Dental Deserts: The Struggle to Find an NHS Dentist

Finding an NHS dentist has become one of the most common frustrations people face when trying to access healthcare. For many across the country, and here in the North East, registering with an NHS dentist or getting a timely appointment has become extremely difficult, leaving some in pain and others resorting to drastic measures.

Access in Crisis.

Access to NHS dental care has fallen below the levels seen before the pandemic, and the situation has been widely described as a crisis. At one point, the overwhelming majority of dental practices, around 96 per cent, were not taking on new adult NHS patients.

An estimated 13 million adults, more than one in four, report some level of unmet need for NHS dental care, whether unable to secure a check-up or the treatment they require. Millions have been turned away or told that no appointments are available over a two-year period.

The North East's Struggle.

The North East has felt these pressures keenly. Since responsibility for commissioning dental services passed to regional health bodies, a number of dental contracts have been handed back across the area, creating real difficulties in accessing NHS dentists in many places, including parts of the wider region such as Darlington.

When a practice hands back its NHS contract, often because it cannot make the numbers work, the patients who relied on it can be left with nowhere to turn. The result is a patchy and shrinking network of NHS provision across the region.

The Workforce Shortage.

At the heart of the problem lies a shortage of dentists willing to take on NHS work. There are estimated to be well over 3,000 vacant dentist positions, and the way NHS dental work is funded and contracted has left many dentists disengaged from the NHS and focused instead on private practice.

Without enough dentists prepared to deliver NHS care, practices cannot meet demand, and the system is left unable to treat millions of patients each year. Reforming the contract that governs how dentists are paid for NHS work is widely seen as essential to fixing the problem.

The Human Consequences.

The consequences of this shortage are serious and sometimes distressing. Unable to find an NHS dentist, some people have been forced to pay for private treatment they can ill afford, while others have gone without, allowing problems to worsen.

There have been widely reported accounts of people resorting to so-called do-it-yourself dentistry out of desperation, and tooth decay has become the most common reason for young children to be admitted to hospital. When routine dental care is out of reach, problems that could have been prevented end up causing pain and requiring more serious intervention.

The Knock-On Effect.

The difficulties in dentistry also place pressure on other parts of the health service. When people cannot access a dentist, some end up seeking help from their GP or even attending A&E with dental problems, neither of which is equipped to provide proper dental treatment.

This not only fails to address the underlying problem but adds to the strain on already stretched services. The lack of accessible NHS dentistry therefore has consequences that ripple well beyond the dentist's chair.

The Plan to Fix It.

A range of measures has been promised to address the crisis, including the delivery of hundreds of thousands of additional urgent dental appointments each year, targeted at the areas that struggle most, alongside efforts to recruit dentists to underserved areas and reform the dental contract. Schemes to encourage prevention, such as supervised toothbrushing for young children, have also been introduced.

Local health bodies have been asked to deliver large numbers of extra urgent appointments. Whether these measures will be enough to turn the situation around, particularly given the depth of the workforce shortage, is a question that remains very much open.

A Basic Need Unmet.

The struggle to find an NHS dentist has become a defining feature of the pressures on the health service, leaving many across the North East unable to access a basic and essential form of care. The combination of a workforce shortage, a flawed funding system and handed-back contracts has created genuine dental deserts in parts of the region.

While measures have been promised to improve access, the scale of the challenge is considerable. For a service that affects something as fundamental as people's ability to eat, speak and smile without pain, restoring reliable access to NHS dentistry is a goal that matters to a great many people.

A Question of Prevention.

One of the most troubling aspects of the crisis in NHS dentistry is the way it undermines the principle of prevention that should sit at the heart of good dental care. Regular check-ups allow dentists to spot and address problems early, before they develop into something more serious and more painful, and to provide the advice and routine care that keep teeth and gums healthy over a lifetime.

When people cannot access a dentist for these routine visits, that preventive function breaks down, and problems that might have been caught early are instead left to worsen, often until they reach the point of pain or emergency. This is not only worse for the individuals concerned, who suffer needlessly, but also less efficient for the system as a whole, because treating advanced problems is more difficult and more costly than preventing them in the first place.

The fact that tooth decay has become a leading reason for young children to be admitted to hospital is a stark illustration of what happens when prevention fails, since most tooth decay is preventable with good routine care. The drift towards a system in which many people only access dental care when they are already in trouble represents a profound inefficiency as well as a source of avoidable suffering.

Rebuilding access to routine, preventive NHS dentistry is therefore not just about treating problems but about stopping them from arising, which is better for patients and better value for the system. Measures to promote prevention, such as schemes encouraging good dental habits in young children, are a welcome recognition of this, but they can only go so far while access to routine care remains so difficult.

A dental service worthy of the name must be one that keeps people healthy, not merely one that treats them once things have gone wrong, and restoring that preventive role is central to resolving the crisis.

Over to you.

Access to NHS dentistry has fallen into crisis, with handed-back contracts creating dental deserts across the North East.

Have you been able to find an NHS dentist when you needed one?