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Urgent action needed as millions miss out on NHS dentistry

The British Dental Association has warned government must commit to rapid and sweeping reform, as the latest official figures underline the huge backlogs facing NHS dentistry.

The NHS Dental Statistics for England biannual report shows 15.8 million adults – a little over a third (35.5%) of the total population – were seen by an NHS dentist in the 24 months to up to 31 December 2021. That is a fall of nearly 4 million adults in the previous year's report, and a drop of 6 million on 2019-20 figures, the last full year without major impact from the pandemic.

Children, who are reported on the basis of annual attendance, saw a modest recovery, with 5.1 million (or 42.5%) seen in the past 12 months, compared to 3.6 million (29.8% of total) in 2020-21 data which covered the first wave of the pandemic. It is still however far south of numbers seen in the last equivalent report before the pandemic – 7 million or 58.4% of the child population.

Data obtained by the BDA under freedom of information shows that over a year's worth of dentistry has been lost since lockdown, with close to 40 million fewer courses of treatment delivered from April 2020 to December 2021 exceeding annual pre-COVID volumes. Experts warn that oral health inequality will widen, as a result of ongoing disruption to dental services and public health programmes, with patients requiring more extensive and costly interventions.

Dentist leaders have urged government to deliver meaningful and urgent reform and turn the page on a decade of underfunding and failed contracts. Nearly 1000 dentists left the NHS in the last year, a trend now set to go into overdrive. Recent BDA surveys show over 40% of dentists indicate they are likely to change career or seek early retirement in the next 12 months given the current pressures on the service. Two thirds (66%) plan to reduce their NHS commitment, with more than a third (34%) stating they plan to go fully private in the next year, and less than half (48%) are confident their practice will continue to provide any NHS services from April 2022.

No long-term funding has been offered to underpin the recovery and reform of the service, and there are now fears that the bill for Covid testing – set to be drawn from existing Department of Health budgets – will hit historically underfunded dental services the hardest. Despite a recent pledge of £50m to provide up to 350,000 appointments by 1 April, the service has faced unprecedented cuts over the last decade and would require an additional £880m simply to restore resources to 2010 levels.

BDA Chair Eddie Crouch said:

"Each missed appointment translates into bottled up problems and widening oral health inequality.

"We've now lost more than a year's worth of dentistry, and any recovery will be impossible if Ministers fail to halt the exodus from a demoralised workforce.

"NHS dentistry is at the last chance saloon. For the sake of our patients real, urgent reform cannot remain stuck on the government's 'too difficult' list."