How rising costs for private care are worsening England’s dental crisis

The inability of millions of patients to access an NHS dentist is one of the longest-running injustices in the history of healthcare. The misery and damage it causes is profound and well documented. The scandal is not new.

Going private is often the only alternative. If it means having a check-up, a scale and polish, a filling, an extraction, or if necessary a root canal, many will pay for it. Everything to keep your teeth in good condition.

But now a new horror is occurring. Like NHS dental care, private dental care is also at risk of becoming more inaccessible. An analysis shows that rates for private treatments are skyrocketing. The average cost of non-surgical treatments has increased by as much as 32% in two years.

Patients can be charged £325 for a white filling, £435 for tooth removal and in some cases £775 for root canal treatment. It means millions more people could face a double whammy by 2025: inability to access NHS dental care and inability to live privately.

Of course, many of those who have not received dental care from the NHS have not been able to afford to go private for some time. One in five people, and two in five of those on lower incomes, already avoid going to the dentist in England because it costs too much, according to a recent Healthwatch survey.

Some go years without care, or live in agony with untreated pain. Some even try do-it-yourself dentistry. The dramatic increase in the costs of a private company could put more Britons in the same danger.

Fundamental changes to NHS dentistry are urgently needed to improve access and prevent people from having to choose between a life of poor oral health or going into debt to pay for private care.

Surveys show that a majority of adults want the option to permanently register with a local NHS dentist, in the same way as a GP practice. This right was removed in 2006.

Most experts also believe that the current contract between the government and dentists in England is failing and should be torn up.

The British Dental Association (BDA), which represents dentists, says some of its members have increased private fees to compensate for the loss they make on NHS patients. The money dentists receive from the government for NHS care is not enough to make ends meet and does not cover their costs, the report suggests.

Inflationary pressures, including rising energy and equipment costs, may also help explain the rise in private reimbursements, the BDA says. It wants a new contract that rewards dentists who help prevent dental problems in the first place.

A recruitment crisis also means there are fewer NHS dentists to see patients, despite a growing population. There were 483 fewer dentists doing NHS work in England last year compared to 2019-2020.

The previous government’s plan to widen access to NHS dental care failed spectacularly. The National Audit Office said two key elements had not been achieved.

None of the promised new fleet of mobile dental vans turned up, and a £20,000 “golden hello” to entice hundreds of dentists to work in acute shortage areas only produced one additional doctor.

The Labor government says it has inherited a dental sector suffering from years of neglect and insists its recovery is a priority.

Ministers have pledged to create an additional 700,000 urgent dental appointments and reform the dental contract to make NHS work more attractive to dentists. But they have yet to determine how and when they will bring about change.

“This government is committed to rebuilding dentistry, but that will take time,” Dentistry Minister Stephen Kinnock said in November. The clock is ticking.