COVID-19 pandemic pushes NHS dentistry to crisis point, finds new report

Healthwatch England calls for action to address widespread issues with access to NHS dental care following an unprecedented surge in concerns.

Healthwatch experienced a 452% increase in feedback on the issue in the second quarter of the year, with continuing accounts of people being left in pain, resorting to ‘DIY’ repair methods and in some cases even extracting their own teeth.

The review of 1,300 people’s experiences of accessing dental care found that:

  • More than 7 in 10 people (73%) found it difficult to access help and support when they needed it.
  • Access issues were caused by dentists not taking on NHS patients, as well as conflicting advice from different parts of the NHS about what help is available.
  • Many people were offered treatment if they went private, despite research indicating that 40% of people would struggle to afford private dental care.
  • The impact of not being able to access care led to many people to experience pain, discomfort and further complications.

The increase in feedback comes after the British Dental Association reported that treatments delivered by NHS dental services in England are at a quarter of pre-COVID levels, with over 14.5 million fewer procedures taking place.

The impact on individuals

Laura Floyd, from West Berkshire, was part-way through significant dental treatment when it was cancelled due to the lockdown in March. The new mother explained:

“As we went from April to May, I had an abscess develop on the tooth which was still awaiting treatment. I did receive care over the phone and a course of antibiotics which helped ease some of the pain and swelling but this never fully went away, I just lived with it as cautiously as I could. Sadly my eight-month-old wasn’t as cautious when reaching out and grabbing my face!”

Laura, who was entitled to free NHS dental care for 12 months after the birth of her child, did then receive some emergency treatment for a further painful cavity but is still waiting for her pain treatment to be completed a year on from her initial diagnosis.  She added:

“My free dental care is due to end next month, and I am still awaiting treatment which is frustrating as this is yet another thing taken away from me this year by COVID-19. I know I am not the only one waiting to be seen, but this also means the chances of getting an appointment to finish my treatment before the exemption expires is unlikely.”

Sir Robert Francis QC, Chair of Healthwatch England, said:

“The COVID-19 crisis has impacted on many areas of NHS support but, problems in dental care appear to be particularly acute.

“Even before the pandemic, people were telling us about problems in accessing NHS dental appointments but since the start of the summer these reports have hugely increased.

“If we don’t improve access to NHS dental care, not only do people risk facing far greater dental problems in the future but it also puts pressure on overstretched hospitals and GPs. Untreated dental problems can lead to pain, infection and the risk of long-term harm, which is comparable with other medical conditions.

“Health and care services are working hard to deal with the pandemic, but we believe the Government and the NHS should give more attention to resolving both long-standing and COVID-related issues in dentistry.”

Key recommendations

While the report accepts that the overall treatment backlog caused by the pandemic will take time to clear due to limited industry capacity and COVID-related restrictions, it makes several recommendations including:

  • providing more accurate and up-to-date information for patients,
  • providing clarity over NHS dentists’ obligations relating to patient registration
  • making more resources available to improve patient access to dental care and;
  • reviewing the overall cost to patients of NHS dental care, particularly with a 5% price increase set to take effect before Christmas.

Healthwatch is also calling for people on low incomes who are forced to travel long distances to access dental care to be reimbursed.

More about our dental findings

Healthwatch England’s report found individuals who struggled to access dental treatments during the pandemic often experienced inconvenience, anxiety and worsening problems. The accounts shared with Healthwatch nationally and locally included:

• Pregnant women who were unable to take painkillers due to their unborn babies and as a result had to experience painful toothache.

• People with ill-fitting dentures or broken fillings developing ulcers, bleeding gums and infections. They were not only struggling to eat and speak, but lack of dental care also affected their self-confidence and their mental health.

• Untreated dental issues that lead to hospitalisation and people resorting to removing their teeth at home.

Healthwatch’s evidence also suggests that when practices reopened in June 2020, some dentists appeared to be prioritising private patients over NHS ones.

And while people were struggling to access NHS dental care, inaccurate and out-of-date information from NHS 111, the NHS website and practices’ own websites often left people forced to telephone many different practices directly in an effort to try and find a dentist willing to accept them.

However, Healthwatch also received praise for dental staff, with some practices providing videos to their patients to help them understand pandemic-related processes and arranging the delivery of medications and dental repair kits to patients they were unable to see.

Read the report

Between July and September 2020, over 38,082 people shared their experiences of using health and social care with Healthwatch. Our briefing is a summary of the key issues that the public are telling us about, including:

  1. Access to NHS dental care
  2. The support provided in care homes
  3. Getting COVID-19 tests

Read the report