The National Health Service (NHS) in the UK is making strides in improving oral health for youngsters while grappling with significant access challenges for adults. In Redcar and Cleveland, a fluoride varnish treatment program is being rolled out to combat high rates of tooth decay, with plans to expand to Middlesbrough. Meanwhile, the NHS dental crisis continues, with one in four adults struggling to access care.
The fluoride varnish initiative, recommended by the National Institute for Health and Care Excellence (NICE) targets primary schools in areas with high risk of poor oral health. Children from nursery to year four in selected schools receive at least two applications per year, with funding provided by the North East Integrated Care Board until November 2028.
Fluoride varnish programs in Redcar and Cleveland and Middlesbrough
The program in Redcar and Cleveland is currently being delivered in nine primary schools, with plans to eventually reach almost 4,000 pupils. Parents must consent for their child to participate, and the treatment involves applying a golden coating that releases fluoride, strengthening teeth and preventing decay. A similar program is set to be delivered in Middlesbrough, following a previous initiative that was halted due to the COVID-19 pandemic and capacity constraints.
Health professionals in the South Tees area are also helping to deliver a supervised toothbrushing program in nurseries and schools. The initiative aims to address the higher prevalence of dental decay in Middlesbrough and Redcar and Cleveland compared to the England average. In Middlesbrough, there was a doubling of decay rates involving 3 to 5-year-olds from the most recent dental surveys undertaken in 2026 and 2026.
The NHS dental access crisis
Despite these efforts, the NHS dental crisis persists, with about one in four adults unable to access the care they need. New analysis of the GP Survey by Ipsos shows that 6.2 million people did not receive treatment in the previous two years because they believed they couldn’t get an appointment. The 8 million in 2026 to 13.3 million in 2026, but progress is deemed too slow.
The analysis by the British Dental Association (BDA) indicates that 4.9 million adult patients tried and failed to secure NHS care in the last two years. BDA chair Eddie Crouch described the situation as “utterly obscene,” highlighting the desperate need for reform. Those with unmet need include 1.3 million who said they could not afford NHS care due to the cost of dental charges, which had been increased under the previous government.
The case of Anne: an 8-year wait for treatment
One patient, Anne, waited eight years for treatment for badly broken teeth. The 58-year-old from South Devon broke a front tooth and damaged another in an accident in 2017 but was told by her dentist that they could not treat her and referred her to hospital. The damage to her teeth made it difficult to eat, and she was told her appearance was not professional enough to teach face-to-face.
Anne’s case highlights the systemic issues within the NHS dental system. She “fell through the gaps” after being passed between local and hospital services. Anne estimated that over 20 hours of NHS hospital consultant time had been spent on ‘treatment planning’ for the two hours of treatment she actually needed. She questioned whether this was an effective use of NHS resources.
Reform calls and funding challenges
Councillors have voiced concerns about the underlying issues in NHS dentistry, calling for a meeting with the Chief Dental Officer to discuss the “crisis of access.” Councillor Noeleen Hayes argued that reform of the current payment model is essential to make it worthwhile for dentists to take on more NHS patients. Councillor Eddie Roofe seconded the proposal, and Councillor Sheamus Greene highlighted the significant shortfall in rural provision, particularly in Fermanagh.
The Health Minister has confirmed an extra £8 million investment in General Dental Services for 2026/27. The funding will support the continuation of a 30% fee enhancement for treatments such as fillings, extractions, and root canal work, as well as the ongoing Enhanced Child Examination Scheme aimed at increasing registrations for children aged up to 10. However, councillors argue that these measures may not address the underlying issues.
The BDA estimates that it would take an increase of £1.5 billion to restore NHS dentistry as a fully universal service for everyone in England who needs it. Despite promises from the Labour government to reform the NHS dental contract, fundamental reform cannot be achieved without additional funding. The BDA calls for real reform to address the comprehensive failure of the current system.
