Key Points
- Nearly a third (32%) of people in England used private dentistry late last year, up from 22% in 2023, according to Healthwatch England.
- Poorer households facing financial struggles saw private usage nearly double from 14% to 27%, forcing them into costly treatments like fillings and extractions.
- Private check-ups cost £64 versus £27.40 on the NHS, creating a “double penalty” for low-income patients, pregnant women, and new mothers who miss free entitlements due to access shortages.
- Healthwatch England warns of a shift to “one-tier” private-only dental care, with vulnerable groups hit hardest by NHS appointment shortages.
- Survey of 2,593 adults conducted October-November 2025 informs Healthwatch’s annual report; acting head Rebecca Curtayne calls for universal NHS dentist rights like GP lists.
- Healthwatch England faces abolition under Health Secretary Wes Streeting’s NHS reorganisation.
- Competition and Markets Authority (CMA) launches review of £8bn private dentistry, noting 29% exclusive private use in England 2023/24 and price hikes (e.g., check-ups up 14% to £55).
- Dentists returned £900m to NHS for unmet contracts, highlighting systemic failures; Rebecca Curtayne notes many cannot access NHS care or find dentists switching to private.
- British Dental Association (BDA) blames inadequate NHS funding and contracts; Shiv Pabary warns of extinction without reform.
- Department of Health and Social Care (DHSC) defends actions: 1.8m extra treatments in early 2026, contract reforms from April 2026 prioritising urgent care and prevention.
- NHS stats: 18m adults seen in 24 months to March 2025 (40% population), 73m units of dental activity (UDAs), down from pre-Covid.
- Over 21% NHS dentist vacancies as of March 2024, leading to half a million lost activity days.
England (Britain Today News) March 9, 2026 – Healthwatch England has revealed a sharp rise in private dentistry use amid the ongoing NHS dental crisis, with almost a third of people in England now turning to paid services. The statutory patient watchdog’s survey shows the proportion jumping from 22% in 2023 to 32% late last year, as scarcity of NHS appointments forces households, especially poorer ones, into expensive private care. This trend risks creating a “one-tier” private-only system, disproportionately affecting the vulnerable.
The findings stem from a representative poll of 2,593 adults conducted last October and November, set for inclusion in Healthwatch’s annual patient experience report later this week. As reported by Rebecca Curtayne, acting head of policy, public affairs and research at Healthwatch England, in The Guardian,
“Our findings are a warning that for some people there’s only one-tier dental care – private.”
She added,
“It’s the most vulnerable people in our society who bear the brunt of the ongoing shortage of NHS dental appointments. Too many people on low income are being forced into private care they struggle to afford, or are going without treatment altogether. The system is failing those who need it most.”
Why Are Poorer Households Hit Hardest?
The percentage of financially struggling individuals using private dentistry has almost doubled from 14% to 27%, according to Healthwatch England. These patients face a “double penalty”: higher private fees and missed free NHS entitlements. For instance, a check-up costs £64 privately but only £27.40 on the NHS, while low-income groups, pregnant women, and new mothers often cannot find NHS providers despite eligibility.
Rebecca Curtayne reiterated this in comments to The Express, stating these figures
“echo what we hear from individuals nationwide—many are unable to secure an NHS dental appointment, and others discover their dentist has ceased providing NHS services altogether, now exclusively offering private options. The consequences are most severe for those already in vulnerable situations, particularly financially strained individuals, who find themselves without options under a dental contract that is simply inadequate.”
The Canary reported that poorer people are disproportionately pushed into private care as NHS access remains insecure.
What Do Recent NHS Statistics Reveal?
NHS dental activity lags behind demand, with 35.4 million courses of treatment in 2024/25, up slightly but down 10% from pre-Covid averages of 39.6 million. Only 39.8% of adults were seen in the two years to June 2025, and 18 million adults (40% of population) in 24 months to March 2025. Child access stands at 57% in the year to March 2025.
Just 73 million UDAs were delivered in 2024/25, a less than 1% rise. The British Dental Association noted in The Probe that these figures underline urgency, with capacity trailing pre-Covid norms. Over 21% of NHS general dentist positions were unfilled by March 2024, equating to nearly 500,000 lost activity days. Healthwatch data shows over half (2025 sample) struggle for NHS treatment, up from 41% in 2023, though 44% accessed without issues (vs 26%).
How Has Private Dentistry Usage Evolved?
Private reliance has surged: 36% turn private due to no NHS access, 31% for speed, 25% as practices drop NHS. CMA data shows 29% adults used private exclusively in England 2023/24, lower than Healthwatch’s 32%, with UK-wide 1 in 5 in 2024. Prices rose: initial consultations +23% to £80, check-ups +14% to £55 (2022-2024).
The CMA launched a market study into the £8bn sector on March 4, 2026, seeking views on access, competition, and hikes; CEO Sarah Cardell noted for many it’s necessity, not choice. BDA argues NHS underfunding subsidises losses with £400m annually, pressuring private prices.
What Are Dentists Saying About the Crisis?
Dentists warn NHS dentistry risks extinction without funding hikes and contract overhaul, per Independent coverage. Shiv Pabary, BDA General Dental Practice Committee chair, told MSN the April 2026 changes are significant but not final:
“This cannot be the final solution. We require a response that matches the challenges we are facing, to ensure a viable future for NHS dentistry.”
He previously urged Chancellor Rachel Reeves:
“The future of NHS dentistry rests in the hands of [Chancellor] Rachel Reeves,”
citing costs and NI rises.
£900m was returned for unmet contracts (2025 data), with NHS England reinvesting; an spokeswoman called it “a year behind reality.” Talking Up Scotland noted England’s half-Scotland’s NHS access levels.
What Is Government Doing to Respond?
A DHSC spokesperson told The Guardian:
“This report highlights that government inherited NHS dent service that been neglected for over a decade. We firmly believe that everyone should have access to care, just those can afford. We have taken swift action to address this issue, providing 1.8 million treatments in first seven of this, with a focus on benefiting children and the most deprived communities. We are also reforming the dental contract to treat more patients and emphasize preventative care. Our goal is to eliminate the two-tier system and make dental care accessible to all.”
Contract quality/payment reforms implement April 2026, redirecting £4bn budget to needs, easing urgent access per National Health Executive. Health minister Stephen Kinnock called it “the first step towards a new era,” preventing escalations to hospitals. Rebecca Curtayne urges ministers grant everyone NHS dentist rights akin to GP lists.
Why Is Healthwatch England Facing Abolition?
Healthwatch, NHS patient champion, is among 201 bodies axed in Wes Streeting’s “bonfire of quangos,” saving £250m+ annually, announced June 2025. Streeting deems the system “too complex,” aiming for “more doers and fewer checkers,” amplifying patient voices via apps. Critics fear lost feedback; Curtayne’s warnings come amid this shift.
What Lies Ahead for NHS Dentistry?
Reforms promise urgent slots from April 2026, but BDA stresses short-term rescue needed. CMA review could address private competition. Unmet need hit 13m adults (28%) per BDA 2024 data. Poorer households’ plight underscores urgency for equitable access.
