THE NHS DENTAL DESERT

10 “Tooth Truths” :-

  1) The “Dental Desert” has been created by governments failing to understand that self-employed private practitioners can never be attracted by  uneconomic “one size fits all” NHS Contracts.    

  2) No patient can be guaranteed access to dental treatment under NHS Terms and Conditions of Service.

  3) NHS Dental Contractors are entitled to inspect a patient’s teeth BEFORE agreeing to provide any treatment under NHS Terms of Service.

  4) It is misleading to state that expectant mothers are entitled to free NHS dental care when NHS benefits cannot be guaranteed.

  5) There is no such thing as NHS Dentistry – NHS dental benefits are sub-contracted from private dental practice.

  6) The NHS Red Book contains advice for expectant mothers on “How to Find a Dentist” which is in effect a “Post Code Lottery”

  7) Tooth decay is largely a result of negligence and the cost of restorative care is wasted in the absence of ongoing preventive care.

  8) If the government wishes to limit the NHS dental budget it should limit the treatments and establish a guaranteed service for expectant mothers and their newborn babies for priority funding based upon the prevenion of tooth decay.  

  9) Since 1950 when dental charges were first introduced, the NHS Dental Contract has become progressively restrictive in scope and financial reward particularly in resoect of the effective prevention of dental caries. No quality audit of treatment outcomes has ever been exercised. 

  10) A properly funded NHS “Children’s Dental Passport” Contract is the most effective way of protecting “Teeth for Life”

A Health Minister once disclosed a belief that the “authorities”(? the DHSS) hoped the NHS dental problem would “go away”. Nearly a decade later this wish has materialised as progressive NHS funding cuts have now created a situation described by National Newspaper headlines as an  “NHS Dental Desert”. The Government’s biggest mistake in 1948 was a failure to understand the nature of the dental market by attempting to control NHS dental remuneration within two years of having delivered the greatest earnings stimulus in history. In the beginning, the negotiating body (BDA)  favoured a grant-in-aid type arrangement that had the benefit of limiting the NHS budget from the outset, leaving patients to fund any difference. Children’s Dentistry and Emergency Care were to be protected and provided for by the NHS free of charge.

There is no doubt the NHS dental funding model is a “bust brand” and a Government decision has to be made in a new direction. There is little point in attempting to remediate the damage caused by the existing dental caries epidemic without a national programme of preventive dental care being introduced and advertised within general medical practices (the Red Book) and UK Schools.  With the NHS now devouring in excess of 40% of the Public Spending Budget and Dentistry less than 2% of NHS funds, we should return to the Drawing Board of 1948 and redistribute the ever dwindling NHS Dental Budget to Children’s Dentistry  and emergency dental care facilities within general practice.