Growing number of ‘dental deserts’ as shortages leave patients without treatment

Shortages of NHS dentists across the country must be addressed before patients forgo treatment or “resort to DIY dentistry” amid the cost of living crisis, the Local Government Authority (LGA) has said.

The LGA found that no local authority area in England has more than one dentist per 1,000 of the population who provides NHS treatment – while there are a growing number of “dental deserts” across the country.

Data shows there are wide variations in the availability of NHS dentists, with the City of Westminster having over six times the number per 1000 of population compared with Ashfield, the area with the lowest number in the country.

Rural and more deprived areas are more likely to have shortages in NHS dentists than their counterparts, with the top ten council areas for shortages mainly having higher than average levels of deprivation, or a higher than average proportion of residents in rural areas.

The findings come from an LGA analysis of data collected by the Care Quality Commission (CQC).

The body, which represents local councils in England and Wales, said not dealing with the situation could risk more people requiring costly emergency dental treatment further down the line.

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This could be exacerbated, the LGA says, by the cost of living crisis and increased interest rates as some may put off dental work to cut down on spending.

Councils have now urged the Government to reform the dental contract and ensure the £762 million clawback taken by the Treasury over the last 10 years from dental practices who miss contractual targets is reinvested into subsidised dental treatments.

Although dentists provide treatment, it is the responsibility of councils to run programmes to promote good oral health and prevent problems, particularly among children.

But councils’ public health grant, which provides funding for this service, has been reduced by 24 per cent in real terms per capita since 2015/16, equivalent to a total reduction of £1 billion.

Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board said: “This stark new analysis shows a shortage in affordable dental treatments for communities all over the country. In particular, it is concerning that it is rural areas as well as those living with the highest levels of deprivation that are more likely to miss out on NHS dental provision.

“As we continue to feel the effect of the cost of living crisis, a lack of NHS dentists could risk people choosing to forgo routine dental treatments or even resort to DIY dentistry, risking more costly emergency dental treatments being needed further down the line.

“The Government should reform the contract it has with dental surgeries as well as develop a workforce strategy to ensure we can have affordable dental treatments for communities across the country.

“Councils also need a real terms increase in their public health grant so they can provide vital oral health improvement programmes to prevent longer term health problems.”

Previous research by Public Health England shows that children in deprived communities have poorer oral health than those living in more affluent communities. For example, across local authorities in England there is huge variation ranging from 7 per cent to 51 per cent of five-year-olds having experience of tooth decay.

The British Dental Association has long warned that the current crisis in NHS dentistry is having a disproportionate impact on high needs patients, in already underserved communities.

British Dental Association Chair Eddie Crouch said: “The Government must be more ambitious in its plans to reform NHS dentistry. To save this service we need real commitment – root and branch reform and adequate funding.

“A broken contract is forcing dentists out of the NHS every day it remains in force. Tinkering at the margins will do nothing to help the patients who need us most.”

A Department of Health and Social Care spokesperson said: “The Health and Social Care Secretary has set out her priorities of A, B, C and D, which includes dentists, and Our Plan for Patients sets out how we will help more people to access NHS dental treatment – already backed by more than £3 billion annually.

“We have already started changing the dental contract to incentivise dentists to do more NHS work – including in rural areas – and we are amending the law to make easier for dentists not trained in England to work in the NHS.”


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