‘DIY Dentistry’ Surges as NHS Fails Patients

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BDA urges government to address NHS access woes in face of DIY dentistry

The British Dental Association (BDA) has urged government and the newly elected Commons Health Committee not to ignore the growing crisis in NHS dental services, as reports emerge from Plymouth of patients performing DIY tooth extractions at home in the face of 14,000 strong waiting lists.

In evidence to Plymouth Council Select Committee, which is holding a special investigation into dental health, Councillor Sue McDonald reported cases of residents dosing themselves up with alcohol and opiates to numb the pain before attempting procedures.

The inquiry follows a detailed report published in December into the city’s dental crisis which found substantial inequalities in both access and outcomes between wealthier and more deprived areas. It noted 3,500 hours of schooling are currently lost in Plymouth each year due to children under the age of 16 having their teeth removed under general anaesthetic.

Dentist leaders point to years of underfunding and failed, target-driven NHS contracts that have devasted morale in the profession and fuelled recruitment and retention problems across the country. Where practices are unable to hit their targets – often due to lack of staff – budget is returned, and often lost from local services.

Dentists treating higher needs patients often struggle to meet their quotas, given that the activity-based contract system places an exclusive focus on the number of courses of treatment preformed rather than improvements secured in a patient’s oral health.

Council estimates suggest Plymouth currently has 13 dentist vacancies, resulting in a perverse situation where a significant proportion of the squeezed NHS budget is being left unspent in face of sky-high demand. The report found a fifth of NHS dental care commissioned in 2017/18 could not be carried out, leaving an estimated 27,000 untreated.

In 2018/19, over 20,000 inquiries came into the city’s three dental access centres for urgent care, but less than a quarter resulted in appointments due to capacity problems. BDA analysis of official government data suggests unmet need for NHS dental services in England now stands at over four million, or one in 10 of the adult population.

The BDA has urged Jeremy Hunt, the newly elected Chair of the Health and Social Care Committee, to press ahead with the inquiry into dentistry left unfinished by 2019's snap general election. The investigation was launched last July shortly following the closure of three practices in Portsmouth, which left patients facing a ferry ride to access care.

The British Dental Association’s Chair of General Dental Practice Dave Cottam said: “Whenever Governments fail to invest in NHS dentistry, desperate patients fall back on ‘DIY’ alternatives. For every vacancy left unfilled, thousands of patients go untreated. These access problems aren’t inevitable, but the logical result of a decade of underfunding and broken contracts.

“Across England NHS dentistry is failing the very patients who need us most. Council leaders are showing the kind of leadership patients desperately need to see from Westminster.”