There is peculiar logic in dental avoidance. You see the appointment must occur. You see the more you put off the worse the reckoning will be at the end. And yet there is never a time when it is not this week – too busy, too expensive, too much there is going on with work, with the kids, the house, some vague but nagging feeling that it can be put off a little longer. Richmond is reeking with individuals making this very calculation, some of them years on end. The teeth, in the meantime, are toing their own score. They are not as optimistic as you are that things are going well there. Check this out.

Richmond is a truly diverse dental landscape. That diversity is useful when you know how to use it, but when you are approaching it without a system at all it can be dizzying. You have NHS practices, at least what is left of available NHS practice in the area, which is significantly less than it was. There are all the completely privatized clinics and small general practices as well as large studios that have spent a lot of money on technology and ambience. You have had mixed practices with both NHS and private treatment on the same roof, and with extremely different waiting times on each. And interspersed throughout of this, are specialist services, orthodontists, implant centres, periodontal clinics, that exist independently of general dental care altogether. Being aware of approximately what category you require, prior to beginning your search, saves much wasted energy and the especially depressing experience of becoming excited by a practice only to find out that it ceased to accept NHS patients two years ago, and that no one had updated the list.

The problem of access to NHS in Richmond is an issue to be approached directly and frankly; it will take many people by surprise. The pretence that NHS dental treatment can be offered to everyone who desires it without any charge has not been true in many years past. Lists of practices have been closed. Others have switched to full privatization. There are others who still have a nominal NHS providing but a waiting list long enough to render the term available seem an act of generosity. When cost is a very real consideration, and NHS treatment is what you require, the correct action is to call individual practices and inquire in an even-tempered way whether they are currently taking on NHS, and not whether they provide NHS treatment, period. Those are other questions and they have different answers. A number of these practices that are listed on NHS finder tools are either not accepting new patients or have waiting lists that are in the many-months range. The two-minute phone call informs you about everything the web site has not informed you.

The selection of a private dentist in Richmond is in part a matter of credentials and experience, but it is also heavily a matter of communication style, and the latter factor is likely to be underweighted. A technically skilled dentist with the ability to explain what is being done, why a certain type of treatment is being suggested and what the practical options are leaving the patient with an opaque and slightly pressured experience despite clinically competent work being quite satisfactory. The finest practitioners in Richmond use each appointment as a form of information exchange, they tell you what they perceive, explain what we are getting in terms you can actually act on and provide you with some real agency in what comes next. That style is a little bit more time consuming per appointment, which is one of the reasons it is more frequently found in private practice where appointment slots are not being stretched to the absolute limit. It is worth making an effort to find. Reviews of patients who tell of effective communication and open cost discussions are better indicators than those who tell how the staff was friendly.

Dental anxiety is an issue that many Richmond patients silently and privately cope with, which is a pity since a more open communication approach is likely to yield much better results. Many adults who put off care over many years are not exactly driven by either price or time constraints, but are instead dealing with a real fear response that can be attributed to something particular and usually to a thing of the past. A dentist that proceeded too fast when doing a sensitive procedure. An injection that had gone wrong and no-one thought. The sense that they were hurried to an appointment and that, in fact, they were scared. The experience accumulates over time and builds a wall between the individual and the attention he or she requires. Richmond practices that do not dismiss this as a box to be checked, but as a true clinical concern that modulates their appointment scheduling, how they converse throughout the procedure, and what other options they can offer the patient who requires more attention. An example is sedation, which can be more readily available than many nervous patients would think. The question of why, instead of assuming it is just extreme cases, is whether it is worth asking about.

It is a more specific requirement than it might seem because families need a practice that actually works with children. Good paediatric dental treatment determines the relationship that a child has with dental visits into adulthood. When incorrectly done, it instills a fear that will continue into adulthood and cause the avoiding behavior mentioned above. Brief, relaxed low-stress appointments with explicitly child-friendly explanations and a reader-of-the-room clinician who insists on going through with it instead of forcing it through the door- these things always count for a lot in the early years. In evaluating practices to be used by the family, inquire about their approach to first visits with young children, the structure of appointment, and whether anyone on the staff is specially trained in paediatrics. A practice familiar with this part of their practise will reply without stuttering.