Dental crisis leading to ‘slow death of NHS dentistry’

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The NHS dental system is “failing” and has left millions of people struggling to get the care they need, MPs have been told.

NHS dentistry is being propped up by dentists who feel an ethical responsibility to their patients but thousands are severing ties with the health service and no longer providing NHS care, the British Dental Association said.

The Health and Social Care committee of MPs heard that the system is designed to only cater for half of the population and dentists are concerned over the “slow death of NHS dentistry”.

MPs heard about “NHS dental deserts” – regions of the country where patients are unable to access dental services – as well as “Victoriana” dentistry occurring when people are so desperate that they are pulling out their own teeth.

Dentists have called for “urgent” reform, saying that one dentists earned just £9 in a day under the current system.

Shawn Charlwood, chairman of the BDA’s General Dental Practice Committee, told MPs: “In NHS dentistry particularly we are facing a crisis the likes of which I haven’t seen in my 35 years in the profession.

“NHS dentists are genuinely struggling to see the light at the end of the tunnel and they’re voting with their feet.

“And so that’s affecting the workforce that is available to see patients.

“Thousands of dentists have already left the NHS dental service and millions of patients are struggling to secure the care they need.

“I think my NHS colleagues feel chewed up and frankly spat out by the NHS dental service and dentists are severing their ties with a failed NHS system.”

He added: “Many of my colleagues talk about how the only thing that is keeping the NHS going really is the dentist ethical responsibility they feel towards their patients.

“But this can only last for so long.

“And obviously we can’t have any NHS dentistry without NHS dentists.”

He said there is a “genuine crisis” in the service, adding: “Unless Government deals with this urgently, the situation is going to worsen and worsen.

“Nothing has been done by Government in terms of NHS dental reform; it has been allowed to wither on the vine and today’s crisis is the result.”

Mr Charlwood said the current contract does not incentivise preventative dental work – widening inequalities in dental health.

Meanwhile, he said dentists are disincentivised from taking on new patients because they are more likely to have higher levels of disease.

He added: “We are, as a profession, are deeply concerned about, ‘Is this the end? The slow death of NHS dentistry?’ And it may not be that slow, to be honest.”

Asked by former health secretary and committee chairman Jeremy Hunt whether NHS dental care is being “rationed by the back door”, he said: “Yes, I am saying that.

“Traditionally, NHS dentistry has only been commissioned for 50% of the British population. Now I think that’s wrong.

“And the crisis that we’re seeing now in NHS dentistry is to do with the NHS contract, and frankly, not enough commissioned service.”

He insisted that dentists are not walking away from the NHS to make more money, adding: “The morale amongst NHS dentists is very, very low.

“We’ve had years and years of underinvestment in NHS dentistry; we’ve seen a 40% decline in real terms in NHS dentistry over the last decade.

“No other elements of the NHS have seen that level of decline. NHS dentistry doesn’t feel part of the NHS.”

“So in Portsmouth, for example, they lost a quarter of their dentists within 18 months.

“We’ve heard increasing stories of DIY dentistry, which is completely inappropriate and is something out of Victoriana frankly – people extracting their own teeth and filling their own teeth.

“It’s not acceptable, not appropriate.”

A BDA new poll of 2,200 high street dentists in England found that 45% have reduced their NHS commitment since the start of the pandemic.

The figures, shared with the PA news agency, also found that 75% are “likely” to reduce, or further reduce, their NHS commitment in the next 12 months.

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