The British Dental Association (BDA) has warned that there needs to be a fundamental reform of NHS dentistry to address the current exodus of dentists from the service and the crisis in patient access. Thousands of dentists have left the NHS since Covid lockdowns, with almost half of dentists in England reporting they have significantly reduced their NHS commitment.


The current targets-based system funds care for just over half of the population but does not take into account the cost of more time-consuming work – so, in effect, dentists are paid the same whether carrying out one filling or ten.


Under Government plans, the payment dentists receive for hitting a target – the Unit of Dental Activity (UDA) – will be set at a minimum of £23. The number of UDAs dentists receive for treating three or more teeth will increase from three UDAs to five, and root canal treatment on molars will be rewarded with seven UDAs (up from three). The plans also envisage a greater role for dental therapists.


However, the BDA believes the current system is fundamentally broken and in need of wholesale reform. It points out that only around 3% of dental practices will benefit from the introduction of the UDA minimum, and that the changes still fail sufficiently to take into account time-consuming or complex work, particularly for high-needs patients. The BDA stresses that major investment is needed to reverse years of cuts to funding and estimates that it would take an extra £880 million to restore funding levels seen in 2010. Over 44 million NHS dental appointments have been lost in England since the start of the pandemic – the equivalent of more than a year’s worth of care pre-Covid.


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