OPINION: Urgent reform is the key to stopping dental industry decay


8:30 p.m. March 13, 2022

Some Norfolk MPs have rightly said we need more dentists. But their proposed solution of a dental training college misses the point.

Dentistry courses last five years, plus up to two years of supervised practice, so even if more money was invested in training tomorrow, it would be years before the results affected the current shortage.

In addition, the whole system is down.

Dentistry was in crisis before Covid-19, with NHS commitments in decline and many young dentists simply not seeing a future for themselves in the service.

The government must urgently come up with long-awaited reforms to the NHS dental contract, which was established in 2006.

The contract limits the number of NHS appointments available, although dentists often have available time slots to fill. It prevents dentists from seeing NHS patients when they need to be seen and expects them to achieve higher patient targets when there are local closures – often without the required full payment .

It also includes perverse disincentives that mean dentists can be paid similar rates for filling as they are for major dental work. NHS contracts may end up being returned because they become unviable.

Dental health has improved over the past two decades; fewer seniors resort to a full set of false teeth, and more working-age people are in customer-facing roles where they are more aware of their appearance.

All of this means greater demands on the system – and yet the government appears to have decided that access to an NHS dentist is not a universal right for everyone and only those with dental emergencies the most urgent are seen. Fewer routine appointments will simply lead to more emergency solutions later.

The government also plans to ban dentists not trained in the UK from practicing in the UK from 2023, even though 22% of dental care and treatment is provided by dentists from the European Economic Area.

Swift action is needed to reduce the impact Brexit will have on those who received their education in the EU but whose qualifications will no longer be recognized in the UK.

This can be done by looking at international qualifications in dentistry. The Overseas Registration Examination has only 500 places available each year in the UK and the Association of Dental Groups has recommended that the number be increased and the examination be offered in home countries candidates.

Then there is the issue of funding. After a decade of brutal cuts to public services, the government must urgently provide adequate resources to reverse the alarming decline of NHS dentistry and ensure its long-term viability.

A recent, time-limited injection of £50m nationwide will fund less than 1% of the 40m appointments lost since the start of the pandemic.

The British Dental Association described the government’s response to the crisis as ‘sound bites instead of direct answers’.

Almost 1,000 dentists left NHS dentistry in England last year, but that’s just the tip of the iceberg.

Two-thirds of dentists in England said they were close to reducing their commitment to the NHS, and more than a third said they planned to go fully private next year. Less than half are confident their practice will continue to provide all NHS services from April 2022.

As Wera Hobhouse MP said: “The current crisis will not improve unless we make it viable for dentists to provide NHS treatment and make NHS dentistry a place where people want to work.

“Dentists in my constituency told me they wanted to provide NHS treatment but just couldn’t make it viable under current conditions.”

A new system is needed now and should be one that prioritizes prevention, is patient-centered and reflects modern dentistry.

Steff Aquarone is parliamentary spokesperson for the North Norfolk Liberal Democrats


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