Saving NHS dentistry: Why retaining dentists is the key to survival

A system driving dentists away

In a recent opinion piece, Prof. Philip Preshaw, editor of the British Dental Journal, captured the gravity of the situation: “What is needed is rapid change now, and a very effective strategy immediately would be to make every effort to retain our committed and supportive workforce within NHS dentistry.” Yet, despite the growing exodus of dental professionals, the government has been slow to act.

One of the greatest deterrents is the failure to provide fair pay. The government’s decision to grant NHS dentists a 4.64% pay increase—far below the 6.0% recommended by the Review Body on Doctors’ and Dentists’ Remuneration—amounts to a pay cut in real terms. With dental inflation at 9.2% and practice costs soaring (staffing costs are up by 15.0%, laboratory fees by 16.5% and utilities by 10%), many dentists are struggling to keep their practices financially viable.

The British Dental Association (BDA) has repeatedly warned that dentists are being forced to choose between subsidising unprofitable NHS work with private practice or leaving the NHS entirely. The result? Worsening access to care for patients. In December, Office for National Statistics data revealed that 94% of new patients who sought NHS dental treatment were unsuccessful.

Long-term workforce plans will not solve the immediate crisis

The NHS Long Term Workforce Plan has promised to increase dental training places by 40% by 2031, raising the number of new dentists to over 1,100 per year. But this plan does nothing to address the urgent workforce shortage happening now. “These are longer-term aspirations,” Prof. Preshaw noted, “and will not generate noticeable impacts on the workforce until several years hence”.

Meanwhile, there is still no clarity on how to prevent more dentists from leaving. Formal negotiations to reform the outdated NHS dental contract—widely regarded as a key factor in driving dentists away—have yet to begin. Without meaningful changes, recruitment efforts may be futile because newly trained professionals may still opt out of NHS work.

A last chance to save NHS dentistry

The urgency of the crisis was highlighted when the BDA delivered a petition to Downing Street on 7 January, signed by over 250,000 supporters, calling for immediate government action. Members of Parliament and campaigners, including Secretary of State for Health and Social Care Wes Streeting, have warned that “NHS dentistry is at death’s door”. Yet, despite these warnings, the government has failed to outline specific steps to retain dentists. Promises to provide 700,000 additional urgent dental appointments and expand supervised brushing programmes remain unfulfilled.

Without urgent reforms—starting with fair pay, contract changes and proper funding—the NHS dental workforce will continue to shrink. If action is not taken now, there may soon be no NHS dentists left to retain.

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