Persistent ‘dental deserts’ risk deprived and rural communities being left behind

No local authority area in the country has more than one dentist providing NHS treatment per 1,000 people, with rural areas more likely to have fewer NHS practices, according to new research by the Local Government Association (LGA).

Using data published by NHS England, the LGA found that an uneven distribution of NHS dental practices in England is leaving many communities struggling to access treatment, particularly in rural and deprived areas.

The findings reveal the ongoing crisis of so-called ‘dental deserts’ – areas where dental practices offering NHS services are scarce.

People living in areas with the poorest health outcomes in England are less likely to find an NHS dentist in their area than those living in areas with the best health outcomes, the analysis found.

This suggests that demand is outstripping supply in communities that need it most.

In Middlesborough, for example, there are just 10 NHS dental practices per 100,000, despite having one of the highest levels of deprivation, compared to Richmond upon Thames with 28 per 100,000 people and one of the lowest deprivation levels.

The analysis – Dental Deserts: An analysis of active dental practices offering NHS services across local authorities in England and Wales –also found that, despite an obvious need, areas with higher rates of child dental decay do not have more NHS dentists than areas with lower rates.

The LGA warns that a persistence of unequal access to NHS dental care is deepening health inequalities and it is urging the Government to introduce targeted policy responses to improve provision in the most-underserved areas.

Councillor Dr Wendy Taylor, chair of the LGA Health and Wellbeing Committee, said: “This new report highlights that there is still a shortage of affordable dental treatment in all communities across the country, particularly rural and more-deprived areas.

“We know that poor dental health can significantly impact overall health outcomes, including increasing the risk of cardiovascular disease.

“Equal access to NHS dental services is vital for every community to ensure all residents have the same opportunities to look after their health.

“It is encouraging that the Government is taking steps to improve dental access, such as expanding provision and investing in community dental services, but it is also vital that the current dental contract is reviewed to make NHS dentistry more viable.

“There is still more to do to ensure equitable care for all communities.”

British Dental Association chair, Eddie Crouch, added: “For millions, NHS dentistry has effectively ceased to exist, especially among those who need care the most.

“The Government can save this service, but that will require real ambition underpinned by sustainable funding."

The research found the mean number of active dental practices offering NHS services per 100,000 people in an English and Welsh local authority was 16 and the median was 15.

The English local authority with the least NHS dentists per 100,000 people was Thurrock with 10; and the most-deprived English local authority with the least dentists per 100,000 was Blackpool with 12.

What is the solution to dental deserts?

On 18 June 2025, the Association of Dental Groups (ADG), the trade body representing NHS, private, and community-based services, published its Creating Dental Oases – the Solution to Dental Deserts white paper, which examined the key issues behind the dental crisis and how shoring up the total dental team is the solution.

In 2022, The ADG launched its first report into the dental workforce crisis, identifying and coining what it called ‘dental deserts’, areas of the country where patient access to a dentist is almost impossible.

And earlier this year the ADG presented its follow-up report offering solutions.

The priority intervention, it says, needs to be reform by the General Dental Council (GDC) to allow trained dentists from overseas to practice in an effort to to shore up the massive gap in the dental workforce – currently a shortage of 2,700-plus.

“There are approximately 6,000 trained international dentists – many already in the UK – on the waiting list to get through the overseas registration exam’s (ORE) bottleneck, which only allows for 600 candidates per sitting,” the ADG said.

“The numbers speak for themselves: a gap in the workforce of 2,700 with 6,000 trained international dentists in the exam’s queue. This is crazy!”

Government policy

In the recently-released NHS 10-Year Health Plan, the Government laid out a series of policy changes and updates to address the issue of dental deserts, particularly the difficulties with recruiting dentists, plans which have received a mixed reaction in the sector.

The policies include:

• New reforms to the dental contract to prioritise those with urgent and complex needs, with new measures for those with extreme tooth decay and gum disease 
• A commitment to deliver 700,000 additional urgent dental appointments every year, and a pledge to ramp up preventative care for children’s dental health
• Plans for newly-qualified dentists to be mandated to work in the NHS for a minimum period, intended to be three years

Health Minister Stephen Kinnock said: “We inherited a broken NHS dental system that is in crisis. 

“We have already started fixing this, rolling out 700,000 urgent and emergency appointments and bringing in supervising toothbrushing for three to five year olds in the most-deprived areas of the country. 

“But, to get us to a place where patients feel NHS dentistry is reliable again, we have to tackle the problems in the system at their root.

“These reforms will bring common sense into the system again, attracting more NHS dentists, treating those with the greatest need first, and changing the system to make it work.”