Tales of pain and patience: the story behind Bristol’s dentist queue

The line wound into the distance, past offices, flats and houses; there were hundreds waiting, shoulder to shoulder, old and young.

But this patient crowd wasn’t tennis fans outside Wimbledon, mourning the loss of a monarch or hoping to buy a bottle of Prime – they were trying to register for an NHS dentist in England in 2024.

The scenes outside St Pauls Dental Practice in Bristol city center – where 1,500 patients were registered for NHS treatment in two days – became one of the defining images of the week.

They have been branded as “a visual representation of the depth and scale of the crisis in NHS dentistry”.

The practice was previously a Bupa dental practice, which closed in June last year. After a passionate campaign led by residents, it reopened under new ownership on Monday, with queues building from as early as 5am and lasting well into Wednesday. At the same time, Rishi Sunak unveiled a £200 million plan to fix NHS dentistry, which is being derided by professionals.

Second through the door was Carol Sherman, 59, who lives across the street from the practice. She took a seat at 5 a.m. on Monday in the cold and dark, her car was parked nearby for safety reasons.

“I was desperate and I thought I wanted to have a chance to get it,” she said. “I thought the only thing I could do was go there.”

Just as the branch closed last June, she suffered ‘excruciating pain’ in her teeth and had no choice but to go private, spending more than £500 on two fillings. She didn’t want to spend that again.

Sisi Hussein, 39, was a few places behind Sherman in line. She arrived at 8 a.m. and saw about 40 people ahead of her, and waited in line for five hours before registering at 1 p.m.

She lived in St Pauls and was an NHS patient under the previous Bupa ownership, but since closure she has moved between private practices to seek help. Hussein has spent around £600 caring for herself and her 16-year-old son.

She previously worked as a cleaner at a bowling alley and has universal credit after tripping on the pavement and injuring her foot. She is also on a waiting list for physiotherapy so she can return to work.

Faced with persistent pain in her tooth, she was at a loss. “I just couldn’t afford it, I had already spent all my money at the dentist,” she said.

During her registration check under the new owner, she discovered that her tooth would have to be removed, despite the money spent on private treatment.

“All the money I spent on private treatment was a waste,” she said. “It was just really hard to find an NHS dentist. They were all full and not taking patients. It was so hard.”

Later on Monday, Rose Robinson, 47, from St Werburghs, a neighboring suburb, arrived at 11am and queued for three hours before police told him to go home after a fight broke out further down the queue.

Determined to get a place, the care assistant returned on Tuesday, when a ticketing system had been introduced, and queued for 30 minutes before being registered.

She had been a patient under the previous owner since childhood, but lost her place on their books during the pandemic after going without an appointment for more than a year.

“I literally can’t afford private prices,” she said. “Same as a lot of other people. So I just prayed that nothing would go wrong with my teeth.”

Something happened. One of her back teeth is cracked, causing pain when she bites it. “I just avoid chewing on that side at all,” she said, adding that she now hopes to correct the problem.

Jen Witt, 43, joined the back of the line around the same time Robinson went through the door and waited in the drizzle and cold for about two hours. She too was an NHS patient under the previous owner and was able to get an appointment on the last day before it closed. The dentist identified a loose tooth, which they were unable to repair that day, and it remained loose.

“I literally thought, I will never have an NHS dentist again in my life,” the mental health facilitator said. “It’s a real cause of stress and worry because I can’t afford a private one and when I came out I just started crying. I was so overwhelmed.”

During the time the practice was closed, Witt moved to Saltford, a village east of Bristol, about eight miles away. Although St Pauls was the nearest practice taking on new adult NHS patients, Witt still felt some guilt. ‘Should I try it? I did ask the dentist if it was okay for me to apply if I was not in the area, even though I had been a patient before. I work for a mental health charity in Bristol, so I felt like I was doing my bit for the community.”

According to the British Dental Association, 23,577 dentists carried out NHS work in the 2022-2023 financial year, the lowest number since 2012. The BDA says the Dental budget of £3 billion has remained static for a decade and has fallen by more than £1 billion in real terms since 2010. Four in five dentists in England are not taking new NHS patients, a Labor Party analysis has found.

Of those the Guardian spoke to in line, all praised the Save St Pauls Dental Campaign because they have played an important role in the return of the practice to the neighborhood.

Before the department closed under previous management, weekly outdoor protests began, the group held meetings with NHS officials and the housing association, hundreds of pounds were raised and the petition gathered more than 1,500 signatures.

Barbara Cook, a community artist and one of the campaign leaders, said: “Campaigning works, it can work. Don’t get knocked down and think you can’t do anything, because now is the time for us to rise up.”

Cook said campaigners were shocked by the closure. “We thought: if we let this go, GPs will be next. Because we know that making an appointment with a GP is horrible.”

She said the group’s success in working with government agencies showed what could be achieved when campaigners were not treated like “nasty protesters”.

Community mobilization, combined with the power of social media and the huge demand for NHS dentistry, created the perfect storm for this week’s scenes, the practice’s dentists and managers said.

“The system is on the verge of breaking, it’s almost broken already,” said Gauri Pradhan, the practice’s lead dentist. “We need to sort it out. I’m sure if better pay was offered to dentists people would consider getting NHS contracts back.”

Pradhan said it was a challenge to secure an NHS contract – “We are all passionate about NHS dentistry, there is a sense of pride” – but reveals that from previous experience they have been at a loss to win the contracts can cover, and explicitly refers to the works as a ‘charity’.

Campaigners like Cook are turning their attention to the broader issue.

“It’s far from over for me,” she said. “The battle for dentistry, this is as if it has only just begun.”