NHS announces reform to fix 'rotting' dentistry sector

The dental therapist will see you now… but only once every two years! NHS reform of ‘rotten’ sector pledges end to DIY dentistry crisis

  • Dental therapists will now be able to carry out fillings, X-rays and crowns 
  • Check-ups could be reduced from every six months to up to two years
  • NHS claims moves will help improve ‘access to necessary dental care’ 

Healthy patients may have to wait up to two years for a dentist check up under new NHS reforms.

Health chiefs have today unveiled a plan to ease the appointments crisis, which has left patients pulling out their own teeth.

Officials argue there is ‘limited evidence’ for six-month check-ups for patients at ‘low oral health risk’. Instead, they should now be offered appointments up to 24 months apart. 

In another move designed to ease pressure on dentists, dental therapists will now be allowed to carry out fillings, crowns and a range of treatments.

Under previous guidance therapists, only trained to do routine work, had to await for instructions on how to treat patients.

Dentists have also been told to publish up-to date info on whether they accept new NHS patients. NHS dentists will also be paid more for treating more complex cases, such as people who need three fillings or more.

Sara Hurley, England’s chief dental officer, said today’s reforms are the ‘first step’ to overhauling the crippled sector.

Healthy patients may have to wait up to two years for a dentist check up and could see their dental therapist more often instead under new NHS reforms in England

Official health service data, which records the number of adults seen by NHS dentists in 24 month periods shows the drastic decline in the number of people seeing a dentist since the pandemic. While people struggled to access NHS dentistry services before Covid due to a lack of appointments, the situation has deteriorated further with 6million fewer people seen compared to pre-pandemic levels

Millions of people have been left without access to dental care after the number of NHS dentists fell to their lowest level ever last year 

She said: ‘These changes will help teams carry out even more treatments and help address the inevitable backlogs that have built up during the pandemic.’

Newly-appointed Health Secretary Steve Barclay said: ‘Improving patient access to NHS dental care is a priority and these changes are an important step.’

How much does NHS dentistry cost, compared to private? 

There are 3 NHS charge bands:

Band 1: £23.80

Covers an examination, diagnosis and advice. If necessary, it also includes X-rays, a scale and polish, and planning for further treatment.

Band 2: £65.20

Covers all treatment included in Band 1, plus additional treatment, such as fillings, root canal treatment and removing teeth (extractions).

Band 3: £282.80

Covers all treatment included in Bands 1 and 2, plus more complex procedures, such as crowns, dentures and bridges.

For comparison, check-ups can cost between £20 and £120 at private dentists, according to Which?.

Dentures and bridges can also cost up to £2,520, the consumer watchdog says.

Chris McCann, from campaign group Healthwatch England, said: ‘The changes will make it easier for people to see which dentists are taking on new NHS patients.

‘Those with more complex dental problems should also have better access to care because of the shift in how the NHS pays dentists. 

‘Ultimately, we hope the measures will end long waiting times, the extended periods of pain many people suffer, and the extreme cases of DIY dentistry we have seen.’

Even before the pandemic, dentistry was in crisis.

Many dental surgeries say it is no longer financially viable to offer NHS procedures, leading to an ‘exodus’ of dentists into the private sector when Covid hit.

Nearly 90 per cent of practices in England are now not taking on new patients.

Patients have been known to call up to 40 practices to find an NHS dentist taking on new patients. 

It has led to some desperate patients resorting to risky at-home procedures — including pulling out their own teeth with pliers.

Others have found it easier to fly to Brazil to be seen.

Dentists claimed the changes are simply papering over the cracks and ‘will not fix the rotten foundations this service is built on’.

Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, said: ‘These are modest, marginal changes which will not fix the rotten foundations this service is built on.

‘Our patients need ministers to do more than paper over the cracks. 

‘The tweaks will do precious little to keep dentists in the NHS or ensure millions get the care they urgently need.

‘Not a penny of new investment has been pledged, and Government targets will still come before patient care.’

He added: ‘Today is little more than a small step on the road to real reform. 

‘If government considers this a final destination then it will mean the death of NHS dentistry in England.’

NHS England’s letter to dental practices setting out today’s reforms states there is ‘limited evidence’ for the need for six-monthly check-ups for people with ‘low oral health risk’.

‘Patients accessing NHS dental care should be advised of their personalised recall interval based upon an assessment of their oral health risk,’ it says.

‘For some people, this might mean that a recall interval of less than six months may be advised. 

‘However, for those with good oral health we expect to see recall intervals more usually to be 12 months, or even 24 months.’

Many people are used to checking in with their dentist every six months for a full assessment of their mouth, teeth and gums.

This gives dentists an opportunity to look for signs of tooth decay or symptoms of oral cancer, among other illnesses.

While most dentists provide a mixture of NHS and private care, a poll by the British Dental Association — which represents 16,000 dentists — suggests the balance could soon shift in favour of more private provision.

Some 45 per cent of the 2,200 dentists polled have reduced their NHS commitment since the start of the pandemic.

The figures also found 75 per cent are ‘likely’ to reduce, or further reduce, their NHS commitment in the next 12 months.

Meanwhile, it emerged last week that the NHS is picking up the bill for ‘Turkey teeth’ gone wrong.

The trend has seen thousands of Britons fly abroad for cut-price crowns and veneers. But many have been left with dead stumps, abscesses and serious dental issues.

A number of dentists surveyed on behalf of the BBC said some of the remedial work was provided by the NHS.

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