Nearly 600 dental practices in England have stopped providing NHS care over the past decade, according to new analysis, fueling concerns about a growing two-tier system and widening inequalities in access to dental treatment.

The Nuffield Trust's data reveals that over one in 10 practices that previously offered NHS dentistry have now withdrawn their services. This decline has been particularly pronounced in regions like the South West and East of England, where finding an NHS dentist has become increasingly difficult for some communities.

NHS dental activity has decreased by 8% compared to pre-Covid levels, with six in 10 adults reporting they have not seen an NHS dentist in two years. Of those who sought a new NHS appointment in the last two years, only 38% were successful, according to the NHS GP Patient Survey.

Regions such as Cornwall, Devon, and Northamptonshire have experienced some of the most significant reductions in practices offering NHS services. In Cornwall, more than a quarter of former NHS practices have ceased their involvement, highlighting a stark shift away from publicly funded dental care.

While ministers have pledged to address "dental deserts," dentists argue that current NHS contracts are not financially viable. Many practitioners have surrendered their contracts, citing that the work is loss-making. Vivak Shah, who operates three dental practices in Northamptonshire, confirmed that while he continues to offer NHS treatment, it operates at a deficit, and he has stopped accepting new NHS patients.

Shah warned that a widespread cessation of NHS treatment by practices could lead to patients experiencing pain or being forced to seek care in hospital accident and emergency departments, potentially overwhelming those services. The cumulative effect of contract handbacks across the country over a decade represents a "quiet transformation of dentistry into a two-tier service," according to Mark Dayan, head of public affairs at the Nuffield Trust.

Access to dental care is increasingly becoming dependent on an individual's ability to pay and their geographical location. Jim Sykes, a dentist in Hexham, made the "hard emotional decision" to hand back his NHS contract in 2024 due to significant financial losses. He noted that even a potential new government offer would not immediately restore his trust in NHS contracts.

Alan, an 83-year-old resident of Somerset, has given up seeking an NHS dentist, stating that finding an appointment near his home is "impossible." His experience underscores the challenges faced by many, with some having to adapt their diets due to difficulties accessing necessary dental care.