Dental care crisis in Wales: Llais calls for urgent action to ensure fair access for all

Access to NHS dental care in Wales is in crisis. One-third of people we heard from were unable to find a dentist or were stuck on lengthy waiting lists.

Children, older adults, disabled people, and low-income families face the most challenges getting essential dental services.

Llais, the citizen voice body for health and social care, has released its position statement on the Welsh dentistry crisis after hearing from over 12,000 people across Wales about their health and social care issues, with dentistry consistently coming out near the top.

Latest figures from Welsh Government show that there were less NHS dentists per person in 2023-2024 than in previous years.

• Over a third of people they spoke to about getting to see dentistry services were not registered with a dentist or were on a waiting list.
• People are travelling further to access NHS dental care with many forced to pay more by turning to private dental care.
• People feel the quality of care available on the NHS is worse than private dental care.
• The current situation is inequitable with those losing out being children, older people, pregnant people, disabled people, those with additional learning needs and those on a lower income.

The effect on people:

Llais heard some distressing comments from people struggling to receive dental treatment, such as:

"I've always been proud of my teeth but now use temporary shop bought filling material. It's very, very upsetting. And has knocked my confidence to talk to people"

"I am in sheer agony and keep getting infection after infection as my teeth are crumbling, but no one is willing to help me because the amount of work that needs to be done. So daily I stay at home in pain and ashamed."

Llais wants clear action to be taken in some key areas:

• Promote: make sure people know about and can easily register on the new NHS dental waiting list once it is launched to help make access easier.
• Update: make sure people know about what's being done to make access to NHS dental services easier and quicker, the difference it's making and what else is planned.
• Provide: clear advice and information for people on how to take care of their teeth
• Research: Conduct targeted research to address barriers for underserved groups in accessing dental care.
• Workforce: Train and retain more NHS dentistry staff here in Wales, especially for children and those with additional needs, to improve care.

Llais Chief Executive, Alyson Thomas said:

"More urgent action is needed to tackle the difficulties people continue to face getting to see a dentist, whether that's to help them to keep their teeth healthy or to get treatment when there is a problem. We know that work is underway to make things better, but progress is too slow.

"We will continue to work with health services and others so that the experiences we heard through our work drives the improvements in dental care everyone living in Wales deserves."

Responding to the findings, a Welsh Government spokesperson acknowledged the issues raised, stating:

"Access to NHS dentistry is still not where we or the public want it to be. Since September 2023, we have been working with the NHS and the British Dental Association to negotiate a new dental contract for Wales. We will soon begin engaging with the wider profession to consult on proposed changes."

The spokesperson emphasised that the new contract will focus on prevention, quality, and access, aiming to improve public access to NHS dentistry while also enhancing working conditions for dental professionals. Additionally, steps are already underway to address these challenges, including introducing a variation to the current contract that prioritises prevention and needs-based care over routine six-month check-ups. This shift has:

Allowed over 384,000 new patients to access routine NHS dental care since April 2022 and over 118,000 to receive urgent care since April 2023.

In response to recommendations from the 2023 Senedd Health and Social Care Committee inquiry, the Welsh Government has also developed a digital all-Wales Dental Access Portal to provide a fair and equitable system for people to register interest in routine NHS dental treatment. The portal, piloted in Powys, is expected to be available nationwide by the end of November.

To discover more about the work of Llais, visit www.llaiswales.org or contact 02920 235558.

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