The Government has unveiled a series of reforms for NHS dentistry in England, headlined by plans to pay dentists more for treating patients with urgent needs. The changes aim to improve access for millions and come alongside a radical think tank proposal for a universal £150 annual dental voucher.
Core Reforms: Incentives for Urgent and Complex Care
Under the new plans published by the Department of Health and Social Care (DHSC), dental practices will receive higher payments for providing urgent NHS care. This is designed to incentivise dentists to offer more appointments for issues like severe pain, infections, or dental trauma.
A further significant change will allow patients requiring complex treatments, such as for advanced gum disease or decay across multiple teeth, to receive a single, bundled package of care. The DHSC states this could save patients an average of £225 compared to the current system where treatment is spread across several appointments.
Shiv Pabary, chairman of the British Dental Association's (BDA) general dental practice committee, described the announced tweaks as "the biggest tweaks this failed contract has seen in its history." He cautioned, however, that while they may help in the short term, "this cannot be the end of the road" for a service needing sustainable, long-term reform.
The £150 Voucher Proposal to 'Fix Our National Smile'
Separately, a report from the think tank Policy Exchange, backed by former health secretary Sir Sajid Javid, calls for the introduction of a universal £150 annual dental voucher. The proposal aims to decisively "end the postcode lottery" of NHS dental access.
The report suggests the voucher could be used to pay for dental insurance, a capitation plan for regular check-ups, or for direct non-cosmetic treatment with any dentist registered with the General Dental Council. All registered dentists would be required to accept the voucher and to treat children at existing NHS rates.
Gareth Lyon, head of health and social care at Policy Exchange, warned that "NHS dentistry is in a truly shocking state," citing figures that only 40% of adults and 57% of children accessed an NHS dentist in the two years to March 2024. He argued the voucher system would put patients in control and incentivise early diagnosis, potentially saving the wider health system from costly hospital treatments for advanced dental problems.
Criticism and the Scale of the Challenge
The BDA firmly rejected the Policy Exchange voucher plan. Its chairman, Eddie Crouch, dismissed it as coming "with the sound of barrels being scraped," arguing it could lead to "spending more money on less access" without solving core issues of funding and reform.
The urgent need for action is underscored by stark statistics. The latest Adult Oral Health Survey found 41% of adults in England had obvious tooth decay, a rise from 28% in 2009. Using a more sensitive measure, almost two-thirds (64%) showed signs of decay in one or more teeth.
The crisis extends to children, with official data revealing up to six in ten five-year-olds in some areas suffer from tooth decay. The Government's wider dentistry recovery plan also includes measures like supervised toothbrushing for three to five-year-olds and the creation of more urgent care slots.
