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Understanding why patients won't attend the dentist

Blog Author Rebecca Harris

Blog Date 15/01/2020

​As a dentist, and someone who has been involved with public health and primary care research for many years, I’m very familiar with the concepts behind dental contract reform.


Red, Amber, Green patients - ‘a jointly shared responsibility between dentists and patients for improved oral health’. Failure rates for Red patients are high – so now the system recognises that some people simply do not want to engage in regular care. 


The sub-text seems to me that some people are ‘non-compliant’, disinterested. 


Just ‘not that bothered’. Sheep and goats. 

Now one of the real privileges of my job is that I get to sit down and have a chat with people like these. Getting to know them as real people, away from the surgery. 


I’ve a suspicion that some wet-fingered dentists think it’s a bit of a cushy number. It shifts your thinking though. Walking a mile in someone else’s shoes – or at least spending just a little bit of time looking at things through someone else’s eyes. 


I’m working in Liverpool, leading a large NIHR programme grant on dental visiting, so I put a letter in the ECHO asking for people to come and work with Pauline-Photo-CAG-650px.jpgme. 


Pauline is one of the people who replied, so I’ve got to know her and her story. Pauline has lived in the same house since her kids were babies. 


Her sister lives nearby in the house her mum was in. Her brother lives next door but one to that. She has three grown-up boys – just like me.

She’s aware she’s got decay at the back of her mouth but says she won’t even go the Dental Hospital with it. She says she’ll “Just let it drop out and suffer with the pain”. 


That’s not the first time I’ve heard of people taking their own teeth out to avoid going to the dentist. 


Last time she went to the dentist it took her a month to get there: “I kept saying ‘Can I go it tomorrow? Can I go it tomorrow?’ That’s what I kept doing. And the pain was just horrible and me face… I was trying to drink soup through a straw.” 

We asked people in the community group to take photos of anything to express how they felt about dental visiting.

This is the photo Pauline gave us:


And this is how she explained her photo: “A lot of people are really scared of the Ouija board, aren’t they? It’s something I’ve never messed with. But I would rather have a go at one of them than go to the dentist. I’m that scared of the dentist.” 


Pauline is obviously a ‘Red’ patient. ‘Non-compliant?’ – yes, you could say that. 


But disinterested or not bothered – definitely not. She’s come to many evening meetings at the university to work with us on the project. So we’ve developed the material (booklets and video) now for the first stage of the grant. 


It’s a toolkit to help people like Pauline, and other people who aren’t quite as anxious but still don’t go to the dentist for other reasons.


For more about the NIHR programme grant (RETURN) project please have a look at our website


We’re wanting to share our work at this stage at an event at Liverpool University on Thursday 13 February pm, all are welcome, please register online, its free and verifiable CPD is available.

It's aimed at a range of stakeholders, dental teams mixed with patients and researchers and policymakers. We'll share our insights into the barriers to dental care, the material we've developed so far, and would love to hear your feedback and ideas. 


Professor Rebecca Harris, Professor of Dental Public Health

Liverpool University and Hon. Consultant Liverpool and Broadgreen Hospitals Trust.  

Twitter @RebeccaVHarris

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