executives of primary care trusts, who take over untried and untested management of the service from today.

The NHS Confederation provided the first hard evidence of how patients will be affected by a dentists’ contract that came into effect at midnight.