NHS dentistry in England

There will be a debate on NHS dentistry on Wednesday 15 June 2026 in the Commons chamber.

This webpage provides up-to-date information about dentistry policy, prepared ahead of the debate.

The attached PDF briefing was published on 11 June 2025. It provides an overview of NHS dentistry in England, including current challenges facing providers.

How is NHS dentistry organised?

Primary care dentists (sometimes called ‘high street dentists’) are self-employed and can provide a mix of NHS and private dentistry. To provide NHS services the provider must hold a contract with the NHS. Dental services are also provided in the community, for people who cannot access high street dentists, and in hospitals.

Patients can receive treatment from any dentist because there is no system of registration for dentistry, unlike for general practice. This means that once a patient has finished their course of treatment, they are not guaranteed access to the same dentist again in the future.

Integrated Care Boards are responsible for commissioning dental services for their local area. They are accountable to NHS England.

Dental services are inspected by the Care Quality Commission as part of its role as the statutory regulator for the health and care services.

Dental professionals are regulated by the General Dental Council.

NHS dental contract

Under the current NHS dental contract, introduced in 2006, the provider agrees in advance to complete a set amount of dental activity per year, measured in units of dental activity (UDAs). Commissioners can ‘claw back’ money from providers that under-deliver and providers have little scope to provide more activity, even if they have the capacity and time to do so. This is why some patients are told their dentist cannot see them for an NHS appointment but can see them as a private patient.

The NHS dental contract has been widely criticised by professionals, unions, and all political parties. Stakeholders have argued it is inflexible and does not fairly reward dentists for seeing more complex and time-consuming patients. Some reforms have recently been made to the dentistry contract (see government activity). However, it remains based on the UDA system.

Funding

NHS dentistry in England is funded by a combination of payments from NHS England and patient charges. Some groups of patients are entitled to free dental care.

NHS England allocates funding to Integrated Care Boards based on the dental activity services provided in 2006 (when the current national contract model was introduced) rather than current need, and contracts were established without a time limit. Public Health England (since abolished) has explained that this effectively capped dental care spending.

In 2024/25, the contribution of NHS England to total funding for dental services was £2.3 billion. Accounting for the effects of inflation, NHS England’s contribution to dental services has fallen by around 16% since 2014/15. Over this period the income from patient charges fell by around 18%. This means that total funding for dental services fell by around 16% in real terms between 2014/15 and 2024/25.

In 2024/25, dental charges to patients provided around 26% of total funding. In April 2023 the Department of Health and Social Care raised dental patient charges, which had been frozen from December 2020 to April 2023, by 8.5%. A 2024 report by the Nuffield Trust, noted that increases in patient charges have been above inflation.

Dental patient charges were increased by 1.66% from 1 April 2026.

NHS dentistry workforce

NHS England publishes data on the number of dentists who carry out any amount of NHS work. In 2024/25, there were 24,655 dentists with any NHS activity in England. This was 1% more than in 2023/24 and 3% more than in 2014/15. There were 42.0 dentists per 100,000 people in 2024/25, compared with 41.9 in 2023/24 and 44.0 in 2014/15.

NHS England has published estimates of the number of full-time equivalent NHS dentists. This data should be treated with caution, but it suggests that in March 2024 (the most recent available data) there were around 10,500 full time equivalent NHS dentists in England.

It has been argued that there are enough NHS dentists in England, but not enough undertaking NHS work. This has been described as a drift towards the private sector, potentially caused by an unfavourable NHS contract.

Dentists are unequally distributed across England, with the workforce concentrated around metropolitan areas and dental hospitals and schools. Recent reports have referred to areas with low numbers of dentists as “dental deserts”.

Access to NHS dentistry How many people access NHS dentistry?

According to NHS England, in June 2025, 39.8% of adults had seen an NHS dentist in the last two years (the maximum recommended interval). 49.4% of adults had seen a dentist in the two years to September 2019; the proportion fell during the pandemic and has been around 40% since December 2022.

In June 2025, 57.3% of children had seen an NHS dentist in the last two years. The lowest level recorded was in June 2021 (32.5%). The current proportion is close to the pre-pandemic rate (59.7% in September 2019).

In 2023, the Commons Health and Social Care Committee warned that there is a “crisis of access” to NHS dentistry, with unequal access across different regions, ethnic groups and socioeconomic groups. A 2024 report by the Nuffield Trust health think tank concluded that “universal dental care has likely gone for good.”

How many NHS dental treatments are carried out?

There were 35.4 million courses of dental treatment performed in England in 2024/25. This was a 4% increase on 2023/24.

Government policy

The Labour Party's 2024 manifesto said a Labour government would:

• provide 700,000 more urgent dental appointments
• recruit new dentists to areas that need them most
• reform the NHS dental contract
• introduce a supervised tooth-brushing scheme for 3- to 5-year-olds, targeted at areas of the highest need

Dentistry contract reforms

The government has said it will deliver “fundamental reform to the dental contract” by the end of this Parliament. In summer 2025, the Department of Health and Social Care launched a public consultation for 6 weeks over proposed reforms to the dental contract. It published its response in December 2025. Some reforms required legislative change, which the government introduced in April 2026. Some reforms will be implemented from 23 June 2026. Major changes include about urgent care reforms, patients with complex needs, prevention in children, quality improvement measurements, and the dental workforce.

The government said it is continuing to engage with stakeholders such as the British Dental Association about further amendments to the dental contract.

Urgent care reforms

The government introduced contractual changes in April 2026 that mandated a proportion of contracted activity to be dedicated to unscheduled care. Unscheduled care covers those immediate conditions that require treatment in either 24 hours or up to 7 days, as set out in NHS England’s Clinical guidance: unscheduled urgent and non-urgent dental care.

The contractual changes also amend payment arrangements for urgent treatment, which was previously measured as 1.2 UDAs.

Patients with complex needs

In its consultation in 2025, the government proposed to introduce 3 new complex care pathways, paid at a set fee per pathway, for patients who meet relevant criteria of having significant tooth decay or gum disease.

In its consultation response published in December 2025, the government said the care pathways will be introduced for patients aged 16 and over. It said it will explore how to best support children’s oral health with evidence-based practice.

From 23 June 2026, the government will implement these reforms to clinical and payment structures for patients with significant tooth decay or gum disease.

Prevention in children

The consultation proposed various measures to support prevention of tooth decay in children, including:

• Introducing a new course of treatment for fluoride varnish for children, applied in between regular check-ups
• Increasing remuneration for dentists for fissure sealants (plastic coating that helps to keep food and bacteria from getting stuck between teeth and causing decay)

These changes were implemented from April 2026.

Quality improvement

The consultation proposed to introduce practice funding of £3400 per year for dental teams to participate in quality improvement activities. This could include reducing unnecessary check-ups.

Quality improvement is being introduced from 2026/27, and the government has set out further guidance on how practices can participate.

Support for the workforce

In the consultation, the government proposed to:

• enable all continuous NHS service to contribute to a person’s eligibility for discretionary support payments, such as long-term sick leave
• seek views on developing an NHS contract and minimum terms of engagement for self-employed dentists
• publish an NHS handbook for dental teams

In its consultation response, the government said all reforms would be carried forward, with reforms on continuous service being implemented from April 2026.

10 Year Health Plan

The 10 Year Health Plan for England, published in July 2025, set out the government’s aim to improve access to NHS dentistry, improve children’s oral health and increase the number of dentists working in the system by making the dental contract more attractive.

More specifically the plan sets out:

• A requirement for a “tie-in” for new dental graduates for a minimum period of NHS service of three years. This follows a consultation launched under the previous government in May 2024. In March 2026, the government said this requirement will apply to individuals entering a dental course of study from the 2027/28 academic year, and it will consult on the details of this.
• That dental therapists and dental nurses will work as part of neighbourhood teams to provide integrated and proactive care. Dental therapists will undertake check-ups, treatment, and referrals, while dental nurses would lead individual and community oral health education efforts.
• Improved dental care access for children by upskilling professionals, such as dental therapists, “to work at the top of their clinical potential beginning in 2026 to 2027”. This would build on the previously announced supervised toothbrushing scheme and expand the use of fluoride varnish and fissure sealants (which help to prevent tooth decay).
• A commitment to “improving the dental contract” in the short-term, for instance introducing payments to cover the cost of treating patients with higher needs.
• To “begin the process of more fundamental contract reform” this year.

Urgent appointments, incentive payments and funding

In February 2025, the Department of Health and Social Care wrote to Integrated Care Boards, directing them to make the 700,000 extra urgent appointments available. The extra appointments are funded from existing funding allocations. The government also confirmed it was scrapping the new patient premium (extra payments for dentists who see new patients) introduced under the previous government, after it was found not to have an impact for patients. The government is continuing a ‘golden hello’ bonus incentive payment (first introduced under the previous government), for dentists who agree to work in hard to recruit areas of the country.

The government said it was making £11 million of funding available to local authorities for the children’s supervised toothbrushing scheme from April 2025.

Former Conservative government activity

The 2023 NHS Long Term Workforce Plan, published under the previous government, set out plans to increase dentistry training places in England by 24% to 1,000 places by 2028/29 and by 40% to over 1,100 places by 2031/32. The government has committed to publishing a ten-year health plan and a refreshed NHS Long Term Workforce plan.

In 2024, a consultation was held on introducing a ‘tie-in’ for graduate dentists, that would require them to spend at least some of their time delivering NHS activity in the years after graduation. The government has not yet responded to the consultation.

In February 2024, the previous government published its plan to recover and reform NHS dentistry. Analysis by the National Audit Office found the plan had failed to deliver improvements in access to NHS dentistry.