Large numbers of people are going without dental treatment and some even report extracting their own teeth because they cannot find an NHS dentist in their area, a survey reveals today.
The Dentistry Watch survey of more than 5,000 people, from the Commission for Patient and Public Involvement in Health, found widespread unhappiness among both patients and dentists despite government reforms to increase the availability of NHS dentistry. More than three-quarters of those who have a private dentist consider they were forced into it because their own dentist went private or they could not find an NHS dentist.
Just over 10% were not registered with a dentist at all. A third of those (35%) said there were no NHS dentists nearby, 22% said they did not know how to find one, 13% said they were on a waiting list and 30% said there were other reasons.
But 6% of the respondents said they were self-treating, which often included pulling out their own troublesome teeth. "Fourteen teeth have had to be removed by myself using pliers," said one Lancashire respondent. "Have pulled teeth out before, easier than finding a dentist," said one in Hull. "Because I could not afford the treatment cost, I had to extract my own tooth on one occasion," said one in Harrow. "I took most of my teeth out in the shed with pliers. I have one to go," said another in Wiltshire.
Some of the respondents show considerable ingenuity. "Filled own teeth - clove oil and Polyfilla," said one in Essex. Another fixed a crown with Superglue and a third used a screwdriver to scrape off plaque.
The survey was carried out by Patient and Public Involvement (PPI) Forums around England. It was triggered by complaints received by PPIs following a new contract for dentists in April 2006, which was supposed to increase access and simplify the charges levied on NHS patients.
Almost half the 5,212 respondents said they did not understand the charging system and 20% of those with NHS dentists went without treatment because of the cost. There are three treatment bands - £15.90 for a basic examination and x-rays, £43.60 if treatment such as root canals is also carried out and £194 if construction work such as crowns is included. In August the Department of Health announced a drop of 50,000 in the numbers attending an NHS dentist, to 28 million. It also said there had been a shortfall in the expected revenue of £159m as a result.
Most (84%) of the 750 dentists surveyed said the contract had not made it easier for patients to get NHS treatment and 45% said their practice was not taking new NHS patients. A majority (68%) had either reduced or kept the same number of NHS patients as the year before.
Fixed charging bands meant dentists were better off if they treated people who needed less work, they said. "If one orange costs 10p, then 10 oranges cost £1. BUT if one filling costs £43.60, ten fillings cost £43.69. RUBBISH," wrote one dentist in Sheffield. "There is no incentive in the contract to take on new patients who often have high needs. I feel the contract discriminates against people who probably need me most," wrote another.
Norman Lamb, Liberal Democrat health spokesman, said: "Eight years after Labour promised that everyone would have access to an NHS dentist, this survey shows the system is at breaking point."
