Hundreds of dentist practices are abandoning NHS work as the service drifts towards a two-tier system, new analysis suggests.
Data analysed by the Nuffield Trust found that nearly 600 practices in England have withdrawn from NHS dentistry over the last 10 years. The decline has been particularly sharp in parts of the South West and East of England, raising concerns about growing inequalities in access to care.
The analysis suggests more than one in 10 dental practices that once offered NHS care no longer do so, leaving it near impossible for some communities to find NHS appointments.
NHS dental activity is 8% lower than it was pre Covid, while six in 10 adults have not seen an NHS dentist in two years. Of those who attempted to get a new appointment in the last two years, just 38% were successful, according to a Nuffield Trust Survey.
Cornwall, Devon and Northamptonshire have seen some of the biggest reductions in the number of practices offering NHS care. In Cornwall, more than a quarter of practices that previously offered NHS treatment have stopped doing so, making it one of the starkest examples of the shift away from NHS dentistry.
The findings come as ministers have pledged to tackle so-called "dental deserts", but dentists say the current deal is not viable. Many have handed back their NHS contracts because to work is loss-making.
In Somerset, fewer than one in five dental practices now offers NHS services. Alan, 83, who lives in the county, says he has given up trying to find an NHS dentist.
"I used to try, but getting a dental appointment anywhere near where I live would be impossible," he says.
Alan has only one tooth remaining after the others "crumbled out over the years" and says he has had to adapt what he eats, although he jokes that he has perfected a way of eating Brazil nuts.
Alan, 83, says he has given up trying to find an NHS dentist
Vivak Shah, who runs three dental practices in Northamptonshire, continues to offer NHS treatment but says it operates at a loss. He no longer takes on new NHS patients.
"Each year we struggle to decide what to do, and there is a limit to how much the private side can cover the NHS losses," says Shah.
He warned that if practices stop providing NHS treatment, many patients could be left in pain or forced to seek help elsewhere in the health service, including hospital accident and emergency departments.
"A contract handed back in one town attracts little national attention on its own but repeated across the country for a decade it amounts to the quiet transformation of dentistry into a two-tier service," says Mark Dayan, head of public affairs at the Nuffield Trust.
"Access to dental care increasingly depends on what people can afford to pay and where they live."