Universal dentistry has been “lost” according to worrying new research which shows 600 practices have stopped seeing NHS patients.
The scale of dentists handing back their NHS contracts and going private is today revealed in analysis for the Mirror ’s Dentists for All campaign. The most comprehensive ever study of the decade-long oral health crisis by the respected Nuffield Trust thinktank concludes – “NHS dental care is hard to find in England, if not impossible”.
One in ten dental practices, or 608 in total, have abandoned their NHS contract since March 2017 in England. This includes a loss of 135 NHS practices since 2024 – the year Labour came to power.
A Mirror special report today publishes accounts from a pensioner who lives in pain because he cannot get an NHS dentist, as well as a former NHS dentist who explains why he has gone private.
New polling of 2,000 adults also shows the vast majority of the public are in favour of Labour fixing NHS dentistry through extra funding, following a decade of real-terms cuts under the Tories.
Mark Dayan, policy analyst at the Nuffield Trust, said: “The retreat of NHS dentistry was never an announcement or a policy. There has been no closure programme for citizens to oppose and no single decision to reduce the service. The loss of universal care happened through practices deciding for themselves that NHS work is no longer worth doing.
“A contract handed back in one town attracts little national attention on its own but repeated across the country for a decade, it amounts to the quiet transformation of dentistry into a two-tier service, in which access to dentistry increasingly rests on what people can afford to pay and what postcode they live in.”
The Nuffield report established the number of registered NHS dentists in England in March each year, dating back to 2017. Back then there were 6,262 dentists who saw NHS patients.
Latest data shows this had fallen to 5,654 by March 2026. This is before factoring in the trend of dentists reducing the proportion of NHS patients they see but still treating some.
Nuffield researchers established that 10,160 dental practices are now operating in England – an increase of over 400 in the previous decade. However the share of these offering NHS general dental services has dropped from 64.6% to 55.6%.
Practices without a general NHS contract – largely private or specialist NHS services – have risen by over 1,000.
More dentists are handing back their NHS contracts in the South West and the East of England. The report highlights how these regions are also seeing the biggest growth in private dental practices.
It states: “Dental capacity has not disappeared from these places, but it has moved beyond the reach of anyone who cannot pay for it. This is not a shortage of dentistry so much as a shortage of NHS dentistry.”
The Patient
Retired shopkeeper Mike Wood told how he has “a mouth full of gaps” and lives in chronic pain because he cannot get an NHS dentist.
The 84-year-old has been trying to get in with an NHS practice for 11 years during which time his teeth have deteriorated and has to rely only on emergency extractions at clinics. He has two cracked front teeth, several fallen-out fillings, no teeth left on the left side of his lower jaw and gaps throughout his mouth.
Mike told the Mirror: “My mouth’s full of gaps and it can be painful. I can’t eat properly on my right side and on my left it’s difficult. There are lots of things I can’t eat. If I could afford to go private I could get it all sorted straight away but I can’t because I’m a pensioner.”
Mike’s teeth were fine 11 years ago when he moved to Blackpool. After the move he and his wife were unable to find a dentist taking on new NHS patients, despite asking at “eight or nine” practices within travelling distance.
Mike said: “I started to have trouble with my teeth and had bad toothache and ended up at an emergency dentist clinic but they just do one thing, and that’s take teeth out. This kept happening.
“One tooth she took out and showed it to me and it just had a pinhead-sized hole in it but they wouldn’t do a filling so it just had to come out.
“If you haven’t got the money then you can’t get treated for anything. It feels like privatisation. I remember a time before the NHS and it feels like things are heading back that way.”
The Dentist
Jim Sykes was an NHS dentist before taking the decision to hand back his contract and go private after getting into financial difficulty.
The current NHS contract leaves practices making a loss treating more complex patients and has driven an exodus of dentists to the private sector.
Jim said: “We were delivering care at a financial loss. The numbers in NHS dentistry don’t add up. I struggle to understand how anyone can make it work.”
Jim said his NHS contracted work at his practice in Hexham in the North East involved delivering high-volume, quality care, within tight to non-existent profit margins. Following the retirement of an experienced dentist, Jim struggled to recruit a replacement.
This meant the practice could not carry out the number of units of dental activity (UDAs) his NHS contract expected so it was forced to pay back large sums of money to the NHS.
Jim wanted to continue treating local children for free on the NHS at least – even though this would have been at a financial loss – but local NHS bosses said a children-only contract was not available under its commissioning arrangements so Jim handed back his NHS contract in October 2024.
Jim said: “I believe strongly that everyone should have access to NHS dentistry, and giving up our NHS contract was one of the hardest decisions we’ve ever had to make.
“We accepted that we couldn’t make the adult contract sustainable, but we still wanted to find a way to care for children. When we were told that wasn’t an option, we had no choice but to relinquish the contract completely.
“This was never about turning our backs on NHS patients. It was about the system and us not being able to find a viable way within it. I hope the contract can be reformed so that other practices aren’t forced into the same decision.”
You get what you pay for
NHS dental funding for England remained at around £3 billion for more than a decade under Conservative governments, failing to keep pace with inflation and population growth.
By the time the Tories left power this funding was only enough to fund care for half the population. The British Dental Association calculated that there had been a £1bn real terms funding cut.
During this period, the proportion of the NHS budget spent on dentistry fell from 3.3% in 2010 to just 1.5% in 2024 – as dentists increasingly handed back their NHS contracts.
Labour increased the annual budget to £3.5bn for 2024/25 but the BDA said fundamental contract reform cannot be achieved without an extra £1.5 billion more a year to restore NHS dentistry as a universal service for all who want it.
The Solution?
Labour has promised to reform the “flawed” NHS dental contract before the end of this parliament.
But before Andy Burnham became Prime Minister, all the noises coming from the Treasury suggested there would be no additional funding of the scale required for substantial contract reform.
New polling by Survation for campaigning organisation 38 Degrees shows that 68% of the public support fixing NHS dentistry through extra funding, with just 10% opposed.
Veronica Hawking, campaigns director at 38 Degrees, said: “Nobody in modern Britain should be living in unbearable pain, or facing bills of thousands of pounds, just to get treatment for their teeth. While this data shows the extent of the deepening crisis in NHS dentistry, our polling shows the public are overwhelmingly behind fixing it.”
Shiv Pabary, chair of the British Dental Association’s general dental practice committee, said: “What we’re seeing here is the direct result of choices made by successive governments. A new team at the Department of Health need to grasp that if they fail to fix and fund NHS dentistry, dentists will have no choice but to walk away.”
National NHS surveys show that six in 10 adults have not seen an NHS dentist in the last two years.
Mark Dayan, of Nuffield, added: “The decline started under previous governments but it certainly hasn’t been reversed. That’s not surprising because nothing the current government has done is of the scale required. Major dental contract reform is what is needed to turn this around.”
The government continues to consult on contract reform but in the meantime Labour has increased the number of emergency dental appointments by paying dentists more for them. Ministers also introduced supervised teeth brushing at schools in more deprived areas.
The government points to progress in overseeing 1.8 million extra courses of dental treatment between April and October 2025, when compared with the corresponding seven-month period before the 2024 general election.
A spokeswoman for the Department of Health and Social Care said: “Too many people are struggling to get the dental care they need. After years of decline, the government has been rebuilding a broken NHS dentistry system.
“We are changing the NHS dental contract to make NHS dentistry more sustainable and are training more dentists in areas where they are most needed.
“We will also make it a requirement for newly qualified dentists to practice in the NHS for a minimum period of at least 3 years. That will mean more NHS dentists, more NHS appointments and better oral health.”