Queuing up in the rain from 4am out of desperation. Flying to war-torn Ukraine to avoid paying hefty private bills. Pulling out teeth with pliers to stop the pain.
That’s the reality of the ever-worsening NHS dentistry crisis, which affects millions across the country.
Yesterday ministers vowed to finally get a grip on the escalating situation, with Rishi Sunak unveiling a blockbuster plan to free up millions of NHS appointments.
But dental experts and MPs immediately warned it wouldn’t work.
So what is behind the crisis? MailOnline’s series of fascinating charts explain the ins-and-outs of why you can’t see and NHS dentist when you want.
Declining numbers of Brits seen by NHS dentists
Fewer adults are seeing NHS dentists in recent years, startling data shows.
The latest figures, for June last year, show roughly 26million adults (about 60 per cent of the population) haven’t had a check-up in the last two years.
This is one of the lowest proportions since modern records start in 2006.
Children haven’t fared any better.
Under-18s are entitled to completely free NHS dental care, with health bosses recognising giving children a good start in oral health helps avoid potential issues like tooth extractions further down the line.
Nearly 8million children saw an NHS dentist within 12 months in 2006, equivalent to about 70 per cent of the population at the time.
The latest data shows this has fallen to about 50 per cent, with only 6million being seen within the year.
Experts blame the lack of appointments on 100 children a day being admitted to hospital last year to have their teeth pulled out under general anaesthetic.
This is equivalent to one child having a rotten tooth pulled every 11 minutes last year.
NHS dentist attendance figures for both adults and children dived off a cliff during the Covid pandemic as practices shut as part of lockdown rules and stopped offering treatments.
But it has failed to bounce back despite the darkest days of the pandemic being well into the past.
Industry experts suggest this is because offering NHS treatment is not as lucrative as going private.
Old NHS contracts for dentists paid them for batches of work carried out rather than for individual treatments, regardless how complicated a particular case might be.
In practice, this meant NHS dentists were paid the same for treating a patient that needed 10 fillings as for a patient that needed just one.
This resulted in dentists on some occasions losing money from treating NHS patients as the remuneration didn’t cover the costs of doing the procedure.
While this contact has now been reformed, the British Dental Association (BDA) estimates thousands of NHS dentists abandoned or vastly scaled back their NHS work post-pandemic.
Estimates from consumer representation Which? show the price of private dentistry is often double, sometimes even triple, the equivalent cost of the NHS.
A routine check up on the NHS costs £25.80, but privately it can cost you nearly triple at up to £75.
Prices increases with the extent of the procedure. A dental crown will cost you £306.80 on the NHS and up to £950 privately.
Compounding the problem is that as more dentists ditch or vastly reduce their NHS work, those who remain risk become overwhelmed.
A BDA post-pandemic survey of dentists in 2022 suggested three quarters were experiencing burnout, feeling unable to spend sufficient time with their patients to give them the care they needed.
The crisis in NHS dentistry has been brewing for years, with some Brits forced to pull out their own teeth with pliers or travel abroad to see a dentist due to a lack of slots in the UK. Others have queued from 4am to gain a spot at dentistry practices that have opened up their list to NHS patients. Pictured, the line of people outside of Saint Pauls Dental Practice, in St Paul’s, Bristol, which police were forced to break up earlier this week
More patients longing for an NHS dentist turned up today but were met with a sign on the door saying: ‘We are not enrolling anymore patients.’ Pictured, the sign outside St Pauls Dental Practice earlier this week
And, much like with the GP appointments crisis, as patients struggle to get access frustrations can boil over.
The same BDA survey found 86 per cent of dentists said their practice had received physical or verbal abuse from patients.
Thinktanks have called for dentists to be lured back from the private sector and the Government plan published this week included some polices to address this.
Under PM Rishi Sunak’s blueprint, dentists will be offered up to £50 to see patients who haven’t had a check-up in the last two years.
Additionally, up to 240 dentists willing to relocate to England’s ‘dental deserts’, where access to NHS dentists is most limited, will also be paid a £20,000 ‘golden hello’.
The exodus of NHS dentists and the paradox of official figures
Industry experts have repeatedly warned the NHS is ‘haemorrhaging’ its dentists, leaving the service in a ‘perilous’ position.
They have even suggested it must just be limited to check-ups, pain management and emergency treatment in future.
Figures show 24,151 dentists took on NHS work in England in 2022-23, down from 24,272 in the previous financial year – a drop of 121 year on year.
The total is also roughly 500 fewer than the number of dentists carrying out NHS work in 2019-20, the last year before the Covid pandemic struck.
The BDA fears numbers could drop even further to below 24,000, a figure not recorded since 2014-15.
But, at the same time, ministers have publicly boasted about providing Brits with more dentists than over a decade ago.
A Government announcement in September last year hailed how there were now 1,352 more dentists doing NHS work in 2022-23 than in 2010-11.
And at first glance this is correct.
MailOnline’s analysis of NHS dental workforce numbers compared to official population estimates for England show the ratio of dentists doing NHS work to patients is better than in 2006-7, the last year of former PM Tony Blair’s reign.
Figures for today show there are 2,365 patients per dentist in England compared to 2,528 back in 2006-7.
So, with 200 fewer patients per NHS dentist, why is seemingly harder to get an appointment as official data shows?
This is because the Government figure is a headcount of dentists carrying out NHS work and doesn’t reflect how much taxpayer-funded work these dentists are actually doing.
In practice it means that, in the figures, a dentist who saw a single NHS patient the entire year counts just the same as one that only saw NHS patients in that period.
And, as previously discussed, with more on dentists scaling back their taxpayer funded work in favour of the more lucrative private sector, boasting about the headcount of NHS dentists is meaningless.
According to the BDA, practices are even struggling to fill dentist vacancies, which, in a further blow to the sector, means they face fines for not hitting their NHS targets.
It estimates practices will have to pay back more than £400million for missing targets this year.
The UK lags behind most of Europe when it comes to dentists numbers
The NHS dental crisis has shown the decline of British taxpayer-funded dentistry in harsh light.
But the UK is even a poor performer when it comes to dentist patient ratios across Europe, losing out to countries like Bulgaria.
Data from the Organisation for Economic Co-operation and Development (OECD) shows Britian has an estimated 5 dentists per 10,000 population.
Latest national figures show only 43 per cent of over-18s were seen by a dentist in the 24 months to June this year, compared to more than half in the same period before the pandemic struck, though some regions have fared worse than others
In comparison, Bulgaria recorded double this amount at 11 dentists per 10,000 head of population.
The UK, in fact, was the third worst performer when it came to dentist to patient ratios in Europe.
Only Ireland and Switzerland performed worse on this metric, recording about 4.5 and 4 dentists per 10,000 people respectively.
Industry experts have told MailOnline it is difficult to estimate exactly how many more NHS dentists the UK needs given the headcount problem with official statistics.
However, they have said they would like to see dentist to patient ratios closer to that of Germany and France which in the OECD data have 7.5 and 6.5 dentists per 10,000 people respectively.
It should be noted that given healthcare systems and access to public funded dentistry varies across Europe, such international comparisons are limited.
However, experts say such figures provide a reasonable benchmark in how the UK compares to its neighbours.
Public satisfaction with NHS dentists plummets
Unsurprisingly, patient satisfaction with NHS dentistry has plummeted amid the appointments crisis.
The British Social Attitudes survey (BSA), an annual questionnaire which has run since 1983 and is considered a ‘gold standard’ by analysts, shows only 27 per cent of Brits were satisfied with NHS dentistry in 2022.
This was a record low, with dissatisfaction with public funded dentistry increasing in tandem to a record high of 42 per cent.
Almost one in four of the 3,300-plus British adults surveyed said they were ‘very dissatisfied’, marking the highest figure for any NHS service in the survey.
The decline in BSA satisfaction with NHS dental services has been rapid and seemingly tied to the disruption and failure to bounce back from the Covid pandemic.
In 2019, the year before the Covid pandemic and lockdown, 60 per cent of Brits reported being satisfied with the state of taxpayer-funded dentistry.
Separate data from NHS England’s GP Patient Survey for 2023, where patients are also asked about their access to NHS dental services, also shows how Brits are struggling to get appointments.
Of those surveyed, one in four had failed to get an NHS dentist appointment in the last 24 months.
One in 10 said they had been told they couldn’t an appointment as the dental practice they were seeking help from was not taking on any more NHS patients.
But the majority of those who did manage to get an NHS appointment rated their experience highly.
Of those surveyed 70 per cent said they were happy with the care they had received.