In Peterborough, Plymouth and other areas with the lowest NHS dental access rates, the same story is being told: people call practice after practice, only to be told the books are closed. Some join waiting lists and hear nothing for months. Others travel long distances in the hope of finding a dentist who will take them on. For those with toothache, a broken tooth or a child who needs a check-up, the search itself becomes part of the problem, adding stress to pain that needs treatment.
The phrase 'dental deserts' is used in public debate to describe areas where NHS dental care is hardest to find. Published analysis of NHS data has put Peterborough and Plymouth among the areas with the lowest adult access rates, and several South West constituencies among the lowest for both adults and children. It is not about a lack of dentists altogether. Private practices may be available, but for people who rely on NHS care, either because of cost or because they have always used it, the options can be extremely limited. The result is a postcode lottery, where where you live shapes whether you can get routine care at all.
This matters because dental care is not only about teeth. Untreated problems can worsen, leading to infection, difficulty eating and time off work or school. Children who miss check-ups may not get early advice on brushing, diet and prevention. Older people and those with long-term health conditions can face particular risks when dental problems go untreated. When routine care disappears, small problems become emergencies.
Why finding an NHS dentist has become so hard
Dentists and patient groups point to a system under strain. NHS dental contracts, funding pressures and workforce shortages all play a part. Some practices say the current arrangements make it hard to take on large numbers of NHS patients while covering the costs of staff, equipment and premises. Others have reduced their NHS work or moved fully to private care, leaving fewer places for NHS patients in their area.
Recruitment is another factor. In rural and coastal towns, practices can struggle to attract dentists, especially where transport links are limited or where there are fewer opportunities for a dentist's family. Urban areas are not immune either. In some cities, demand is so high that practices fill their NHS lists quickly and then close them, leaving new patients with nowhere to go.
The pandemic added to the backlog. Practices closed or worked at reduced capacity for a period, and routine appointments were delayed. Catching up has proved difficult, because dentists must balance urgent cases, routine check-ups and new patients within limited surgery time. For patients, this often means that even practices that once took new NHS patients now say they cannot.
Information is part of the difficulty too. Lists of practices taking new patients can be out of date, and patients may spend days calling numbers that lead nowhere. Some are told to keep checking back, without any clear sense of when a place might open. For people in pain, that uncertainty is hard to bear, and some give up looking altogether.
The impact on patients
For patients, the consequences are practical and personal. A person with toothache may rely on pain relief while waiting for an appointment, sometimes for weeks. If the pain worsens, they may turn to urgent dental services, a GP or even hospital emergency care, none of which is designed to replace regular dentistry. Others try to manage the problem themselves, which can make it worse.
Cost is a major barrier when NHS care is unavailable. Private treatment can be far more expensive, and for families on tight budgets it may simply be out of reach. Some people pay for a single private appointment to deal with urgent pain, then go without routine care afterwards. Others borrow money or delay treatment, hoping the problem will settle, though dental problems rarely resolve on their own.
Children are particularly affected. Parents who cannot find an NHS dentist for their child worry about check-ups, fillings and prevention. School nurses and health visitors often hear these concerns, but they cannot create appointments where none exist. In some families, children have never seen a dentist, not because parents have not tried, but because no practice would register them.
Older patients face different challenges. Travelling to a distant practice can be difficult for those who do not drive or who rely on public transport. Denture problems, gum disease and mouth pain can affect eating, speech and confidence, yet the journey to care may itself be a barrier. Carers also report difficulty finding dentists willing to visit care homes or treat patients with complex needs.
The emotional impact should not be underestimated. People describe embarrassment about the state of their teeth, anxiety about pain, and frustration at a system that seems closed to them. Some avoid smiling or eating in public. Others feel they are being blamed for a problem they tried hard to solve, when the real issue was access, not effort.
What dentists and practices say
Dentists themselves often express frustration. Many entered the profession to provide NHS care and want to help more patients, but say the current system limits how many they can take on. They point to rising costs, difficulties recruiting dental nurses and hygienists, and the time needed for complex treatments that may not be reflected in funding arrangements.
Some practices have tried to help by running waiting lists, offering advice by phone, or prioritising urgent cases. Others work with local health services to signpost patients to urgent care when needed. But dentists say these measures can only go so far without wider change, and that patients need a clearer, fairer system for finding and keeping an NHS dentist.
What needs to change, and what patients can do now
The British Dental Association (BDA), which represents dentists, has argued that fundamental reform of the NHS dental contract and fairer funding are needed so practices can take on more NHS patients — including clearer information about which practices are taking NHS patients, faster routes to urgent care, and support for practices in areas with the greatest need. Some argue for changes to dental contracts so that practices can afford to take on more NHS patients, while others call for targeted recruitment in towns and rural areas where shortages are worst.
Local health leaders face difficult choices. They must balance funding across many services, from hospitals to mental health to dentistry, and dental budgets compete with other pressing needs. But patient groups argue that investing in routine dental care saves money and suffering later, by preventing emergencies and hospital visits.
For patients searching now, advice services suggest a few practical steps. Keep a record of practices contacted, ask to join waiting lists where they exist, and check official directories regularly, as availability can change. Those in pain should seek urgent dental help rather than waiting, and parents should keep asking, even when the search feels endless. None of this replaces a working system, but it can help in individual cases.
The wider question is whether access to an NHS dentist will be treated as a basic part of healthcare, available wherever people live. Until that happens, dental deserts will remain a stark example of inequality in health care, where a routine check-up depends less on need than on postcode.