NHS dentistry on brink of collapse warns British Dental Association Northern Ireland

The British Dental Association Northern Ireland is urging politicians to pledge their commitment to rebuilding and reforming Health Service dentistry, which is facing an uncertain future as it emerges from the pandemic.  With massive hikes in costs to deliver Health Service dentistry, dentists are worried about the future of the service and the patients who depend on it. 

They say without additional support to address the spiraling costs to provide care, and work on a new contract which takes these into account, Health Service dentistry will not be financially viable.

The unions stressed that an overhaul of the contract model to which NHS high street dentists work, which involves low margins and high numbers of patients, is now needed.

It warned that fees provided for care – for individual items from crowns to dentures – have fallen by as much as a quarter in real terms in the last decade.

With these fees often failing to match costs incurred the BDA warn dentists are growing increasingly reliant on private revenue to prop up NHS side of their practices.

It says high street Health Service dentistry should be able to stand alone, and not be forced to rely on those working within it to tap other earnings to plug the funding gap.The BDA says urgent action on funding is needed if Health Service dentistry is to be maintained for families across NI.

Dental earnings have reduced by 40% in real terms since 2008, with committed HS dentists providing care to those who need it most now earning the least.

With morale among the profession at an historic low, half of all dentists are now stating their intention to move towards more private work.

Over two-thirds of Health Service dental practices reported at least one unfilled dentist vacancy last year, with every vacancy translating into thousands of patients unable to access care.

Around 40% of practices say reluctance to work in Health Service dentistry is the key difficulty to recruiting.  The union is calling on all parties to set out a concrete plan to shore up firm foundations for Health Service dentistry and stem the flow of talent away from Health Service dentistry.

It calls for the restoration of a scheme – axed in 2016 – that recognised and rewarded commitment to the NHS.It has also stressed the need for sweeping action to tackle rampant oral health inequalities in NI. Northern Ireland is at the bottom of the UK league table for oral disease, and Covid means this inequality is set to widen.

NI residents are twice as likely to have filled teeth as counterparts in England, and children are three times as likely to have multiple teeth extracted under General Anaesthetic.

The gap in attendance between the most and least deprived communities widened during the pandemic. The BDA has pointed to Welsh and Scottish programmes – that have been exported worldwide from Chile to Israel - with activities such as supervised tooth-brushing in nurseries that would pay for themselves through reduced treatment need.Dentist leaders have called for ring-fencing of proceeds from the Sugar Levy to fund pioneering efforts, alongside commitments to a feasibility study into water fluoridation. Roz McMullan, Chair of the British Dental Association’s Northern Ireland Council said: “Short-term financial support saved Health Service dentistry from collapse during the pandemic, but the next Assembly must deliver real change if we’re going to avert a crisis. “Northern Ireland’s dentists are working to a financial model that no longer adds up. Overstretched and underfunded, Health Service committed practices are struggling to remain financially viable.  “Colleagues feel they are being pushed out of HS dentistry – at the very time we face a huge COVID backlog. We all need to know this service has a future, because otherwise the UK’s deepest oral health inequalities will only widen.“We need an ambitious Oral Health Strategy. Our children are three times as likely to face tooth extractions as those in England. There’s nothing inevitable about this, and a 21st century plan can secure huge savings by investing in prevention, not just cure. “It is incumbent that the next Assembly prioritises the rebuild and reform of dentistry in NI. We are ready to work with every party and every candidate to secure a better future for patients and practitioners alike.”