Urgent reform needed in child dentistry

Dentists call for urgent reform as charities step in to fill access gap for school children: The British Dental Association has warned Government must pick up the pace on the reform of NHS dentistry, following an investigation from the BBC which found that teachers have requested charities to step in to provide access to dental care for school children.

The BBC learned that with no local practices able to provide NHS care, teachers at Trinity Academy Grammar in Calderdale had appealed to their local authority, who have arranged for the charity Dentaid to assess and treat their pupils. Many of these children have not seen a dentist since the onset of the pandemic, impacting on both their health and ability to learn. The BDA understands the charity has already provided treatment to as many as 80 children for conditions including decayed and cracked teeth and abscesses, as part of a visit set to last for two weeks.

Over 40 million NHS appointments have been lost since lockdown in England alone – amounting to over a year’s worth of dentistry in normal times – including over 12.5 million for children. Given the ongoing disruption to dental services and public health programmes, experts warn these unprecedented backlogs mean oral health inequality will inevitably widen, resulting in patients requiring more extensive, time-consuming and costly interventions. Tooth decay has long been the number one reason for hospital admissions among young children.

At present practices are still working significantly under capacity owing to ongoing pandemic restrictions. However, access problems have been the norm for a generation. Since 2006 dentists have been forced to work to a widely discredited target-based NHS contract – where practices have to deliver a fixed amount of activity. This perverse system pays dentists the same amount for doing 1 filling as 10, and has fuelled recruitment and retention problems across the service.

No long-term funding has been offered to underpin the recovery and reform of the service. Despite a recent pledge of £50m to provide up to 350,000 appointments by 1 April 2022, the service has faced unprecedented cuts over the last decade and would require an additional £880m per year simply to restore resources to 2010 levels. While negotiations are now ongoing on a reformed NHS contract, there are real questions over the extent of the Government’s ambitions, and whether any meaningful improvements in access can be achieved within the current financial envelope.

From 1 April 2022 NHS dentists in England are now working to an imposed target of 95% of pre-COVID activity, effectively amounting to a return to ‘business as usual’ while dental teams continue to be subject to pandemic restrictions. Nearly 1000 dentists left the NHS in England last year, a trend now set to go into overdrive given current pressures.

The BDA has called on the Government to recognise the urgency, set a date for breaking from the current failed system, and provide the necessary resources to underpin the rebuild and reform of the service.

British Dental Association Chair Eddie Crouch said:

“We salute these volunteers, but this isn’t the Victorian era. A wealthy 21st century nation shouldn’t be relying on charities to provide basic healthcare to our children.

“Schools can see how crucial access to dentistry is, with children struggling to eat, sleep and study. Ministers really need to learn lessons from these teachers about the importance of oral health.

“NHS dentistry is on its last legs. Overstretched, underfunded and facing an unprecedented backlog many dentists have reached the end of their tether. One-off visits to playgrounds risk becoming the new normal unless the government steps up.”