Patients 'pulling their own teeth', report into 'grim' Nottinghamshire dentists reveals

Health bosses have described the access to NHS dental services in Nottinghamshire as 'grim' - after a public health assessment shared stories of patients 'pulling' out their own teeth and sticking 'Blu Tack in'.

The report by NHS England in the Midlands says the pandemic had a 'considerable impact' on dental services and the long-term affect on oral health is 'a cause for concern'.

The primary care commissioner for the region said it should be back to pre-pandemic levels by the end of next yearThe Nottinghamshire County Health Overview and Scrutiny Committee discussed the issue at its meeting on 28 March.

The report by NHS England shows Nottinghamshire currently has 109 general dental practices.

Councillors unanimously agreed at the end of the meeting to send a joint letter to Nottinghamshire MPs requesting support in reforming the current NHS dental contract.

Chair of the committee Cllr Sue Saddington (Con) said: "We wanted you to come to explain why people out there can't get dental appointments.

"We all meet people who pull their own teeth out and stick Blu Tack in - horrendous things."

Caroline Goulding, head of Primary Care Commissioning for the East Midlands, said: "Being completely transparent, dentistry was challenged before the pandemic in respect of access.

"The pandemic has significantly worsened that. Access to dentistry not just in Nottinghamshire but across the East Midlands is not where we want it to be.

"The team are doing everything we possibly can, there is a huge amount of work nationally to try to address bigger contractual issues.

"In Nottinghamshire, we are working at around 87% restored pandemic activity.

"We feel that by the end of the financial year of 2024, we will have restored all activity from pre-pandemic.

"We are aware that there are huge swathes of the population that we need to access.

"It's grim, I've got to be honest, with all the MP letters and patient complaint letters. We are doing everything we can within our scope to improve it for patients.

"My team investigate every single complaint with clinical advisers."

Measures have been implemented to deal with increasing backlogs - in Nottinghamshire two NHS practices have been contracted to provide 140 additional appointments at a cost of £70,000.

Nottingham city and Nottinghamshire councils have also been awarded £150,000 towards oral health improvement activities.

Another scheme called the 'Golden Hello' scheme intended to improve recruitment and retention among dentists will see payments of up to £15,000 for each new eligible full-time dentist within East Bassetlaw.

Claire Hames, commissioning manager, East Midlands, said the team has commissioned weekend sessions for over 300 patients and has also received funding dedicated urgent care slots during surgery opening hours.

Two practices in Hucknall and Mansfield are also offering an additional 25 urgent care slots per week.

Lib Dem Cllr Steve Carr said: "I've come across several people that I represent who have actually pulled out their own teeth which must be dreadful.

"This will have a long-term detrimental impact on residents.

"With NHS appointments scarce at best, people are being forced to spend hundreds if not thousands on private care.

"Fault lies solely with national government who have done next to nothing to tackle this crisis."

Regional Chief Dentist Adam Morby agreed with the councillors concerns adding: "There are enough dentists in this country to deliver a service, unfortunately, the contract is stopping them from going into that.

"Currently, we've got graduates leaving university, who have had public money to become a dentist, and they are going straight into private practice. That needs to change.

"We are limited with workforce. We are fighting a losing battle at the moment, unfortunately."

The report also said the districts with the highest proportion of five-year-olds with tooth decay are Bassetlaw and Gedling, at 23.5% of children.

Rushcliffe has the lowest proportion with 12.7%.

Cllr Michelle Welsh added: "I am concerned that people can't get their children into an NHS dentist, I am very worried about that."

All routine services were required to stop operating when the UK entered lockdown in 2020 - and a network of Urgent Dental Care centres (UDCs) was set up across the Midlands to allow those requiring urgent dental treatment to be seen.

Services reopened from June 2020 but social distancing was required.

"For a large part of 2020, many practices were only able to provide about 20 per cent of the usual number of face-to-face appointments and relied instead on providing remote triage of assessment, advice, and antibiotics (where indicated)", the report stated.

The report said that only in early 2021 did the situation start to improve.

Nottingham and Nottinghamshire Integrated Care Board has responsibility for dental services in the city and county.

The NHS England report stated: "Reduced access to NHS dental care over the course of the pandemic will have resulted in compromised outcomes for some patients.

"Due to the duration of the lockdown and the length of time during which routine face to face activity ceased, a number of patients who ordinarily would have had a clinical intervention may have struggled to gain access to NHS dental care.

"Some who were part way through dental treatment will undoubtedly have suffered and may have lost teeth they would not have otherwise - temporary fillings placed pre-lockdown, for example, and only intended as temporary measures, may have come out causing deterioration in outcome."