NHS “dental deserts” persist in rural and deprived communities – LGA analysis

New analysis by the Local Government Association reveals a growing number of “dental deserts” across the country with more deprived or rural local authority areas having fewer NHS dentists than those in more affluent urban areas.

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The LGA, which represents over 350 councils in England and Wales, is calling on the Government to address shortages in NHS dentists urgently or risk more people requiring costly emergency dental treatment further down the line.

As we face increased rates of inflation and the cost of living crisis bites, councils and their local directors of public health are warning some people may have to go without important dental work as they look to cut down on spending.

Analysis of data, collected by the Care Quality Commission (CQC) and published as a rate per 1,000 residents, on the LGA’s data platform, LG Inform, shows that:

  • No local authority area in the country has more than 1 dentist per 1000 of the population who provides NHS treatment.
  • Rural and more deprived areas are more likely to have shortages in NHS dentists than their counterparts, with the top 10 council areas for shortages mainly having higher than average levels of deprivation or higher than average proportion of residents in rural areas.
  • There are wide variations in the availability of NHS dentists, with the City of Westminster having over six times the number of NHS dentists per 1000 of population compared with Ashfield, the area with the lowest number in the country.

Previous research by Public Health England shows that children in deprived communities have poorer oral health than those living in more affluent communities. For example, across local authorities in England there is huge variation ranging from 7 per cent to 51 per cent of five-year-olds having experience of tooth decay.

To tackle the growing shortage of NHS dentists, councils have urged the Government to reform the dental contract and ensure the £762 million clawback taken by the Treasury over the last ten years from dental practices who miss contractual targets is reinvested into subsidised dental treatments.

Dentists are commissioned by NHS England to provide treatment although it is the responsibility of councils to run programmes to promote good oral health and prevent problems, particularly among children.

However councils’ public health grant, which provides funding for this service as well as sexual health services, school health visitors, substance misuse support , has been reduced by 24 per cent in real terms per capita since 2015/16, equivalent to a total reduction of £1 billion.

Councils are calling on the Government to commit to long term public health funding increases so councils can provide important early interventions to take pressure away from NHS dentists.

Cllr David Fothergill, Chairman of the LGA’s Community Wellbeing Board said:

“This stark new analysis shows a shortage in affordable dental treatments for communities all over the country. In particular, it is concerning that it is rural areas as well as those living with the highest levels of deprivation that are more likely to miss out on NHS dental provision.

“As we continue to feel the effect of the cost of living crisis, a lack of NHS dentists could risk people choosing to forgo routine dental treatments or even resort to DIY dentistry, risking more costly emergency dental treatments being needed further down the line.

“The Government should reform the contract it has with dental surgeries as well as develop a workforce strategy to ensure we can have affordable dental treatments for communities across the country.

“Councils also need a real terms increase in their public health grant so they can provide vital oral health improvement programmes to prevent longer term health problems.”

The British Dental Association has long warned that the current crisis in NHS dentistry is having a disproportionate impact on high needs patients, in already underserved communities.

British Dental Association Chair Eddie Crouch said:

“The Government must be more ambitious in its plans to reform NHS dentistry. To save this service we need real commitment - root and branch reform and adequate funding.  

“A broken contract is forcing dentists out of the NHS every day it remains in force. Tinkering at the margins will do nothing to help the patients who need us most.”

Notes to editors

  1. The full data, covering a three month period from July- September 2022, is available on the LGA’s data sharing website, Local Government Inform (LG Inform). LG Inform, funded by UK Government, brings more than 10,000 data items about councils into one place, to help authorities compare themselves to other authorities and be transparent with the public. This online service allows users to access, compare and analyse data, and present their findings online or offline.
  2. LG Inform data on the number of dentists per 1000 people
  3. LG Inform data on the proportion of five year olds with dental decay
  4. Recent research developed in partnership by the BBC and the British Dental Association found that nine in 10 NHS dental practices across the UK not accepting new adult patients. No dentists are taking on adult patients for treatment in a third of the UK’s more than 200 council areas.