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The state of teeth in Wales: is enough being done?

Blog Author Tom Bysouth

Blog Date 07/08/2018



We are pleased to see that the Welsh Assembly has announced a new inquiry into dentistry in Wales and we will be responding, to make the case for action, for real investment, and for positive change. 

To put it simply, it is not enough just to maintain the status quo.

We are keen to hear your thoughts and ask you to take just a few minutes to answer some questions to help frame our response:


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The inquiry will be looking at the progress on dental contract reform, the issue of how clawback money is being used, issues around the training, recruitment and retention of dentists, the provision of orthodontic services, and improvements into the oral health of children and younger people.
What’s the state of dentistry in Wales?
Our response will also include the evidence that we gather every year on your behalf, to help inform the pay review body’s (DDRB) recommendation for pay uplifts for dentists working in the NHS. 

Government in England accepted a recommendation by the pay review body, that dentists’ pay should be increased by 2 per cent. An announcement which was met with dismay by the profession.

In Wales we still await an announcement and we have written to Wales' Chief Dental Officer to express our concern and seek clarity on when, and how much, the uplift will be for dentists in Wales. 

Simply mirroring the uplift in England is not acceptable, as yet again, it would actually mean a pay cut for dentists and places further question as to the true independence of the pay review body.
If Welsh Government are serious about improving the oral health of the nation then such a decision will only worsen the morale and recruitment of dentists, and will not help things improve. 

These real terms further pay cuts contribute to the negative views of NHS dentistry, with a recent survey showing forty-one per cent of associates in Wales said they felt they were not fairly remunerated. 

We appreciate we are working within a cash limited system but with the ever growing numbers of practices closing, we feel Welsh Government would want to take the opportunity to make NHS dentistry in Wales a truly attractive environment in which to work

Our most recent evidence to the DDRB also highlighted that 62 per cent of practice owners in Wales say they’ve experienced difficulties recruiting dentists. 

This is leading to the closure of rural practices (especially in Mid and West Wales) leaving patients with difficulties accessing a dentist. This is placing other areas of the health service under additional and unnecessary strain.
Welsh Assembly Government have been made aware of such shortages and the impact this is having on dentists and their patients. However within their own DDRB evidence, they do not acknowledge a recruitment problem.


Morale is low and 62 per cent of associates working in Wales said they would not recommend a career as a dentist, the highest figure in comparison with data from the other UK countries. Just under half said morale was low or very low. Surely this shows all is not well?

Clawback in Wales doubled two years ago, to £6.6million, and last year it was another £6.6m. All told in the last three years a total of £20million has been lost to general dentistry through clawback and contract reduction and only a small fraction reinvested by one or two Health Boards to improve practices. A Freedom of Information request we undertook revealed that one health board moved £2.5million from the dental underspend to other areas of healthcare.

Prevention first?
We fully agree that prevention must be a priority. But prevention feels a long way away, when we have some pressing, structural problems with the delivery of comprehensive dental care for our patients in Wales. 

We are pleased that oral health is improving, particularly for children, but we cannot gloss over the fact that it’s not improving equally for all and those in more deprived or rural areas are lagging behind. 

The 'Designed to smile' programme has made great inroads into safeguarding younger children’s health, but levels of decay remain unacceptably high in Wales and we are pleased to see this highlighted in the response. 

The vision outlined is to be applauded, but to make it reality is going to take more than just words, it’s going to require sustained investment. 

We’ve been engaging with the Chief Dental Officer and the Welsh Assembly and we want to see more dialogue taking place, so the very real concerns of our members can be heard.

We now want to see a real commitment to dentistry in Wales, with evidence-based research into workforce planning and incentives to keep Welsh-trained dentists in Wales, and real progress to a reformed contract that has prevention at its heart.

With your help, we can help make this dream a reality, by making a strong case for the urgent need for improvements for dentistry in Wales.

Tom Bysouth, Chair

Welsh General Dental Practice Committee

BDA Wales

BDA Wales campaigns for the interests of all dentists working in Wales. With our elected committee members, we negotiate on behalf of the profession on terms and conditions, pay and contracts: join us.