For years, access to NHS dental services has been plagued by shortages of practitioners, underfunding, and systemic inefficiencies. According to Healthwatch England, patients often find themselves unable to secure timely appointments, forcing them to make difficult and expensive decisions. With one in four adults unable to access an NHS dentist, many are left with little choice but to turn to private care or, in the most extreme cases, take matters into their own hands.
Reforms Set to Boost Urgent Care and Complex Treatments
The government’s proposed changes to the NHS dental contract, set to come into effect in 2026, aim to provide urgent care more efficiently. Dentists will be incentivised to treat patients with urgent needs, including those suffering from severe pain, infections, or dental trauma. These reforms are designed to alleviate the burden on emergency services and provide much-needed relief for those in distressing pain. According to a Department of Health and Social Care (DHSC) spokesperson, the new measures will ensure patients can access care more easily and prevent conditions from escalating into hospital admissions.
One of the most significant changes is the introduction of a standardised payment package for complex treatments. Previously, patients requiring care for multiple dental issues, such as severe gum disease or widespread decay, would need to return for multiple appointments. The new system allows for a single treatment package, which could save patients up to £225. However, experts have raised concerns that these reforms may only address the symptoms of a deeper problem. The British Dental Association (BDA) has cautioned that the changes, while helpful, are merely a “tweak” to a fundamentally broken system, without the necessary funding or comprehensive restructuring needed to fix NHS dentistry in the long term.
The Growing Disparity in Access to Care
While the government’s reforms may improve access for some, the ongoing disparity in access to care remains a critical issue. According to Healthwatch England, many patients in deprived areas are more likely to require urgent dental treatment compared to their wealthier counterparts. The gap in service availability is particularly concerning, as people in lower-income communities are often left with no option but to travel long distances or pay out of pocket for private treatment. This disparity has led to what some experts call “dental deserts,” where certain regions are devoid of available NHS dental services.
In a 2025 survey, 41% of adults reported visible signs of tooth decay, a figure that mirrors statistics from the late 1990s. The government’s pledge to deliver an additional 700,000 urgent dental appointments by 2029 aims to reduce this gap, but critics argue that such measures do not go far enough. Furthermore, proposals such as the introduction of £150 dental vouchers, suggested by the Policy Exchange think tank, have been met with resistance from the BDA, who argue that they would not solve the fundamental issues of access and affordability.
The situation remains urgent, with millions of people struggling to secure even basic dental care. As the government pushes forward with reforms, experts agree that addressing the more in-depth issues of workforce shortages and systemic underfunding will be key to ensuring the long-term sustainability of NHS dentistry.
