Our position on access to dentistry in Wales

What did we do?

From April to September 2024, we heard from over 12,000 people. Almost every month, one of the biggest problems we heard about was how hard it is to get an appointment with an NHS dentist.

A recent report from the Welsh Senedd said that getting dental care in Wales is a serious problem, but they were unsure just how bad the situation is.

To learn more about people’s experiences we asked ACCESS, an independent research consultancy, to research people’s experiences of dental care in Wales.  
We used what we learned from this research along with what we hear through our open listening, regional engagement activities and engagement through national events over the Summer including National Eisteddfod, Royal Welsh, and Pride to produce this statement.

What we have heard

Difficulty getting dental care

Lots of people told us it’s really difficult to get an appointment with a dentist. Over 33% of the people we talked to didn’t have a dentist or were stuck on a waiting list. Even the people who had a dentist said they struggled to book an appointment.  Some had to fix their teeth themselves because they couldn’t get proper care.

A Welsh Government report from October 2024 shows that more people are being treated than before, but the numbers are still lower than before the pandemic. 

“I've always been proud of my teeth but now use temporary shop bought filling material. It's very, very upsetting. And has knocked my confidence to talk to people”  

“I am in sheer agony and keep getting infection after infection as my teeth are crumbling, but no one is willing to help me because the amount of work that needs to be done. So daily I stay at home in pain and ashamed.”  

Shift to private practice

Many NHS dentists are becoming private, which means people who are able to often pay a lot more money for care. Some people said there are no NHS dentists in their area, so they have to travel far away to get help. This can take all day, and some people can’t travel at all, so they don’t get any care.

Latest figures from Welsh Government show that there were less NHS dentists per person in 2023-2024 than in previous years.

“NHS dentistry is extremely difficult to access. The dentists are prioritising private patients for a reason. This must be rectified. Dentistry should be available to all.” 

“It is ludicrously overpriced and that needs improving, people don’t have a disposable income. If you’re poor, you don’t stand a chance in looking after your oral health.”

Who is affected the most?

Children, older people, pregnant people, people with disabilities and additional learning needs, and families with less money are having the hardest time getting dental care. This could cause problems for their health in the long run, especially for children, people living with disabilities and older people.

Statistics show that fewer children living in the most deprived areas of Wales have received dental care than those in less deprived areas.

“My children are 8, 9 and 10 years old and haven't seen a dentist in their lives. NHS dentists need to be available to everybody who needs it, especially children.” 

“If you have paralysis like I have, the total left side paralysis, it's quite difficult to clean your teeth when you can't effectively, when you can't get in there and use one hand to get them out of the way. You've got to have two hands to get in there with a brush. My dentist advises me you can use a technique which I can't do with one hand, but there's no hygienist to give me top up care like there used to be.”  

Welsh Government statistics show that a higher percentage of white people, both adults and children, received treatment compared to other ethnic groups, though many patients did not share details of their ethnicity with them.

People with learning disabilities, and the people who support them, have told us they face extra issues getting help from dental services. Not all dentists are accessible or make adjustments for them, and this can make them feel anxious. Some may need treatment from a specialist dental service, but these services can be hard to find or are far away from where they live.

Cost and quality of care

Going to the dentist can be expensive, especially if your options are limited to paying for private care. Even for people who go to NHS dentists, it's sometimes hard to get the care they need. 

Some people feel like the care NHS patients get is not as good as what private patients get, saying they have shorter, rushed appointments and lower-quality materials are used to fix their teeth. 

Lots of people have to wait too long to see a dentist, and they don't get enough care to stop problems from happening in the first place.

"Very poor provision in this part of Wales. Long waits for appointments, then appointments cancelled. Withdrawal of NHS dentistry and very high cost of private dentistry means I can no longer afford dental treatment. I have no back teeth left.” 

“NHS dental care is appalling. If you can get an appointment, they give you very little time when you are in there and can’t be bothered to explain things in detail. They can’t wait to get you out of the chair when you’ve been able to get an appointment”

Our calls for change

Urgent action is needed. 

We know that there is a lot of work going on with Welsh Government and the NHS in Wales to improve access to dentistry.  Things like the introduction of a centralised dental waiting list will help everyone have a better understanding of the demand for dental care in Wales, as well as help match those waiting for treatment with available NHS dental care.  

Progress is still too slow.  People have been waiting a long time for things to get better – so that they can get the care they need without having to wait too long or travel too far to get it.  

We are calling for a range of actions: 

•  Once the new centralised dental waiting list is ready in November 2024, Welsh Government and Health Boards need to make sure that they tell people right away how they can sign up to get dental care in their area.  People need to be able to do this easily even if they don’t have access to do so online.
•  Welsh Government and Health Boards need to do more to help people understand how dental services are developing and what this will mean for their care. Meanwhile, they should update people on current changes to services to improve access to dentists now, showing where things are getting better and where further work is still needed.  
• Welsh Government and Health Boards need to do more targeted research to better understand and take action to remove barriers where some people, like those with disabilities, Black, Asian and Minority Ethnic people, older people, and people with less money, find it harder to get dental care. This is important to make sure dental services are developed in a way that is fair for everyone. Health Education and Improvement Wales (HEIW), supported by Welsh Government, needs to develop more dentistry staff here in Wales. More training is needed for staff to be able to support the specific needs of children or adults with additional needs.   This will help them to get the right care, and feel comfortable and safe each time they go. 
• Welsh Government and NHS Wales should provide the same, clear advice and information for patients on how to take care of their teeth.

Actions Llais will take:

• Access to primary care will continue to be an All-Wales priority for Llais. We’ll keep talking to communities and use what we learn to make representations to decision makers and service providers.
• We will also make sure people’s voices are heard in groups like the Dental Strategic Oversight Group and the Digital Health and Care Wales’ dental access portal group.
• We’ll talk to dentists from both the NHS and private practices to understand why many are moving to private care and how recent changes to dental contracts are affecting them.
• We will do some more work with children and young people about getting dental care, by asking them and those that care for them what they think. This will help to find ways to improve dental care for children across Wales.
• We will work with partners across the UK to learn from what’s working and what’s not and will bring together key organisations and government representatives to discuss the actions they need to take to make dental care better.