THE significant challenges Cornwall residents face in accessing essential dental care were laid bare in the Dental Crisis Report released on November 1 by Healthwatch Cornwall.

Findings show a lack of NHS dental availability, taking a physical and mental toll on individuals. Patients often wait over a year for appointments, with more than half unable to secure NHS dental care. Financial barriers further prevent vulnerable individuals from accessing costly private treatment, leading to worsening health issues.

Healthwatch Cornwall engaged with 1,097 members of the public and 96 dental practices to understand the experiences and challenges of local people accessing dental services in Cornwall.

The report highlights that no practices were accepting new adult NHS patients at the time of research. This has led to a surge in dental emergencies, increased hospital admissions for extractions, and dangerous attempts at self-treatment.

Underfunding and systemic problems within the NHS dental care system are identified as the root cause of the crisis. These include financial pressures on NHS practices due to the Unit of Dental Activity (UDA) payment system, difficulties in meeting contractual targets, and ineffective centralised NHS waiting list management.

As a result, many dentists are reducing their NHS commitments or transitioning to private practice. All dental practices included in this report said they have faced challenges in recruiting staff in the last 24 months.

Certain areas, particularly North Cornwall, face severe shortages in dental services, with limited public transport options further restricting access for many residents.

The dental crisis is having a ripple effect on other sectors in the NHS, placing undue pressure on GPs, A&E departments and other healthcare services ill-equipped to handle dental issues.

Meanwhile, 61 per cent of those surveyed said they didn’t know how to access NHS dental care. Vulnerable populations – such as low-income individuals, those with disabilities and residents in rural areas - were affected disproportionately, with many forced to incur debt for private care or forego necessary treatment altogether.

The report recommends several solutions to these issues, including implementing a mobile dentist service to provide accessible dental care directly in rural communities, addressing barriers to traditional services such as limited public transport.

It also suggests introducing flexible NHS contracts to target vulnerable and high-need patients on a local level; improving the management of the NHS dental waiting list; and launching a communication campaign to educate residents on dental care and services.

“Access to dental care is essential,” said Debbie Gilbert, CEO of Healthwatch Cornwall. “The Dental Crisis Report highlights a pressing issue: too many people in Cornwall are unable to access the dental care they need, facing long waits and significant costs. This lack of access affects their daily lives, including physical health and mental wellbeing.

“Healthwatch Cornwall urges local health authorities to address these challenges by prioritising funding and resources for dental services, working collaboratively to make them accessible and affordable for everyone.

“Every resident deserves the right to timely care, and we are committed to driving the changes needed to achieve this.” 

Healthwatch Cornwall is an independent health and social care champion, one of 150 around the country. It monitors people’s views on GPs, hospitals, dentists, pharmacies, care homes and other support services from Saltash to Penzance, making sure NHS leaders and other decision makers are given the feedback needed to understand care needs and improve provision.

Chris Reid, chief medical officer for NHS Cornwall and Isles of Scilly Integrated Care Board, said it was implementing a range of measures locally to address national pressures on NHS dentistry.

This includes commissioning additional urgent care and stabilisation services; operating an emergency dental service to deliver 20,000 appointments a year; an extensive schools’ dental education programme; and the Seafit Smiles at Sea scheme, offering free dental treatment for fishing communities in partnership with by Fishermen’s Mission and the Seafarers Hospital Society.

He added that a pilot scheme in collaboration with a Lostwithiel dental surgery was enabling children and vulnerable patients to access an NHS dentist and reducing waiting list backlogs.

The board is also taking part in a scheme offering a ‘golden hello’ of £20,000 to encourage dentists to relocate to areas struggling to recruit. Since July 2024, Cornwall ICB has invested £188,000 in 10 posts across Cornwall.

The First Dental Steps programmes has seen health visitors and midwives trained to give oral health care advice to families with children under two, and toothbrushes and toothpaste to families in need. It is hoped this will lead to an increase in dental access and attendance, and a reduction of poor oral health and hospital-based tooth extractions, in children aged up to two years.

“We will be working hard to develop a strategy that addresses the recommendations in the Healthwatch report – we are determined to serve our population better with access to NHS dentistry,” said Mr Reid.