Nearly 600 dental practices in England have withdrawn from providing National Health Service (NHS) care over the last decade, a trend that is pushing the service towards a two-tier system and making it increasingly difficult for patients to find affordable dental treatment.
This decline in NHS dentistry is attributed by some to choices made by successive governments. Shiv Pabary, chair of the British Dental Association's General Dental Practice Committee, stated that unless ministers "fix and fund NHS dentistry," more dentists may reduce their NHS commitments or leave the service entirely.
While the overall number of dental practices in England has increased over the past decade, this growth has not translated into more NHS services. "This is not a shortage of dentistry but a shortage of NHS dentistry," explained one observer. "Practices will need to be incentivised back into NHS work in the places where the NHS footprint has thinned most."
The availability of NHS dental care varies significantly by region. Most areas of England have seen a reduction in practices offering NHS treatment. However, the decreases were least pronounced in North West London, the Black Country, and North East London. Notably, North East London was the sole region to experience an increase, with one additional practice offering NHS treatment compared to ten years prior.
Data on the number of practices offering NHS work does not fully capture the available capacity, as practices can differ in size. However, other metrics, such as the volume of treatment being performed, also show a decline, though not as steep as the fall in practice numbers.
In response to the growing crisis, the government has indicated it is revising the dental contract and increasing training for dentists in areas with the greatest need. Furthermore, it plans to mandate that newly qualified dentists commit to a minimum of three years practicing within the NHS.
Campaign group 38 degrees has described the current situation as "shameful," highlighting that individuals are being "forced to pay money they can't afford or suffer with the pain, shame, and further complications that come from being denied vital NHS healthcare."
Some dental professionals are opting out of NHS work, with one dentist noting that none of his friends from his dental school graduating class still work in the NHS. He added that their career paths include private practice, retirement, or teaching, with any route chosen to avoid NHS dentistry.