The number of dentists providing services through the National Health Service (NHS) in England has fallen by nearly 10% over the past decade, with at least 600 dental practices ceasing to offer NHS treatment. This trend has led to the emergence of 'dental deserts' in many areas, making it increasingly difficult for patients to access care.
According to research by the Nuffield Trust think tank, while the total number of dental practices has increased since 2017, the proportion offering NHS services has dropped by 9%, now standing at 56%. Of the practices that have stopped offering NHS services, 135 have done so since 2024. The report highlights that for six in ten adults, accessing an NHS dentist appointment within the last two years has been unsuccessful, with only 38% of those seeking new patient appointments succeeding.
Overall visits to NHS dentists are 8% lower than pre-pandemic levels. The decline in NHS services is evident across most of England's integrated care boards, with the South West and East of England experiencing the most significant drops. Concurrently, private dentistry has seen substantial growth in these same regions. In Cornwall, for instance, over a quarter of practices that previously provided NHS treatment have shifted away from it.
The Nuffield Trust's findings suggest that dental capacity has not vanished but has moved beyond the financial reach of many.
Shift from NHS Contracts
NHS dental contracts have decreased from approximately 6,260 in March 2017 to 5,650 in the current year. During the same period, the number of practices operating without these contracts, focusing instead on private or specialist NHS services, has risen by nearly 1,000. Many dentists report that continuing with NHS patients is financially unviable, leading them to relinquish their contracts. In the past two years, dental practices have returned over £900 million to the government for failing to meet NHS targets.
Mark Dayan, a policy analyst at the Nuffield Trust, stated that the government faces a critical decision as it implements contract reforms. He indicated that the government must either make NHS work sufficiently attractive to reverse the trend or accept a move away from a universal service, prioritizing those most in need or unable to afford private care.
Shiv Pabary, chair of the British Dental Association's General Dental Practice Committee, emphasized the need for the Department of Health to adequately fund and reform NHS dentistry to prevent further dentists from leaving the service.
The government has announced plans to require newly qualified dentists to practice within the NHS for a minimum of three years. A spokesperson for the Department of Health and Social Care acknowledged the difficulties many face in obtaining dental care and stated that changes to the NHS dental contract are being made to improve sustainability and increase the training of dentists in underserved areas.