Make or break: A manifesto for dentistry in Wales

Untested policies have already seen many dentists walk away from the NHS. Whoever forms the next government needs a plan to guarantee the future of this service.

It is make or break for dental care in Wales. As we approach the 2026 Senedd election, we urge all political parties to commit to a long-term, sustainable vision for dentistry, one that places oral health at the heart of a healthier Wales.

In 2026, Wales needs a government that will offer:

1. A safety net for dentistry

2. Sustainable investment

3. Protection for the most vulnerable

4. A step change on the workforce

5. A change in tone.

Download our full manifesto: Make or break: securing the future of dentistry in Wales

1. A safety net for dentistry

• Protect struggling practices

  Establish a pilot or mitigation period for the introduction of the 2026 dental contract to ensure practices can adapt without potentially crippling levels of clawback. An annual review mechanism should also be established to allow fair, transparent adjustments. An overwhelming majority of dentists want the start delayed by a year, but Welsh Government have refused this option.

• Make effective use of the Dental Access Portal

  The Dental Access Portal (DAP) is for patients without a dentist. They can register for care and wait their turn on a Local Health Board central database. Once a patient is allocated to a dental practice they can remain under their care. The Government made a U-turn on their ill-considered policy of sending healthy patients back to the DAP. By ensuring patients are receiving ongoing care, the system can better manage demand, improve continuity and support long-term oral health for those most in need.

• Offer continuity and choice

  The patients’ right to remain with their chosen practice must be protected to preserve the long-term relationships that patients have built with their family dentist. Protecting continuity of care builds trust, improves health outcomes and ensures patient need is met effectively from a personalised approach.

2. Sustainable investment

• Expand the fixed financial envelope

  Wales needs a broader and more adaptable funding framework to meet the growing and changing demands of dental care. Expanding the fixed financial envelope will support equitable access across all communities, strengthen long-term service resilience, and create the flexibility needed to plan for the future, including the integration of efficient models of care.

• Provide fair and evidence-based funding

  The typical NHS practice has long delivered NHS dental care at a loss. Funding must reflect the true cost of delivering care, with annual inflation adjustments to ensure services remain viable. The next Welsh government should engage in an open and honest conversation with the public about what can realistically be provided and how it will be funded, securing a fair and sustainable future for dentistry in Wales.

• Double down on infrastructure and digital

  Investment is urgently needed to renew and modernise dental facilities and digital systems across both General Dental Services (GDS) and Community Dental Services (CDS). Upgrading infrastructure will improve efficiency, patient experience, and service sustainability across Wales.

• Invest in prevention

  Schemes like Designed2Smile have paid for themselves. Building on this, with expanded targeted funding for preventive oral health programmes, including community and school initiatives, is essential. Building on this success will help reduce the burden of dental disease and support healthier communities across Wales.

3. Protection for the most vulnerable

• Refocus the mission

  The CDS must be supported to focus on its core mission: providing care for vulnerable patient groups with complex needs. It should not be used as a stopgap to cover shortfalls in GDS reform. CDS patients often lack a strong voice in the system, and it is vital that the Welsh government protects their access to dedicated specialised care by reinforcing the CDS’s distinct and essential role.

• Invest and modernise

  CDS funding must be increased to modernise clinical facilities and upgrade IT infrastructure to enhance service efficiency. The facilities in the CDS can be unsuitable for their patients, lacking bariatric access or even basic accessibility provisions. The next Welsh government must prioritise these critical issues to ensure the service can continue to support some of the most vulnerable members of our population.

• Deliver efficiency and transparency

  Regular audits must be conducted on capacity and performance to ensure optimal use of surgeries, as well as fair resource allocation. An increase in data transparency is also needed with staffing and whole-time equivalents, as well as waiting lists for patients. To improve the CDS, it is crucial that we have a clear picture of the service.

• Collaborate and communicate

  The CDS is too often treated as an afterthought. Health boards frequently fail to engage in meaningful consultation with CDS staff, merely informing them of major changes after decisions have been made. The next Welsh government must strengthen collaboration between the CDS and health boards and improve communication within both the CDS and GDS to foster integrated care and deliver better patient outcomes.

• Support patients with the highest need

  Develop dedicated Personal Dental Service (PDS) schemes to support very high-needs (blue) patients, rather than placing additional strain on already overstretched high street and community services.

  The PDS is a locally commissioned NHS dental contract that allows services to be designed flexibly around specific patient groups. This model is best suited to very high-needs patients because it can fund longer appointments, continuity of care, and bespoke pathways. It should do so, without overburdening the CDS to the detriment of the most vulnerable in the Welsh population, and without destabilising GDS practices, as the current and upcoming contract systems constrain and disincentivise treatment for these very high-needs patients.

4. A step change on the workforce

• Support recruitment and retention

  The Welsh Government must improve recruitment across all branches of dentistry by addressing pay disparities and establishing structured career progression pathways. Ensuring fair pay and clear advancement opportunities will help attract and retain talented dental professionals committed to serving communities throughout Wales.

• Create flexible training pathways

  Access to flexible, high-quality training and continuing professional development should be expanded. This will enable dental professionals to update their skills and adapt to changing service demands, supporting a workforce that is both competent and motivated.

  For community dentists this must include automatic spine progression and structured pay bands that recognise experience and support career development. Trainee dentists should also be offered two study days within the CDS to gain valuable exposure to this vital area of practice.

• Put wellbeing first

  The mental health and wellbeing of the entire dental team must be a priority. Our surveys have shown years of high stress and low morale among the entire dental team. Support structures and mentoring programmes should be embedded at all levels to create a positive working environment, reduce burnout, and foster a resilient workforce dedicated to delivering excellent patient care.

• Collaborate in education

  Welsh Government must work with Health Education and Improvement Wales (HEIW) to enhance professional education and leadership skills. By working together, these organisations can better equip the dental workforce to meet future challenges and lead service improvements.

5. A change in tone

• Be transparent and accountable

  The next Welsh government must commit to regular, open communication between government, health boards, and the dental profession. Genuine collaboration and transparency are essential for restoring trust, ensuring that decisions reflect the realities of frontline care, and delivering dental services that are responsive, efficient, and aligned with patient needs.