Can you still get an NHS dentist?

NHS dentistry in England has been in accelerating decline since the pandemic, but the pressures pre-date COVID-19 by years. An estimated 5 million people have no access to an NHS dentist at all, and 42% of adults report being unable to get an appointment when they need one — up from roughly 25% in 2019.^[1] The consequences are not merely inconvenient. Tooth decay, untreated without access to routine care, has become the leading cause of hospital admissions for children aged 6 to 10 in England. In 2022–23, 35,000 children had teeth removed under general anaesthetic in hospital settings — a costly, avoidable intervention that carries real clinical risk.^[2] Oral disease that elsewhere would be caught and filled has instead progressed to extraction.

The structural cause is a contract that has not worked since it was introduced in 2006. NHS dentists are paid per “unit of dental activity” (UDA) — a system that values a single filling identically to a full course of complex restorative treatment. As inflation has eroded the real value of UDA rates, many practices have concluded that NHS work no longer covers its costs. Between 2019 and 2023, 1,100 dentists stopped providing NHS services in England and moved to private practice, which can pay several times more for equivalent clinical time.^[3] The government has pledged 2,400 extra NHS dentists as part of its dental recovery plan, but recruitment takes time and the underlying UDA contract remains unchanged. The inequality this creates is severe: children in the most deprived areas of England are three times more likely to need teeth extracted than those in the least deprived, reflecting both dietary factors and a near-complete collapse of NHS dental access in some communities.