Dental Deserts in England
Nearly 13 million people in England live in areas with little to no access to NHS dental care. Here's where the problem is worst, why it's happening, and what you can do.
What is a dental desert?
A dental desert is an area where residents have little or no access to NHS dental care. In England:
- No local authority has more than 1 NHS dentist per 1,000 residents
- Only 40% of adults have seen an NHS dentist in the last 2 years
- The worst-affected areas have just 10 NHS practices per 100,000 people
- 97% of new patients trying to access NHS dental care are unable to get an appointment
The scale of the problem — England in numbers
Source: NHSBSA 2024/25, BDA, Denplan
These numbers tell a stark story. While 24,543 dentists in England do some NHS work, this has barely changed in a decade — and hasn't kept pace with population growth. The number of dentists per 100,000 people was 44 in 2013/14; today it's 42.
More critically, having dentists with "some NHS activity" doesn't mean they're available to new patients. The British Dental Association reports that 97% of people without a regular dentist who tried to get NHS care were turned away.
The NHS recommends adults see a dentist at least every two years and children at least once a year. At current rates, 60% of adults and 43% of children aren't being seen within these timeframes.
The worst-affected areas
Local authorities with the fewest NHS practices
| Local Authority | Per 100k | Deprivation |
|---|---|---|
| Barking & Dagenham | 10 | High |
| Middlesbrough | 10 | Very high |
| Newham | 10 | High |
| Thurrock | 10 | Moderate |
| West Northamptonshire | 10 | Mixed |
| Blackpool | 12 | Highest in England |
National average: 16 NHS practices per 100,000 people (median: 15).
For comparison, Richmond upon Thames — one of the least deprived areas in England — has 28 NHS practices per 100,000 people. That's nearly three times the provision in Middlesbrough, despite Middlesbrough having significantly higher dental need.
Areas with the worst health outcomes have the fewest NHS dentists — the inverse of what you'd expect. This is sometimes called the "inverse care law" — those who need care most have the least access to it.
Regional differences — who sees an NHS dentist?
| Region | Adults seen (24m) | FTE per 100k |
|---|---|---|
| North East | 44% | 26.0 |
| North West | 44% | 27.8 |
| Yorkshire & Humber | 42% | 25.8 |
| East Midlands | 39% | 25.1 |
| West Midlands | 39% | 25.6 |
| East of England | 38% | 24.3 |
| London | 38% | 27.6 |
| South East | 36% | 25.3 |
| South West | 32% | 24.4 |
The South West stands out: only 32% of adults have seen an NHS dentist in the last two years — 12 percentage points below the North East and North West. The region also has the highest rate of A&E dental visits in England.
If you live in the South West or another underserved area and need urgent dental care, see our Emergency Dentist Guide for what to do right now.
Why do dental deserts exist?
There isn't a single cause. Dental deserts are the result of several overlapping problems.
The NHS dental contract
Most experts — including the BDA, the Nuffield Trust, and parliamentary committees — agree that the NHS dental contract is the single biggest factor. Introduced in 2006, the contract pays dentists based on "Units of Dental Activity" (UDAs) — a system widely criticised for rewarding volume over quality and making NHS work financially unviable for many practices.
The result: dentists are leaving the NHS for private practice. The total number of dentists in England has grown slightly, but the number doing NHS work hasn't kept pace.
Uneven distribution
Dentists cluster around cities, university towns, and affluent areas. Rural and coastal communities — often older, with higher dental need — have far fewer practices. The lack of a formal registration or catchment system for dental patients means there's no mechanism to ensure coverage.
Post-pandemic effects
COVID-19 hit dentistry harder than most healthcare services. Aerosol-generating procedures required extensive new safety measures, slashing the number of patients who could be seen. Recovery has been slow: in 2024/25, treatment volumes were still 12% below pre-pandemic levels.
Workforce challenges
The NHS Long Term Workforce Plan aims to increase dental training places by 40% to over 1,100 by 2031/32. But training a dentist takes five years, and the Government's July 2025 decision to end skilled worker visas for dental technicians, hygienists, and nurses has raised concerns about short-term staffing.
What the Government is doing
700,000 extra urgent appointments
From April 2025, NHS England is rolling out 700,000 additional urgent dental appointments per year, targeted at dental deserts and areas of high unmet need. Patients can access these by contacting their usual practice or calling NHS 111.
Contract reform
The Government has said it is negotiating with the BDA on reforming the dental contract, though no timeline has been provided. The NHS 10-Year Health Plan, published in July 2025, included commitments to reform the contract to prioritise urgent and complex needs.
Supervised toothbrushing
An £11 million supervised toothbrushing programme, rolled out in April 2025, targets three-to-five-year-olds in the most deprived areas. It's estimated to reach up to 600,000 children annually.
Mandatory NHS service for new graduates
The Government has proposed requiring newly qualified dentists to work in the NHS for a minimum of three years after graduation. This is intended to address the geographic imbalance, but the consultation response has not yet been published.
These reforms are a start, but most experts agree that without fundamental contract reform, the underlying problems will persist. The BDA has warned that the current contract makes NHS work unsustainable for many practices.
What can you do if you live in a dental desert?
If you can't find an NHS dentist in your area, you have several options.
1. Search more widely
NHS dental patients don't have catchment areas — you can register with any practice in England. Expanding your search radius even by a few miles can reveal practices that are accepting patients.
Search for NHS dentists accepting patients near you
2. Contact your local ICB
Integrated Care Boards are responsible for commissioning dental services in your area. If you can't find a practice, they have a legal duty to help you access NHS dental care. Contact NHS England on 0300 311 2233.
3. Call NHS 111
NHS 111 can help you find urgent dental care, particularly if you're in pain. They can refer you to emergency dental services in your area, including the new 700,000 additional urgent appointments.
4. Check regularly
Practice accepting status changes frequently. A practice that was full last month may be accepting patients today. Use Smylo to check which practices near you are currently open to new NHS patients — our data is updated daily from NHS.uk.
5. Consider the NHS Low Income Scheme
If cost is a barrier to private care, you may qualify for help. Even if you don't get free treatment, the NHS Low Income Scheme can reduce what you pay.
Frequently Asked Questions
What is a dental desert?
A dental desert is an area where residents have little or no access to NHS dental care. There's no official definition, but the term is widely used by the Local Government Association, the British Dental Association, and Parliament. Dental deserts are characterised by few NHS practices, low dentist-to-population ratios, and high proportions of people unable to get appointments.
How do I know if I live in a dental desert?
Check how many NHS dental practices near you are currently accepting new patients. You can search on Smylo by postcode to see current availability. If you can't find any practice accepting NHS patients within a reasonable distance, you're likely in a dental desert.
Can't find an NHS dentist — what should I do?
Widen your search area — you can register with any NHS dentist in England, not just one near your home. If that doesn't work, contact your local Integrated Care Board (ICB), which has a duty to help you access NHS dental care. For urgent problems, call NHS 111. See our full guide: How to Register with an NHS Dentist.
Why are there so many dental deserts in England?
The main driver is the NHS dental contract, introduced in 2006, which many dentists find financially unworkable — leading them to reduce NHS work or go fully private. This is compounded by uneven geographic distribution of dentists, slow recovery from COVID-19, and a training pipeline that takes years to produce new graduates.
Is the Government fixing the problem?
The Government has announced 700,000 additional urgent dental appointments from April 2025, a supervised toothbrushing programme for young children, and plans to reform the NHS dental contract. Mandatory NHS service for new dental graduates is also proposed. However, contract reform — widely seen as the most important change — has no published timeline yet.
Are dental deserts worse in rural or urban areas?
Both can be affected, but for different reasons. Rural and coastal areas tend to have fewer practices and struggle to attract dentists. Urban deprived areas may have practices nearby, but those practices may not be accepting NHS patients or may lack capacity. The worst dental deserts tend to be areas that are both deprived and have low provision.
Is dental care free in dental deserts?
NHS dental charges are the same everywhere in England (Band 1: £27.40, Band 2: £75.30, Band 3: £326.70). The challenge in dental deserts isn't cost — it's finding a practice that will see you on the NHS at all. Many people who qualify for free treatment can't access it because no practice near them is accepting patients.
What about private dentists — are they available in dental deserts?
Private dental care may be available in some dental desert areas, but at significantly higher cost. A private check-up typically costs £40–£80 (vs £27.40 NHS). Our focus is on NHS provision because that's what's accessible to everyone. If you're considering private care, check whether you might qualify for help through the NHS Low Income Scheme.
Who should I complain to about dental access in my area?
Your local Healthwatch can record your experience and escalate issues. Your MP can raise dental access in Parliament. Your Integrated Care Board is responsible for commissioning dental services locally. The NHS complaints process is also available if a practice has refused to treat you.