Dentists warn radical action needed to save dental services

Dentists say they are under huge pressure

Health service dentistry in Northern Ireland could be caught in a "death spiral" without radical action, more than 700 dentists have warned.

They say a combination of factors could make the service unsustainable.

These include a potential ban on dental amalgam metals used in fillings, budget pressures and a "financially unviable contractual framework".

The dentists have called on the Department of Health (DoH) "to show leadership and take action now".

A DoH spokesperson said the department "valued the important role" of dentists and was "aware of the ongoing pressures on dental practices".

'Intolerable pressure'

In an open letter to Peter May, the top civil servant at the DoH, dentists from the British Dental Association (BDA) Northern Ireland warned that services were under "intolerable pressure".

The letter said: "Despite clear evidence and repeated warnings issued by the BDA about the death spiral health service dentistry in Northern Ireland appears to be in, we have seen inaction from the authorities."

The dentists added that a move away from health service dentistry was "well and truly underway" and dentists would "be increasingly driven out of health service dentistry to keep their practices afloat".

Financial pressures

Following April's budget, the DoH said it had been left £470m short of its estimated needs for this financial year.

In addition, Northern Ireland is set to be subject to the EU ban on dental amalgam from 1 January 2025.

Dentists say practices are braced for a hit from increased costs and time pressures from the shift to alternative materials.

A DoH spokesperson said banning dental amalgam "is the direction of travel for the EU and the UK" a final decision by the EU had not yet been made.

They added that the DoH was "developing plans to ensure that any changes can be implemented as seamlessly as possible".

Investment needs

The letter said dentists were "passionate about maintaining a future for health service dentistry" but that this depended on the DoH "investing to stabilise and reform the service".

The DoH spokesperson said that the department recognised "the concerns expressed by the profession and has committed to exploring measures to support the delivery of health service dental treatment".

The department said it had invested an additional £88.1m in general dental services through the Financial Support Scheme and Rebuilding Support Scheme since April 2020.

This came to an end in July 2023 due to "financial pressures" following the 2023-24 budget.

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The spokesperson added: "Within the context of the department facing a funding deficit, it has not been possible to progress the recommended pay uplifts for any staffing group for 2023-24.

"This is the cause of significant regret to the department and we hope this situation will change."

It follows a previous letter to Mr May in 2023, when representatives from across dentistry in Northern Ireland stressed that cuts could lead to the collapse of services.

A BBC News NI Spotlight investigation found dentists could be losing money on most active NHS treatments they performed.

Some dentists were going private because of the costs, with others dentists performing NHS services no longer taking on new patients.