How easy is it to find an NHS dentist? It depends where you live

Hundreds of dentist practices are abandoning NHS work as the service drifts towards a two-tier system, new analysis suggests.

Data analysed by the Nuffield Trust found that nearly 600 practices in England have withdrawn from NHS dentistry over the last 10 years. The decline has been particularly sharp in parts of the South West and East of England, raising concerns about growing inequalities in access to care.

The analysis suggests more than one in 10 dental practices that once offered NHS care no longer do so, leaving it near impossible for some communities to find NHS appointments.

NHS dental activity is 8% lower than it was pre Covid, while six in 10 adults have not seen an NHS dentist in two years. Of those who attempted to get a new appointment in the last two years, just 38% were successful, according to a Nuffield Trust Survey.

Cornwall, Devon and Northamptonshire have seen some of the biggest reductions in the number of practices offering NHS care. In Cornwall, more than a quarter of practices that previously offered NHS treatment have stopped doing so, making it one of the starkest examples of the shift away from NHS dentistry.

The findings come as ministers have pledged to tackle so-called "dental deserts", but dentists say the current deal is not viable. Many have handed back their NHS contracts because to work is loss-making.

In Somerset, fewer than one in five dental practices now offers NHS services. Alan, 83, who lives in the county, says he has given up trying to find an NHS dentist.

"I used to try, but getting a dental appointment anywhere near where I live would be impossible," he says.

Alan has only one tooth remaining after the others "crumbled out over the years" and says he has had to adapt what he eats, although he jokes that he has perfected a way of eating Brazil nuts.

Vivak Shah, who runs three dental practices in Northamptonshire, continues to offer NHS treatment but says it operates at a loss. He no longer takes on new NHS patients.

"Each year we struggle to decide what to do, and there is a limit to how much the private side can cover the NHS losses," says Shah.

He warned that if practices stop providing NHS treatment, many patients could be left in pain or forced to seek help elsewhere in the health service, including hospital accident and emergency departments.

"A contract handed back in one town attracts little national attention on its own but repeated across the country for a decade it amounts to the quiet transformation of dentistry into a two-tier service," says Mark Dayan, head of public affairs at the Nuffield Trust.

"Access to dental care increasingly depends on what people can afford to pay and where they live."

Jim Sykes is a dentist in Hexham. He handed back his NHS contract in 2024.

"It was a really hard emotional decision, but the NHS work was running at such a loss. I had to think of my team of staff and make it work," he says. Sykes asked if he could continue treating just children but was told he had to accept adults as well, or give up the NHS work.

"There has been a real breakdown in trust for me. Even if there was a new government offer, I would still be very nervous about entering a new NHS contract," he says.

Sykes says that none of his friends in his graduating class in dentistry still works in the NHS. "My friends have gone private, retired or teach - any pathway to avoid NHS dentistry."

Shiv Pabary, chair of the British Dental Association's General Dental Practice Committee, says the situation is "the direct result of choices made by successive governments". He warns that unless ministers "fix and fund NHS dentistry", more dentists could choose to reduce their NHS work or leave the service altogether.

Overall dentist practice numbers have risen in England over the last decade.

"This is not a shortage of dentistry but a shortage of NHS dentistry," says Dayan. "Practices will need to be incentivised back into NHS work in the places where the NHS footprint has thinned most."

While most parts of England recorded declines in practices offering NHS dental care, the reductions were smallest in North West London, the Black Country and North East London.

North East London was the only area to see any increase during the period, recording one additional practice offering NHS treatment compared with a decade ago.

Every other region of England saw the number of NHS dental practices fall.

Looking at the number of practices doing NHS work is not the same as looking at exactly how much health service capacity there is - practices can vary in size. But if you look at other measures such as the amount of treatment being done, the numbers are still down, although not as steep as the fall in practice numbers.

The government says that it is changing the dental contract and training more dentists in the areas most in need. The government says it will also make it a requirement for newly qualified dentists to practice in the NHS for a minimum period of at least three years.

Campaign group 38 degrees calls the current dental crisis "shameful", with people being "forced to pay money they can't afford or suffer with the pain, shame, and further complications that come from being denied vital NHS healthcare".