The extent of the dentistry crisis in Wales is currently unclear, a report has found. The Senedd's cross-party health and social care committee published the findings of its inquiry into dentistry in Wales on Wednesday.
The inquiry found that it was very difficult to get a clear picture of how many people were currently waiting to see an NHS dentist as there is no centralised waiting list. It also found that there was no centrally-held data on the number of patients being treated privately.
It comes after the BBC reported that the access for new patients to NHS general dentistry across the UK was very poor with research finding that access for new patients in Wales was overall the worst. In summer last year the research showed that the percentage of NHS dental practices not accepting new adult patients was 93% in Wales while it was 91% in England, 90% in Northern Ireland, and 82% in Scotland.
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The Senedd inquiry, led by committee chair Russell George MS, found that Covid-19 had a "severe impact" on access to NHS dentistry as well as a "negative effect" on the dental workforce. In response the dental association BDA Cymru said: "Dentistry in Wales was in crisis before the pandemic. Now Covid-19 has demolished the flawed foundations the service was built on. Without urgent reform and financial support the Covid-19 crisis will leave dental services in Wales compromised beyond repair."
The report also raised concerns that a three-tier system was developing in which those who couldn't register with an NHS dentist but couldn't afford to pay privately were left with no access other than the emergency dental service. It also noted that the current cost of living crisis was likely to have an impact on both dental patients and practitioners which could lead to further inequalities in accessing dental services.
The committee has now called for "radical reform" to help tackle the issues with dental services in Wales. In the report Welsh Conservative MS Mr George MS said: “If we really want to tackle inequalities in access to NHS dentistry we have to target resources where they are most needed. It is incredibly difficult to do this, however, if we have no idea of how many people are actually waiting to see an NHS dentist. It is also unacceptable that once people are on a waiting list they could be waiting up to 26 months before getting an appointment."
He added: "While the Welsh Government’s latest contract reform has been broadly welcomed it is seen by some as merely tinkering round the edge when perhaps what is really needed is radical reform of the system to increase capacity and reduce inequalities to access."
The report found that many parents were feeling anxious that their children had not been able to see a dentist since the pandemic. It also found that the Welsh Government’s Designed to Smile programme, which had been its flagship programme to prevent dental cavities in young children in Wales, had not recovered since the school closures and staff redeployment that was a part of the response of the coronavirus pandemic.
There were significant inequalities in access to dentistry services, the report also found, with groups including people with learning disabilities, people from gypsy and traveller communities, and asylum seekers and migrants experiencing particular barriers to accessing the care they needed. As a result recommendations from the committee included calling for the Welsh Government to ensure every health board in Wales provided information on how to join waiting lists for dental services that would be available in a variety of formats and languages, not just online, by the end of 2023. Another recommendation suggested that the Welsh Government should review whether the current levels of funding were appropriate for the service to achieve what was needed in terms of reducing the backlog.
In response to the report a Royal College of Paediatrics and Child Health officer for health services, Dr Ronny Cheung, said that although the report was "enlightening" it was a "difficult read". Dr Cheung added: "It highlights the huge impact that poor dental and oral health has on children including high numbers of hospital admissions. It shows once again the impact that the cost of living crisis is having on children’s health. As the report highlights it is our most vulnerable members of society who struggle most to access these services. Quite simply this is not good enough.
"Designed to Smile was a hugely successful national programme which managed to deliver a 25% reduction in levels of tooth decay in children from 2008 to 2016. Seeing what has been achieved with the right resources only adds to the frustration of seeing the impact this recent lack of investment has had on children’s dental and oral health in Wales today.
"We would urge the Welsh Government to carefully consider the recommendations made by this report and as a matter of urgency ensure that Designed to Smile is resourced to deliver at least at the levels we saw pre-pandemic. Considering the poor oral health figures in Wales we are once again asking the Welsh Government to consider its position on water fluoridation."
Politicians have also had their say on the report's findings. In response to the publication Welsh Liberal Democrat leader Jane Dodds MS said: "NHS dental provision in Wales is not good enough and this report raises really important questions about the reasons why Labour has allowed a two-tier dental system in Wales to develop where the rich can go private and everyone else is left languishing on waiting lists. I am also disappointed to hear that relations between Welsh Government and the dental profession are at a low point when, to deal with both the effects of the pandemic and the longer-term structural problems in NHS dentistry, we need government and dentists to work together.
"Ultimately we need to ensure the resources are in place to fix this problem including raising spend on dentistry per head to similar levels as Scotland or Northern Ireland as I argued for in the most recent Welsh Government budget debate. By failing to address this issue now Labour is potentially creating a longer-term problem."
In response a Welsh Government spokesman said: "We are grateful for the committee’s work on this report. We will consider the recommendations made by the committee and will respond in due course."
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