England’s worst dental blackspots revealed, with patients pulling out own teeth

Patients across England face a postcode lottery for NHS dental care, with many travelling miles to get an appointment and some even resorting to pulling out their own teeth.

Access is getting “worse” across large swathes of the country, the British Dental Association (BDA) has warned, with dentists leaving the NHS in their droves.

Those that do stay are flocking to big cities. It means that NHS dental treatment in rural and coastal areas is under acute stress, with huge numbers of patients struggling to be seen.

The Somerset Integrated Care System (ICS) – meaning the local health and care region – faces the most intense access issues, with nearly half of patients unable to book an appointment over the last two years, the 2025 GP Survey suggests.

Just 56 per cent of people were able to get an NHS appointment, according to the data.

Among those who were unsuccessful, 16 per cent said it was because no appointments were available, 20 per cent said it was because the dentist was not taking new patients, and 14 per cent gave another reason. Respondents could select more than one reason in the survey, meaning the percentages do not necessarily add up to 100.

In contrast, 89 per cent of patients were able to book an appointment in the Coventry and Warwickshire ICS over the last two years, suggesting that just 11 per cent were unable to find one.

The survey shows patients also struggled to access NHS dental care in Devon, Cornwall, Norfolk and Waveney, and Cambridge and Peterborough.

Patients travel from Cornwall to Birmingham for dentist

Eddie Crouch, chair of the BDA, said that while there are “huge areas where dental deserts do exist, there is sand in most parts of the country”. With dentists opting to work in big cities, rural and coastal areas are left with a lower ratio of people to dentists.

“The number of dentists actually providing NHS work has either diminished or stopped altogether. Many of them are sitting on long waiting lists for the available NHS provision that’s there.

“It’s really, really difficult for those practices in those areas to recruit and retain staff to deliver the NHS contracts, and it means that many of the population are having to travel large distances to actually seek care out of area, or even returning to where they may have previously lived.”

Patients have been known to travel more than 150 miles in a round trip from Cumbria for dental care, he said. Others who have retired to Cornwall continue to travel back to their former NHS dentist in Birmingham due to a lack of local NHS provision.

Toothless in England, a grassroots group campaigning for universal access to an NHS dentist, said the “postcode lottery” leaves people “in pain, having to travel long distances, pay privately – often [unaffordable] – or go without care altogether”.

Patients in “deprived and rural” areas are often the worst hit, with parts of the South West, Lincolnshire, Norfolk, Middlesbrough or Blackpool facing “significant barriers to getting an appointment”, said the organisation’s founder, Mark Jones.

“The NHS dentistry crisis has reached a breaking point, with millions of people across England enduring unbearable pain, preventable extractions, and desperation simply to access basic care.”

He warned the problem “remains acute and in many areas is persistent or worsening” because of underfunding of the NHS dental contract, an exodus of dentists from the NHS and an uneven distribution of dental practices in deprived, rural and coastal communities.

Patients taking out own teeth

Dr Sejal Bhansali, a dentist at Northwick Park Dental in London, said she has seen multiple cases where patients have “taken out their own teeth” because they were in pain and had been unable to get an NHS appointment for up to a year.

But they are putting themselves at a higher risk of infections, as well as other long-term health issues.

Dr Bhansali, who does both NHS and private work, said the crisis is “getting worse” because many NHS dentists are “giving back their contracts”.

If a dentist has not completed all of their contracted NHS hours by the end of the financial year, they may choose to hand the contract back to avoid being penalised. But once a dentist leaves the NHS, it is a long process to get back on the register.

The BBC reported last week that more than £900m has been handed back to the Government for unfulfilled NHS care over the last two years.

It comes as the NHS has outlined new plans to clear backlogs, with 50 more undergraduate training places in dental deserts and an expansion of exam capacity to allow 2,400 more overseas-trained dentists to be registered annually by 2028 to 2029.

The BDA said the Government’s plans do not go far enough, branding the 50-place expansion “quite pathetic”.

Rebecca Curtayne, head of policy and public affairs at Healthwatch, welcomed plans to get dentists who trained overseas registered more quickly, but warned that this “does not automatically mean that they will go straight into the NHS”.

She said that recruitment is “not the only answer”, adding that an overhaul is needed to the NHS dental contract to make it “attractive enough to the existing and experienced workforce”.

The Government has indicated that wider dental contract reform is on the way, but no timescale has been provided.

NHS North East and North Cumbria Integrated Care Board (ICB) said the reasons behind the access issues include difficulties recruiting and training dentists, with many struggling to afford the cost of delivering NHS services.

Improving access is a “key priority”, NHS Devon said, with work is underway to increase the number of NHS appointments and urgent dental care sessions available, and retain more dentists in the area.

NHS Somerset said three new practices have opened to give 20,000 more people access to care, with the number of urgent care appointment rising.

NHS Cornwall and Isles of Scilly said a mobile dental van is providing thousands of additional appointments, adding that it is working with local practices to recruit and retain dentists.

Cambridge and Peterborough and Norfolk and Waveney have been contacted for comment.

The Department of Health and Social Care said: “We have taken action over the past 20 months to stop the rot and rebuild NHS dentistry, but we know that progress has not yet been felt evenly across the country.” The spokesperson added that 1.8 million additional courses of NHS treatment had been delivered, with nearly £400m reinvested back into NHS dentistry for more appointments and treatment.