Number of NHS dentists falls by 10 per cent in under a decade
The number of dental practices offering NHS treatment in England has fallen by around 10 per cent over the past decade, with at least 600 practices dropping their NHS contracts, according to research by the Nuffield Trust think tank. The decline has created so-called "dental deserts" in many areas, particularly the South West and East of England, where researchers say finding NHS care has become "hard to find, if not impossible" while private dentistry has expanded in the same regions.
Although the overall number of dental practices has risen by more than 400 since 2017 to 10,160, only 56 per cent now offer NHS services, and NHS dental contracts fell from about 6,260 in March 2017 to 5,650 this year. Six in ten adults have not seen an NHS dentist in the past two years, only 38 per cent of those seeking a new appointment succeeded, and practices have handed back more than £900 million to the Government in the past two years for missing NHS targets. The Department of Health and Social Care said it is reforming the NHS dental contract and training more dentists for areas of greatest need, while it plans to require newly qualified dentists to work in the NHS for at least three years.
- NHS dental practices in England have dropped by roughly 10% in a decade
- "Dental deserts" are spreading, especially in the South West and East
- Government pledges contract reform and mandatory NHS service for new dentists
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Dental care through the NHS is provided by dentists who agree contracts with the health service to treat patients at set, subsidised fees, alongside private treatment that patients pay for in full. Not every dentist takes on NHS patients, and practices can choose how much NHS work to offer, or drop it altogether in favour of private-only treatment, which tends to be more profitable but costs patients more.
The Nuffield Trust is an independent health think tank that researches how the NHS is performing, and its analysis looked at how NHS dental provision across England has changed over roughly the last ten years. The Department of Health and Social Care, the government body responsible for the NHS, oversees dental contracts and funding, and is the one that has to respond to concerns about shrinking access.
This matters because dental care affects everyone, from routine check-ups to treatment for pain and infection, and difficulty finding an NHS dentist can leave people paying private fees they cannot afford or going without care entirely. Patterns in access also vary by region, meaning the ability to see an NHS dentist can depend heavily on where someone lives.
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The case for
Those alarmed by the figures argue this represents a genuine failure of government stewardship of a core public service: a decade of underfunding and an outdated contract system has pushed hundreds of practices out of NHS work, leaving millions unable to access a dentist and forcing people into DIY dentistry or costly private care they cannot afford. They contend that oral health is essential to overall wellbeing and that the state has a duty to guarantee a functioning universal service, meaning ministers should treat this as an urgent priority requiring higher investment, meaningful contract reform, and binding commitments to keep dentists working in under-served areas rather than relying on incremental fixes.
The case against
Others sympathetic to the pressures facing dentistry argue that the current NHS contract, which pays by activity units rather than reflecting real clinical time and costs, has become financially unworkable, so practices handing back contracts or going private are making a rational choice to survive rather than abandoning patients out of indifference. They would say that simply mandating more NHS provision, such as compelling newly qualified dentists to work within the system for three years, risks discouraging people from entering the profession or driving them abroad, and that a durable solution must first fix the underlying payment model and workforce incentives rather than imposing obligations on a system dentists say is already broken.