When you feel your tooth suddenly crack, as I did during a family supper back in February, you know you need to see a dentist, and fast. But when I rang to make an appointment at my longstanding dentist, I was told I’d been “deregistered”. “We take people off our list if they don’t make an appointment in two years,” they told me, as I clutched my jaw in a mix of pain and disbelief. “Can you re-register me then?” I asked, but I was told this was not possible, since they had no space for any more NHS patients.
Finally they agreed to see me as an “emergency” and I was examined by a dentist I’d never met before, who proceeded to press down hard on my tooth, causing a large chunk of it to break off in my mouth. She then told me that, apart from applying a dressing, there was nothing more she could do because I wasn’t a patient. “I’ll just find another dentist”, I thought.
But little did I know this would be almost impossible.
A new poll by the British Dental Association (BDA) has found almost half of NHS dentists (47 per cent) say they are likely to reduce their NHS work this year if working conditions do not improve, while 30 per cent say they will go fully private and 47 per cent may take early retirement or change career.
Lockdown measures mean many dental practices are not running at full capacity yet, and the BDA warns the backlog will take years to clear and warn “eye watering waiting times risk becoming the new normal”.
Meanwhile, a new report from Healthwatch suggests NHS Dentistry is in a “twin crisis” of access and affordability. Post-pandemic, waiting lists are in the hundreds or even thousands, with people being asked to wait up to three years for an appointment, and around 80 per cent of people reporting they have struggled to get timely care.
“There simply isn’t enough dentistry to go round,” Ashley Dé, from the BDA, told me. “Prior to Covid, care was commissioned for barely half the population. There has been an access crisis in many communities for a decade. Now these problems are nationwide.”
None of this was on my radar when I confidently walked out of my dentist thinking I’d simply find another one. I was unable to, in spite of trying every NHS dentist in a 30 mile radius. Not one was taking on new patients. In the end I waited over a week to see a private dentist – during which time the razor-sharp edges of my broken molar meant I could barely swallow and had to drink soup through a straw – before paying £150 for a temporary filling. Since then, I’ve been waiting for a space to open up at a recommended private (but cheaper) local dentist. And chewing rather cautiously.
There are currently no stats on those who, like me, went back to their usual dentist, only to find themselves deregistered. But according to Healthline, it’s a reoccurring issue. Claire Bradford, from Taunton, missed her regular 18-month appointment due to the pandemic, only to find herself struck off. “I am now pregnant and suffering with hyperemesis gravidarum”, she told me. “I feel I should be seen by a dentist because the constant acid is irritating what I believe to be a couple of cavities. I have called every NHS dentist in the four closest towns and I was told my best bet is to go private, or wait nine to 24 months to be added to a list where I may get an appointment within six months.”
Like Claire, I wasn’t warned I would be delisted and no leeway was made for the pandemic. I was told it’s simply a standard NHS practice that I should have known about. But according to the BDA, this isn’t the whole picture, and in fact, the concept of a dentist having a “list” – from which you can be “removed” – no longer exists. “Patient registration ceased to exist in England with the advent of the widely discredited 2006 dental contract”, they told me. “While lists are maintained for a range of purposes, and the old model is still regularly referred to even by officials and ministers, it lacks formal status. Dentists aim to maintain contact with patients they’ve seen to ensure continuity of care, but this is not mandated by the system.”
After a year on lockdown, dentists themselves are struggling and the Department of Health and Social Care say they are supporting the dental sector through the pandemic, but the targets they set in January 2021 for surgeries to reach 60 per cent of pre-Covid activity levels are controversial, with the BDA saying they have “forced a focus on volume over need” with nearly two thirds of NHS dentists estimating that they will not meet them.
MPs are gathering to tackle these issues in a Back Bench Business debate led by Bedford MP Mohammad Yasin. “NHS England has a duty to commission dental services to meet local need”, the Department of Health and Social Care told me. “Where a patient cannot get access to an NHS dentist, NHS England is expected to provide help in doing so”. But it’s not clear how.
My story of a broken tooth – yet to be repaired – is symbolic of a system in need of decisive government action.