NHS dentistry - improvements and issues

NHS dentistry is in urgent need of systemic change. Healthwatch North Yorkshire has been pushing to make dental access a political priority so that it’s easier for people to find dentists taking on NHS patients.

Our report back in 2022 highlighted the devastating impact the oral health crisis is having on adults and children across the region.

Through 80 case studies, the report revealed alarming findings:

• Many people were forced to pay for private treatment when they could afford it.
• Others resorted to drastic measures, such as using do-it-yourself tooth kits or pulling out their own teeth.
• The crisis is deepening health inequalities, with vulnerable populations suffering the most.

One person shared their despair - and how they have resorted to drastic measures:

I have pulled out four of my own teeth, and number five is getting to the stage it’s going to come out. I don’t want to leave the house.

Extra funding to address the crisis

In March 2024, additional funding was allocated to dental practices in North Yorkshire to help them treat more NHS patients. Practices are now eligible for payments of £15-£50 for treating patients who haven’t seen an NHS dentist in over two years. New NHS dental practices have also opened in Scarborough, Whitby, Helmsley, and Thirsk, but those are now fully booked.

These measures are part of a broader dental recovery plan that was published in February 2024. It promised:

• 700,000 urgent NHS dental appointments nationally to address immediate needs.
• £20,000 ‘golden hello’ payments to attract dentists to underserved areas.
• Dental vans to serve rural and coastal regions like North Yorkshire, although there is still no specific rollout details. Locations, times and availability remain unclear.

Despite these efforts, challenges persist. One person told us:

I moved to Catterick Garrison – and it’s a five-year wait to see an NHS dentist.

Rising costs push people to the brink

The shift of NHS dentists to private practice has made affordable care even harder to find. One person told us:

My NHS dentist recently turned private. I pay a monthly membership, but then was told I’d have to pay for a filling repair, which would cost £100 more than my monthly mortgage payment.

For others, private care is simply out of reach:

The cost of private dental care is just too high. I can’t afford it.

A growing impact on health and wellbeing

The inability to access dental care is affecting more than just oral health—it’s taking a toll on mental health and overall confidence. A person told us about their their experience:

I am starting to struggle with my mental health due to being unable to access NHS or Denplan treatment after four years of trying. My teeth are loose and about to fall out. I feel so depressed and embarrassed about my other bad teeth and gum disease. I am only 52 and starting to refuse photographs or smiling. I will never go out in public again.

Persistent inequalities in oral health

The ongoing dental crisis is further widening health inequalities. Dental access and oral health are among the top concerns shared with Healthwatch North Yorkshire, and the crisis is affecting people’s health, wealth, and happiness.

Here are some key insights:

Health impact

• Severe dental conditions: Hospitals in the North of England report a rise in life-threatening dental infections, such as sepsis, due to delayed access to primary care. Some cases have resulted in fatalities from untreated dental abscesses, an alarming trend attributed to systemic gaps in dental accessibility. Read more in the Yorkshire Times.
• Oral cancer concerns: Late diagnoses of oral cancer have led to poorer outcomes, with survival rates dropping from 90% to 50% when diagnosis is delayed. The UK saw a 12% increase in oral cancer cases compared to earlier years, highlighting the consequences of limited routine dental care (Yorkshire Times).

Financial and social strain

• Economic inequality: Despite high demand, NHS dental services in Humber and North Yorkshire underspent their allocated budgets by 12% in 2023/24, leaving residents dependent on expensive private options or without care altogether. This disparity creates a "postcode lottery" in service availability and quality. Details are available in the Yorkshire Post.
• Dental health in children: In England, over 30,000 decayed teeth were extracted from children in hospitals in a single year, according to the Oral Health Foundation. Dental decay remains the top cause of hospital admissions for children, indicating a lack of preventative care (Oral Health Foundation).

Systemic issues

• Emergency service burden: Over 52,000 people visited A&E for dental abscesses last year in England, underscoring how a lack of routine care overburdens emergency departments. These cases often represent preventable conditions that escalated due to limited access to primary dental care (Yorkshire Times).
• Widespread inefficiency: NHS dental statistics show a slight increase in dental activity in 2023/24 but acknowledge persisting inequalities in care provision.

The British Dental Association continues to advocate for urgent reforms, emphasising the need for improved funding models and equitable care distribution. The current state of NHS dentistry in North Yorkshire and beyond represents a pressing public health issue.

We want change

The NHS "Find a Dentist" website has faced widespread criticism for several issues that hinder patients' ability to find NHS dental care:

1. Inaccurate listings: A British Dental Association survey found that only 10% of 100 listed dental practices were actually accepting new NHS patients. This discrepancy often misleads patients into believing they can secure appointments, wasting their time when they contact practices listed as "accepting" patients. For more, see the British Dental Association's findings at Dentistry.co.uk.
2. Outdated information: Listings on the website are not regularly updated. Many practices appearing as open to new patients have not revised their status for months.
3. Misleading status definitions: The definitions for practices "accepting" new patients can be vague. In some cases, practices only accept referrals or patients with specific urgent needs, but this is not clearly indicated on the website. For more information, visit Dentaly.org)​.
4. Underlying NHS dentistry crisis: The broader systemic issues, including a significant reduction in dentists willing to accept NHS patients due to financial and administrative pressures, contribute to the limitations of the website. This reflects the struggles of NHS dentistry as a whole, which further undermines the tool's utility. You can learn more at Dentaly.org.​

These issues underscore the need for systemic reforms and improvements to digital tools intended to support patients in accessing NHS dental care.

Moving forward

While additional funding and the dental recovery plan are steps in the right direction, they are only part of the solution. The NHS must prioritise systemic reforms to make dental care accessible, affordable, and equitable for everyone.

Healthwatch North Yorkshire will continue to amplify the voices of patients and push decision-makers to prioritise oral health. If you’re struggling to access dental care, Healthwatch is here to listen and support you. Together, we can work towards meaningful change.