Healthwatch England is calling for action to address widespread issues with access to National Health Service (NHS) dental care following an unprecedented surge in concerns.
The public advocacy organization experienced a 452% increase in feedback about access to care in the second quarter of the year, with continuing accounts of people left in pain and even restoring to “do-it-yourself” dentistry including extractions.
The review of 1,300 experiences found that:
- 73% of people found it difficult to access help and support when they needed it.
- Access issues were caused by dentists not taking on NHS patients as well as conflicting advice from different parts of the NHS about what help is available.
- Many people were offered treatment if they went private, despite research indicating that 40% of people would struggle to afford private dental care.
- The impact of being unable to access care led to many people experiencing pain, discomfort, and further complications.
The increase in feedback comes after the British Dental Association reported that treatments delivered by NHS dental services in England are at a quarter of pre-pandemic levels, with more than 14.5 million fewer procedures taking place.
Laura Floyd of West Berkshire was partway through significant dental treatment when it was canceled due to the lockdown in March.
“As we went from April to May, I had an abscess develop on the tooth, which was still awaiting treatment. I did receive care over the phone and a course of antibiotics, which helped ease some of the pain and swelling, but this never fully went away,” she said.
“I just lived with it as cautiously as I could. Sadly, my eight-month-old wasn’t as cautious when reaching out and grabbing my face!” she said.
Floyd, who was entitled to free NHS dental care for 12 months after the birth of her child, received some emergency treatment for a further painful cavity, but she is still waiting for her pain treatment to be completed a year on from her initial diagnosis.
“My free dental care is due to end next month, and I am still awaiting treatment, which is frustrating as this is yet another thing taken away from me this year by COVID-19,” she said.
“I know I am not the only one waiting to be seen, but this also means the chances of getting an appointment to finish my treatment before the exemption expires is unlikely,” she said.
“The COVID-19 crisis has impacted on many areas of NHS support, but problems in dental care appear to be particularly acute,” said Sir Robert Francis QC, chair of Healthwatch England.
“Even before the pandemic, people were telling us about problems in accessing NHS dental appointments, but since the start of the summer, these reports have hugely increased,” he said.
“If we don’t improve access to NHS dental care, not only do people risk facing far greater dental problems in the future, but it also puts pressure on overstretched hospitals and GPs,” Francis said.
“Untreated dental problems can lead to pain, infection, and the risk of long-term harm, which is comparable with other medical conditions,” he said.
“Health and care services are working hard to deal with the pandemic, but we believe the government and the NHS should give more attention to resolving both longstanding and COVID-related issues in dentistry,” Francis said.
While Healthwatch England accepts that the overall treatment backlog caused by the pandemic will take time to clear due to limited industry capacity and pandemic-related restrictions, it makes several recommendations, including:
- Providing more accurate and up-to-date information for patients
- Providing clarity over NHS dentists’ obligations relating to patient registration
- Making more resources available to improve patient access to dental care
- Reviewing the overall cost to patients of NHS dental care, particularly with a 5% price increase set to take effect before Christmas
Healthwatch England also is calling for people with low incomes who are forced to travel long distances to access dental care to be reimbursed.
The organization also found that individuals who struggled to access dental treatments during the pandemic often experienced inconvenience, anxiety, and worsening problems. Accounts included:
- Pregnant women who were unable to take painkillers due to their unborn babies and as a result had to experience painful toothaches
- People with ill-fitting dentures or broken fillings developing ulcers, bleeding gums, and infections, struggling to speak, and seeing an impact on their self-confidence and mental health
- Unrelated dental issues that led to hospitalization and people extracting their own teeth at home
Healthwatch England further said that when practices reopened in June, some dentists appeared to prioritize private patients over NHS patients.
And while people were struggling to access NHS dental care, Healthwatch England said, inaccurate and out of date information from NHS 111, the NHS website, and practices’ own websites often left people forced to telephone many different practices directly to try and find a dentist willing to accept them.
However, Healthwatch England also received praise for dental staff, with some practices providing videos to patients to help them understand pandemic-related processes and arranging the delivery of medications and dental repair kits to patients they were unable to see.