LONDON: The NHS dental care system in England is facing an unprecedented crisis, with millions of patients unable to access affordable treatment. Amid warnings that the government’s current dental recovery plan is insufficient, experts are proposing significant reforms to address the challenges. These suggestions aim to improve access to care, alleviate pressure on the system, and restore public confidence in NHS dentistry.
One proposal calls for reinstating a GP-style right to register with NHS dentists. Before 2006, patients had the right to register permanently with a dentist, ensuring consistent care and access to regular appointments. That right was removed with the introduction of a new dental contract, which replaced patient registration with a system that compensates dentists based on "units of dental activity" (UDAs). Critics argue that bringing back the old system would promote continuity of care and simplify access for patients.
Another idea focuses on reducing the frequency of routine checkups for patients with healthy teeth. Traditionally, dentists recommend six-monthly visits, but experts suggest extending the interval to one or two years for low-risk individuals. This change could free up capacity for dentists to treat more urgent cases without compromising patient health, as studies have shown that less frequent checkups are safe for many adults.
The dental contract introduced in 2006 has also come under heavy scrutiny. Dentists are compensated equally for vastly different levels of care under the current UDA-based system, discouraging treatment for high-need patients and preventing a focus on preventative care. The British Dental Association (BDA) and other experts advocate for a new contract emphasizing prevention and providing fairer compensation for complex cases.
Reforming funding mechanisms for NHS dentistry is another critical recommendation. The existing system often penalizes dental practices for keeping patients healthy or addressing challenging cases, as UDAs fail to account for varying levels of patient need. Switching to a capitation model—where dentists receive a fixed sum to care for a local population—could incentivize better long-term oral health management and help address staffing shortages.
These proposed changes have drawn widespread support from healthcare professionals, policymakers, and patient advocates. As discussions continue, the government faces mounting pressure to implement meaningful reforms that ensure equitable access to dental care for all and end the crisis plaguing NHS dentistry.