Millions of Brits are unable to get an appointment with an NHS dentist as some resort to ripping their own teeth out.
We can reveal a huge rise in “unmet need” with one in four adults either unable to get an appointment, languishing on a waiting list, put off by long long waits, or the cost.
New analysis of the GP Survey suggests 11 million people in England were in one of these situations last year - up from four million in 2019.
We can also reveal that “high needs” patients are being turned away from dentists because of a flawed national payment contract.
And some are attempting DIY dentistry before taking out loans to pay for treatment abroad.
The Health and Social Care Committee has launched an inquiry after concluding the way NHS dentists are paid is “not fit for purpose” and the Mirror has obtained evidence set to be submitted.
Polling shows half of dentists have slashed the number of NHS patients they see and 43% say they now plan to go fully private.
Dentists blame a decade of funding cuts and a “perverse” payment contract that does not reward work actually carried out.
Shawn Charlwood, committee chair for the British Dental Association, which submitted the evidence, said: “This is a desperate warning from this profession.
“NHS dentistry is running out of road. Every day a broken system remains in force we lose dentists, while millions struggle to access care.”
BDA analysis of the 2022 NHS GP Survey indicates that unmet need has risen by every measure.
Nearly six million adults tried and failed to get an NHS dentist appointment in the past two years, and 3.6 million did not try because they thought they could not secure one.
One million people were put off by the spiralling cost of NHS dental charges while half a million people were stuck on a waiting list for an NHS dentist.
BDA polling of 1,900 dentists reveals 50 report having reduced their NHS commitment since the start of the pandemic - by 27% on average.
This reduced NHS work is going unseen in official workforce data where dentists doing one NHS check-up a year carry the same weight as an NHS full timer.
The BDA says the discredited NHS contract is driving a further exodus from the NHS workforce.
The proportion of dentists now reporting their intention to reduce – or further reduce – the amount of NHS work they undertake stands at 74% this year. Some 43% said they are likely to go fully private.
Research by the BBC over summer indicated nine out of ten practices in England are unable to take on new adult NHS patients.
It sparked the probe by the Health and Social Care Committee during which MPs will consider to what extent the current NHS dental contract disincentivises dentists from taking on new patients.
Committee chair Steve Brine MP said: “People resorting to DIY dentistry, even taking out their own teeth without anaesthetic or medical care are stories that should belong to another era yet such events are reported to be happening here today.
“Perhaps it’s not surprising when research shows that some parts of the country have become dental deserts.
“We’re launching an inquiry to ask why dental treatment is so difficult to find and to establish what the government and NHS England must do to improve access and reduce such unnecessary pain and suffering.”
Dentists are turning away some of the most complex NHS patients because their funding formula means they may end up missing targets and facing financial penalties.
Many are also avoiding NHS dentists due to the cost.
Meanwhile clinics in Turkey report huge increases in ‘health tourists’ fleeing the NHS dental system and travelling to Turkey for treatment.
One major dentistry firm there told the Mirror patients from the UK seeking “Turkey teeth” have increased a hundredfold in four years.
Dentakay said in 2019, there were 15 patients in total from the UK treated by its four hospitals in Istanbul.
By the end of this year the firm expects to have treated 1,470 patients.
Dentakay boss Dr Gülay Akay said: “The increase we have seen in the number of patients coming to Turkey from the UK is really quite incredible, and shows no sign of slowing.
“There is no doubt that the crisis in NHS care is driving British people to seek treatment in other countries.
“We have seen some real horror stories, including one patient who had lost almost all of his teeth in a traffic accident but was unable to get treatment on the NHS.
“The potential savings are also a big factor.”
Shadow Health Secretary Wes Streeting said: “People are finding it impossible to sign up with an NHS dentist.
“The Conservatives are overseeing an exodus of dentists from the NHS, leaving those who can’t afford to go private without any care at all.”
Rishi Sunak angered dentists when he claimed in the House of Commons to have fixed the NHS dental contract during Prime Minister’s Questions.
In response to questions on patient access from Lancaster and Fleetwood MP Cat Smith, Mr Sunak: "As a result of the new reformed NHS dentistry contract there are now more NHS dentists across the UK with more funding making sure people can get the treatment they need."
The BDA have stressed that not one of the PM's claims is accurate, saying “there are no new dentists, no new money and there is no new contract”.
The BDA and several opposition MPs recently urged Rishi Sunak to correct the record.
A spokesman for the Department of Health and Social Care said: “We are working to improve access to NHS dental care by investing more than £3 billion a year in dentistry for all NHS patients but we know there is more to do.
“We have enabled NHS dental practices to deliver an extra 10% of NHS care on top of their contracts to improve patient access and recently completed work to remove barriers and support dental team members such as therapists and hygienists to work to their full skill set in the NHS.
“The number of dentists practising in the NHS increased by over 500 last year and we recently implemented reforms to provide fairer pay for practices to take on high needs patients also.”
Grant Lakey pulled out own teeth
Plumber Grant Lakey told how he yanked out four of his teeth with string because he was unable to access an NHS dentist.
The 58-year-old has been forced thousands of pounds into debt to pay to have teeth replaced abroad because no dental practices locally were accepting NHS patients.
The father-of-two lost some of his upper teeth in an accident at work which meant his lower teeth started to come loose.
Grant tried all six local dentists near his home in Bromley, south east London, before taking out a £6,000 loan to have six implants fitted in Turkey.
He explained: “I called around all the dental practices in the local area and they weren’t interested.
“It’s terrible when your teeth are all moving around because you are scared to bite anything. It feels like you have a mouth full of marbles.
“It sounds a bit mediaeval but I ended up having to tie string around them and kind of garotted it out.
“I was in a lot of pain and there was quite a bit of blood. I was just so lucky I didn’t get infected.
“The only other option was to go private in the UK. I work and I pay my taxes but I couldn’t afford that. I paid my taxes so the NHS should have been there for me.”
Grant said he was left depressed by the state of his teeth and the “stigma”.
“The emotional effect and the stress have been awful,” he said.
“I’m a manager at work and have to stand up and talk in front of people. There is a stigma when you have gaps in your teeth.
“People are just thinking ‘look at the state of him’ and they think you’re a crack head.”
Grant now has temporary teeth on his six implants. He needs to find another £6,000 to pay to fly back out to Turkey and have proper dentures fitted on them.
He added: “Now I’ve got to find another six grand and I don’t know where I’ll get that from.”
Lawrence Wilcox: 'This is a crisis'
Pensioner Lawrence Wilcox lost his dentures and was eating only soup and soft food while unable to get in with an NHS dentist to replace them.
The retired blacksmith had stayed away from his dentist in Harborne, Birmingham, during the pandemic and was told because he hadn’t kept up regular check ups he was no longer registered with them.
Lawrence, 79, explained: “I just needed a dentist to do me a new set of dentures.
“I phoned around every dentist in the district and they were just saying no more NHS patients.
“I was just eating soup and soft food for a month.”
The grandfather-of-three had seven good teeth but needed dentures around them.
However he ended up flying to Turkey and got 12 dental implants, two root canals, 15 extractions and 28 porcelain crowns at a cost of £8,000.
“For the first time in years I had teeth,” he said.
“You pay for a package and it includes flights and hotel stay while you have them done. They even send a limo to the hotel to take you to the dentist.
“I’m skint now though. The NHS ought to provide dentistry but it doesn’t any more.
“When I came back with my teeth I told people about my situation and everyone I spoke to said the same thing or knows someone who can’t get an NHS dentist.
“This is a crisis.”
Janice Davidson-Lund: 'I had to go to Turkey'
Factory manager Janice Davidson-Lund flew to Turkey to have her teeth done because it was cheaper than paying soaring NHS dental charges.
A crown on one of her top front teeth fell out during lockdown and she did not have the £2,000 she was quoted by her dentist to have an implant.
When she inherited some money she decided to spend £7,000 getting a full oral refit.
She had a sinus lift, bone graft in her jaw, nine implants, five root canals and 21 crowns.
However she has been told NHS dentists now will not work on her new teeth so if she has any dental issues she has to fly back to Turkey.
“I can’t get in with any dentist in the UK now,” she said.
“The dentists here won’t do anything with these teeth.
“But it would have cost me more than £20,000 to have what I had done here in the UK.”
Q&A
What's wrong with how dentists are paid?
The main issue driving this crisis is the flawed NHS dental contract.
Practices have a contract with a fixed number of Units of Dental Activity to carry out, which dentists say bears little relation to work actually done.
An NHS dentist is paid the same whether they do three or a dozen fillings on a patient.
Vital work on prevention does not feature in the targets.
“High needs” patients are now the least welcome in practices because it is difficult to hit targets treating complex cases. Practices often calculate they make a loss by treating such patients.
The NHS dental contract means that if a practice fails to meet their target they face financial penalties. If they try to do more, they won’t get paid for the work.
These penalties are expected to hit all-time high this year as practices struggle to fill vacancies and work through a huge pandemic backlog.
This “clawback” is pushing frustrated dentists to quit the NHS and go private.
Around £400 million - more than 10% of tota NHS dentistry budget - is set to be clawed back by Government from frontline dentistry this year in penalties.
The system already only funds enough Units of Dental Activity for half the population.
Has funding been cut?
The overall NHS dentistry budget has remained at around £3 billion for a decade - despite inflation and increased demand from a growing and ageing population .
But this flat budget masked the fact that over the last decade patients were paying in ever more through inflation-busting charge hikes.
A check up now costs £23.80, up from £16.50, and a filling £65.20, up from £45.60.
This has meant less well-off patients putting off treatment and contributed to worsening oral health in England.
Going into the Covid-19 pandemic, revenue from patient charging had increased from £614 million in 2010/11 up to £856 million in 2018/19.
Funding from Government had dropped from £2.2 billion to £1.9 billion - a cut not enforced on any other area of the NHS.
Government funding had to increase to £2.7 million in 2020/21 to keep dentists afloat during Covid lockdowns, as patient charge revenue dried up.
However this central funding for dentistry is now falling again and was £2.4 billion in 2021/22.
OECD data indicates that the UK spends the lowest proportion of its health budget on dentistry of any European nation.
England has the lowest spend per capita of any UK nation.
