By Neil Carmichael
The crisis in UK dentistry is worsening by the day. The Association of Dental Groups is launching a national campaign calling on ministers to take urgent action.
Few dentists are looking forward to seeing the full impact that lockdown has had on the nation’s teeth. Since the pandemic took hold, the fear is that more sugary treats, fizzy drinks and alcohol have found their way into our diets.
Dental health routines have been ignored or forgotten, say many of the UK’s dentists.
Too many people are ignoring minor symptoms such as toothache or bleeding gums and allowing them to get worse.
But while dentists are already sounding the alarm about where lockdown has left us, this is just the latest part of a bigger crisis we have been seeing in UK dentistry.
It is a crisis which is worsening by the day and the reason why the Association of Dental Groups is launching a national campaign calling on ministers to take urgent action.
Before Covid struck we were already seeing rising problems with access to dentistry.
Although the total numbers of dentists practising in the country has remained static over recent years, the number of dentists working in the NHS is plummeting.
At the same time, with an ageing population, demand from patients is higher than ever before.
In large parts of the country, it is now very hard to get access to an NHS dentist and the poorest patients are often paying the price.
We know that the crisis in dental recruitment has hit particularly hard in more deprived parts of South West, East and Northern England. In Yorkshire, just 20% of practices are accepting new NHS adult patients.
At the same time, more than 50,000 people are on waiting lists for NHS dentistry in Cornwall and the city of Portsmouth now no longer has a single dental practice accepting new NHS patients.
Since dentistry reopened in June, we have been fully committed to turning this around.
However, with Covid restrictions such as extra cleaning and compulsory time periods between seeing patients still in place the numbers of people we can physically help in any given day has fallen dramatically.
The reality is that Covid has made the situation worse and we will shortly be bringing forward new analysis that sets out just how bad it has become. At this stage, all of the signs point to a worrying picture with lockdown having led to less patients being seen and some of the most vulnerable groups being hit hardest.
Our long-term goal is attracting and training enough people here in the UK to become dentists. Currently training takes five years to complete and Covid has further complicated matters for dental students, who have not been allowed to treat volunteer patients since March.
Dental exams have been cancelled for the rest of 2020 and it is unknown when they will recommence in 2021. The likely upshot is that many current students will not be able to fully graduate to work as dentists, dental therapists or dental hygienists until the pandemic is well and truly behind us.
In the short-term, the only realistic solution to the crisis right now is to make it easier for overseas professionals to enter UK dentistry.
We now need to see an increase in recruitment of dentists from outside the UK and this is where the system itself is posing the biggest barrier.
On average over the last year, it has taken 199 days to onboard an EU dentist, even though they can currently automatically register with the General Dental Council – something that is not guaranteed to continue to be the case after Brexit.
For candidates who qualify in the Rest of the World, the system is deeply complex, requiring first the completion of an Overseas Registration Exam or Licence in Dental Surgery exam, then a Tier 2 visa and then an extended Performer List Validation by Experience process which can take up to 12 months.
It is an irony not lost on dentists that as the Government announced a new health and social care visa to attract the best overseas professionals to work for the NHS, the professional overseas registration process remains archaic and in suspended animation due to the pandemic.
Breaking the logjam
We urgently need to find ways of breaking the logjam. For example, the General Dental Council should look at how to reform the ORE and recognise the qualifications of dental schools meeting UK standards in territories outside of the EEA, in countries such as India where there is significant demand. The ADG will also be fighting for more provision in UK dental schools and more domestic training opportunities for the sector as a whole.
By implementing solutions such as these we could go some way to removing the needless obstacles to recruiting and onboarding outstanding clinicians who are trained abroad.
If that happens, UK dentists still face a tough task, but at least there will be light at the end of the tunnel. In the future, we could once again have NHS dentists out in force in Yorkshire, Cornwall and Portsmouth.
For now, we will work tirelessly to make this case to policymakers and our campaign starts today.