French dental service is ‘fundamentally flawed’, says ex NHS dentist

The retired practitioner writes that the system is ‘badly organised, poorly regulated, understaffed and not based on continuous patient care’

A stomatologue specialises in problems relating to the mouth, jaw and, more broadly, the face

Many people we meet, as well as articles we read, speak unfavourably of the French dental service, especially in comparison with other outstanding medical care.

Having worked as an NHS dentist in England for 50 years* before retiring to France six years ago with my wife, I can say with some authority that these criticisms are justified.

Unfortunately, my wife’s experience with French dentistry bears out these unfavourable opinions.

Soon after our arrival in France, she developed an infection around a lower wisdom tooth which had remained dormant in the jaw for many years.

This was a difficult tooth to remove and, having previously discussed the matter with a specialist surgeon in England, we had decided to leave well alone. Emergency treatment was now required, as such infections can have serious consequences.

However, emergency treatment in France seems difficult to obtain, even for registered patients. Locally, such services appear to be available only on Sunday mornings.

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Fortunately, we knew a friendly dentist and I had also kept some basic equipment so I could irrigate the area around the tooth. The dentist kindly agreed to see my wife, took and gave us the necessary X-rays of the tooth, and prescribed antibiotics.

She also wrote a referral letter to a stomatologue (whatever that is) although, unlike in the UK, we had to contact this person ourselves. This system of referral – quite unfamiliar to those from the UK – is the same as with general French medicine, but that is well organised, whereas the dental service is not.

My wife attempted to telephone this stomatologue several times without success, so we returned to our dentist, who provided the name of another stomatologue.

We visited this man, who took a large number of X-rays before pronouncing that the tooth was too difficult for him to remove. No further help or advice was offered. He then produced his bill for telling us something that I could have told him!

Our friendly dentist then gave us the name of a third stomatologue, this time in our department’s main city, some 70km away. After examining the X-rays we provided, this stomatologue again told us she could not help but did refer my wife to a surgeon, who she assured us would be of more assistance.

This involved a further 70km trip for another appointment, but the surgeon turned out to be an ENT specialist. I assume most readers will know what an ENT surgeon does, but clearly some members of the dental profession do not.

The ENT surgeon was kind and helpful, telling us she would contact an oral surgeon and arrange an appointment.

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We returned home and were told that an appointment was available that very afternoon. We returned to the city for a third time and the oral surgeon efficiently arranged to remove the difficult wisdom tooth in a hospital environment.

The surgery was successful but my wife had been periodically unwell during this long wait. Fortunately, I was able to carry out some emergency treatment when needed. Nevertheless, her immune system became compromised after these recurrent infections and courses of antibiotics and she developed influenza, becoming quite ill.

This was followed, as can be the case, by a chronic muscle condition which, after a long course of treatment, has now subsided.

These problems presumably arise because the dental service in France is basically badly organised, poorly regulated and understaffed, although there appears to be a more fundamental issue: the French service is not based on continuous patient care, as in the NHS.

The latter has many problems but its founding principles are sound. The NHS dentist is obliged to examine the patient and then carry out any necessary treatment the patient requires and will accept.

The dentist must also point out any potential problems that are developing (including mouth cancer) and advise on daily care.

This is rather like taking your car for a service: the driver relies on the motor engineer’s specialist knowledge and acts on his advice.

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In the French system, by contrast, the patient often tells the dentist what he or she wants and the dentist does just, and only, that. It is reassuring that the medical service through the GP practises a continuous care policy.

It should have been a simple matter for experienced dentists to know where to refer a patient with an infected and difficult wisdom tooth, but obviously not (and I still do not know what a stomatologue does!).

What is a stomatologue?

A stomatologue specialises in problems relating to the mouth, jaw and, more broadly, the face.

Stomatologie gained momentum during World War One when these specialist doctors were tasked with repairing soldiers who were victims of facial trauma, such as fractures and infections.

They can perform bone grafts and facial prostheses and intervene when cancer affects the mouth, as well as performing more complicated tooth extractions, such as removing wisdom teeth.

*The writer has asked not to be named. The Connexion has seen proof of training and former dentistry position