Written evidence submitted by Caroline Lucas MP (DTY00061)

I noted your current call for evidence for your important inquiry into access to NHS dentistry.  I have received several alarming cases over recent months, including more and more constituents saying they cannot access NHS dentistry for their children.   On noting your inquiry, I issued a general call to constituents with children to contact me with their experiences of accessing NHS dentistry in Brighton Pavilion.  The situation remains dire.

As you will note, the first is a deeply concerning case of a vulnerable adult being unable to access the treatment they need.  The other examples are largely concerning children and NHS treatment, although many of the parents also need, but cannot access, NHS dental treatment.

I hope that this testimony from constituents is helpful background for the Committee.  I have been working with our local Healthwatch on this issue and there is clearly a very serious problem - an urgent plan is required to address this totally unacceptable and counterproductive state of affairs. 

NHS principles should apply to essential dentistry, it should be free according to need and paid for via progressive taxation.  The current model is clearly failing both adults and children - we need a system that is capable of ensuring that everyone can access NHS dental treatment. 

I am hoping that you could be the person who could help me with a very distressing problem.

My daughter, xxx lives in your Brighton constituency.

xxx has Downs Syndrome and is [adult years] old.  All her life she has worked hard at looking after her teeth and I have taken her to the dentist every six months.  Her teeth have not grown normally, some teeth have never formed, and one is lying sideways in her gum and will probably not move now.  Eight years ago, I saved up four thousand pounds to pay for her to have two implant teeth put in place and hoped that would set her up for life.  However, recently three of her perfectly sound teeth have just fallen out, they were very small with no proper roots, she is now not able to eat properly.

Her NHS dentist says that she cannot do any implants for xxx as the work needed is too complicated and a false teeth plate will not work for her. Her dentist has written to a London NHS hospital to ask the experts there to do the work that xxx needs, but they say that they cannot take on any more work as their lists are full for years to come.

I have gone back to the private implant specialist who did the work for xxx eight years ago, but the cost will now be impossible for me to find.  I am [xxx] years old and living on a pension.

If this work was surgery on her body that xxx needed, and the NHS could not do it, they could send her to a private hospital paid for by the NHS.  Is it at all possible for you to ask the NHS to fund this work with a private specialist for xxx?  I do not want to make her situation public and open to publicity in the press.  Or have to go begging from a public funding campaign.  xxx has lived a very happy semi-independent life in Brighton for 25 years. She works at three voluntary jobs in the community.  She is well worthy of some help with this problem.

17.1.23

My daughter was de-registered from our NHS dentist because we hadn’t been for a few years – because of COVID.  Really annoying because they weren’t doing standard check-ups, but only urgent ones during Covid!!

I contacted lots of dentists with no luck – but found a lovely dentist on New Church Road.  He’s been very good actually.  My daughter is autistic, so I needed a gentle dentist and he was.  I also managed to sign up too, which was great because I’m diabetic and was struggling with bleeding gums – I can’t fault the dentist once I found one.  He sent me over for a periodontalist/dental hygiene appointment for free on the NHS – she did a great job and my gums have now stopped bleeding.  She actually said that my gum issues could have been causing the diabetes – so it really is important to have good teeth and checked up properly. 

We also had a problem getting my partner a dentist.  His teeth were in a terrible state.  He had to go privately (slightly reduced rate as on Universal Credit).  He needed 14 teeth fixing, with fillings etc!!  We couldn’t afford it all and requested (begged) to go over to NHS as we were on UC – thankfully they did - but it took persuasion and a wait!!  He has ADHD and potentially autistic too, so needed my help to advocate for him.  He had not managed to find a dentist until I stepped in to help him, as I didn’t realise how bad his teeth were until he was in a lot of pain.  He had to pay £500 for the first lot of teeth and the rest were going to cost over £1,000 without the NHS.  So all in all lucky I helped advocate for him otherwise he would have been in a terrible mess.

17.1.23

In response to your post on Facebook in relation to finding an NHS dentist for children within the Brighton area, I have a 16 month old who I tried to sign up early in anticipation of waiting lists. The only option I was able to find was one dentist who said they would be able to sign my daughter up if one of us paid monthly for ourselves. My mum has ended up paying a monthly subscription for herself in order for my child to be registered.

I also found when I was pregnant (I ended up with an infected wisdom tooth) I was unable to find a single NHS dentist appointment and in the end was told to call 111.

Hoping the situation can improve.

17.1.23

I could not get a dentist for my sons. My ex husband eventually managed to get them a space in another county. I am still without a dentist and can't afford private care and this is a worry of mine.

Are you able to help please?

I have called all dentists on list who are supposedly taking on new nhs patients, but in reality, none are.

16.1.23

I live in Preston Park and last year I was unable to get an appointment for my son at his registered dentist, Bupa Dentalcare at Fiveways on Ditchling Road because I was told his NHS dentist had left the practice and they were struggling to recruit. My son was 13 years old at the time and on the list for orthodontic treatment. This meant that they were unable to make an appointment for a check up for him and I was told we would have to wait until they had recruited and to call back - with no idea of a timeframe. I was told that if I wanted an NHS appointment it would have to be for an emergency only or I could pay for him to be treated privately. 

When I questioned about other NHS dentists at the practice I was told that they couldn't just transfer my son to another dentist. This was all very stressful and felt like stealth tactics to get him off the NHS list and into private care. I had already heard about these sorts of stories from other parents in the area and I wasn't prepared to accept this as a response and potentially end up paying for his treatment. I persisted and called back the dentist a couple of weeks later and pressed the point. Eventually I got him an appointment but he was delayed in starting his orthodontic treatment by a few months. It took a full year to get his first appointment with an NHS orthodontist following his referral.

I've also had a couple of comments from the orthodontist that have not felt completely genuine and like a lead in to finding a reason to get my son onto a private treatment list e.g. they have so far only put braces on his top teeth to 'see how he goes'... Of course they know that once the braces are on, we will want his teeth treated completely, top & bottom and will be invested in it and therefore perhaps more prepared to pay. I am resisting at all turns but it feels like we have to be on your guard at all times.

16.1.23

We moved to your constituency in December. I spent some time looking online but only found one dentist that appeared to be taking NHS patients. But after a month, they still haven't replied.

17.1.23

I am getting in touch to give you feedback regarding getting registered in dental practises let alone appointments.

I was with my dentist since 2004 with my son and there was an issue seeing a dentist when we needed it.

This changed completely in the past year or so.

I had an abscess which I had to treat myself, but before this I had terrible pain in my tooth. I have not been able to chew on that side properly for over a year.

My son now 24 has a wisdom tooth growing facing the wrong direction but isn’t also able to get seen. He too has been suffering for some time.

When we move on to GP’s - I am with the Pavilion practise, it takes weeks before you can be seen.

The fact is, we are working hard and paying our NI without fail, it would be interesting to know how much money is generated by the UK citizens through NI and after this money is divided what proportion is left on the pot for the NHS.

What is the government going to do about tackling this backlog?

As we learnt in the pandemic people can be trained fast to take on some low level procedures. I worked on the Covid project as a frontliner from 2020 until 2022 when the government chewed us out without a penny to survive. I am still yet to secure a job due to the temporary roles and short term 3-6 month FTC contracts, this is all I mostly find.

Everything is just so bleak but we should be in pain on top of the misery tbag life is right now.

16.1.23

Our story is quite mundane, but very happy to share it - essentially, my daughter is under a year old, her teeth are coming in and as per NHS recommendations we wanted to get her seen by a dentist so she can start getting used to the experience, rang 5 or 6 local (ish - a few would have been drives away) places, none of whom taking NHS patients so we had a look on Facebook and it seems to be the case that most people couldn't find a place, or those who had were told they'd been lucky/got the last place etc. And these were often again drives away, despite there being a million private dentists in the area in very walkable locations.

16.1.23

My daughter has been on the NHS waiting list for our nearest dentist since 2017. 

Occasionally people post on the facebook community board about a new dentist opening up that are taking on NHS patients but these dentists are usually miles away (there was one in Shoreham apparently).

Last time I called around was about a year ago when my daughter needed a root canal, I called between 8-10 before giving up and going private. Private cost nearly £1k and I had to use my credit card to pay.

Now my daughter needs 4 teeth removed in order to have a brace fitted and I have been quoted just under £600. I am a single parent and although I work full-time there is no way I can afford this.

I've had a hole in one of my back molars for over a year and have had to ignore it. 

24.1.23

My 16 year old son has been deregistered by Fiveways BUPA dental practice because, admittedly, I have not maintained his regular check ups during/since the pandemic. 

But to do so without even an email reminder that this would happen makes me angry.   The same practice seems well able to keep sending me plenty of communication regarding private services provided by BUPA that I might be interested in as a private patient despite me also not having attended for a few years.

26.10.21

I am a local teacher with 3 children.

I have just been told by our NHS dentist that she is no longer seeing NHS patients,  I have phoned the helpline to find out there are no dentists in Sussex taking on NHS patients.

I am absolutely appalled.

From a longstanding NHS dental practice manager

23.1.23

I would like you to be aware that dental surgeries aren't allowed to prioritise children over adults. 

The access issues that are affecting all surgeries (mostly lack of dentists since Brexit and covid) are across the board not specific for children.

I tried to only accept new child patients for a while as the access need was high and because generally they would need less treatment than adults and their appointments are quicker, it seems like an obvious way to ensure they can be treated while we have an issue recruiting new dentists to replace the ones that have left.

Because of the way the NHS banding system of payments is, you get paid the same for an adult or a child and are therefore not allowed to prioritise children as it looks like you're trying to maximise UDA for less work (I assume this is the reason)

There should be a better system in place at least in the short term as we are seeing a lot of children who have never been to a dentist or haven't for a long time due to covid closures and then access problems.

Jan 2023