People struggling financially are hardest hit by the shortage of NHS dental appointments
The new Healthwatch England research warns that poorer people are being disproportionately pushed into private dentistry as access to NHS dentistry remains precarious.
The findings point to a sharp rise in the number of people turning to private dental care, including a near‑doubling among those who describe themselves as financially struggling.
The data is from our upcoming report, ‘The public’s perspective: The state of health and social care’, and based on a poll of 2,593 adults in England, conducted from 31 October to 07 November 2025.
Overall, the number of people who have used private dentistry in the last year has increased by 10 percentage points. Almost a third, 32% of people in England, have used private dentistry in the last year, compared with 22% of people in 2023.1
Poorer households are increasingly forced to go private
Since our first poll in 2023, the proportion of people who have used private dentistry has almost doubled among the people who described themselves as struggling financially - from 14% (129 of 933) to 27% (303 of 1,102) in 2025.2
Over the same period, the share of people who consider themselves financially comfortable who reported using private dentistry rose from 30% (251 of 825) to 36% (538 of 1,491).
Financially comfortable households are still more likely to use private care, but the gap between the two groups has narrowed sharply, from 16 percentage points to nine, as private use has increased faster among those who are financially struggling.
Together, these figures point to a significant shift in how people who are struggling financially access essential dental care, with growing numbers feeling they have little choice but to pay privately.
People on lower incomes face a double penalty
NHS dentistry is increasingly not an option for people on lower incomes. In some areas of the country, there are no dentists offering NHS appointments.
And there’s no guaranteed right to care from an NHS dentist, because permanent, GP-style registration with dental practices doesn’t currently exist.
People living in deprived areas who can’t find an NHS dentist and feel they have no choice but to pay for private dental care are potentially penalised twice by:
- Higher costs: When NHS appointments are unavailable, patients must pay significantly more for the same treatment. For example, a routine NHS Band 1 check‑up costs £27.40, whereas private prices for a routine examination can start from £50 to £75.
- Loss of entitlements: Many low‑income patients and all pregnant women and new mothers, some of whom may also be on low pay, are exempt from NHS dental charges. When they cannot access NHS care, they lose the benefit of the exemption.
People in deprived areas are almost twice as likely to say they went private because they could not find an NHS dentist (59%), compared with those on higher incomes (30%).
Donni’s story: “I’ve used my inheritance money to pay for private care”
Donni, 65, from Norwich, says the dental surgery she uses stopped seeing NHS patients three years ago. Since then, she’s had to pay privately for her care.
“I can't get an NHS dentist since mine left the practice,” she explains. “Now it costs me nearly £70 for a five-minute check up!”
Donni says her practice offered her a dental payment plan. But, Donni, who lives alone and can only work part-time due to other health issues, says she can’t afford another monthly expense.
In November, Donni paid privately for a bridge to be fitted. However, she says she was only able to afford this as her father had passed away, leaving her with some inheritance that she could put towards paying for her care.
“I’ve used my inheritance money to pay for the bridge. Without the money from my father, I wouldn’t have been able to afford this procedure. Even then, I opted for a cheaper option as some treatments are just beyond my means.”
Why do people turn to private dental care?
Our findings show that nearly a third of people (32%) have been to a private dentist in the last year, up from 22% in 2023.
The latest Adult Oral Health Survey, lists the top reasons for people using private dental care:
- Difficulty finding an NHS dentist, 39%
- Getting better quality of care, 22%
- More convenient opening times, 19%
- Shorter waiting times, 19%
- NHS dentist moved to private practice, 18%.
How confident are people that they can access timely NHS dental care?
Our data suggests that confidence in accessing timely NHS dental care has risen slightly, from 30% in 2023 to 35% this year. However, the improvement is uneven:
- Urban areas saw an eight‑point rise in confidence.
- Rural areas saw no improvement, reflecting persistent dental access issues in isolated communities.
- People who are financially comfortable, 43%, remain far more confident than people who describe themselves as financially struggling 25%.
What can be done to fix NHS dental care?
Rebecca Curtayne, our acting head of policy, public affairs and research, said:
“Our findings are a warning that for some people, there’s only one tier dental care - private. And it’s the most vulnerable people in our society who bear the brunt of the ongoing shortage of NHS dental appointments.
“The government won’t end health inequalities until it fixes NHS dentistry. Too many people on low incomes are being forced into private care they struggle to afford, or are going without treatment altogether. The system is failing those who need it most.
“However, it’s positive to see that public’s confidence in NHS dentistry has increased slightly. The government needs to build on this, by improving access to NHS dentistry especially in rural and more deprived areas, and setting out its plans for fundamental reform of the NHS dental contract.
"These plans should aim to give everyone the right to a permanent NHS dentist, in the same way people get a local NHS GP care who is there for both new and urgent problems."
Four steps to help improve access to dental care
- Give people the right to register permanently with an NHS dentist: As part of dental contract reform, the Government should introduce a legal right for people to register with an NHS dentist for life, in the same way as they can with GPs.
- Make NHS dentistry affordable: Review NHS dental charges to ensure cost is not a barrier to care.
- Monitor and tackle inequalities in dental access: NHS Integrated Care Boards should track and address differences in access between communities.
- Improve communication about dental charges: Ensure patients understand the costs of treatments and what the NHS covers.
The public’s perspective: The state of health and social care
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Notes:
- Findings on private care and confidence in the NHS come from two polls carried out for Healthwatch England by Savanta: (a) Use of private healthcare services: A poll of 1,758 people in England between 22 to 25 September 2023 (b) Public confidence in health services: A poll of 2,507 adults in England between 13 June and 7 July 2023.
- In our survey, respondents are classed as “struggling financially” if they described themselves “just getting by” or “really struggling”, and “financially comfortable” if they said they were “quite” or “very comfortable”.
