Complaints about dental services in England have risen by two thirds since 2017, with access to NHS dentistry and fees common causes of concern, according to the Parliamentary and Health Service Ombudsman (PHSO).
Ombudsman Rob Behrens said his office received around 100 calls each week in 2022-2023 about issues relating to dental practices in England.
The British Dental Association (BDA) said the increase was "to be expected" given the "huge pressure" practices were under.
The PHSO said that complaints about dentists increased from 1193 in 2017-2018 to 1982 in 2022-2023, a rise of 66%. The proportion of complaints completely or partly upheld after PHSO investigation rose from 42% to 78% in the same time span. "This is significantly more than the average uphold rate of 60% for all other NHS services," the Ombudsman said.
Poor Dental Care Leaves Patients Frustrated and in Pain
The PHSO cited examples of cases upheld this year. These included a pregnant woman charged for private root canal treatment after her dentist failed to tell her that she was exempt from NHS fees; a woman burned inside her lower lip during a root canal treatment, and a patient left without a front tooth after he was misinformed about the cost of a bridge.
Complaints about access to dental care included a shortage of NHS dentists and patients being removed from NHS lists.
Mr Behrens said, "Many of us will have read recent headlines of people removing their own teeth and seen images of people queuing outside practices for an NHS dentist. This shows in access problems, such as appointment availability and lack of treatment being a common issue in complaints brought to us."
MPs Have Called for Urgent and Fundamental Reform of Dentistry
Earlier this year, in evidence to the Commons Health and Social Care Committee inquiry into NHS dentistry, the PHSO identified the most common themes in complaints from patients who did manage to access NHS treatment as:
- Poor complaint handling by dental practices
- Poor management and updating of records following diagnosis and treatment
- Failure to follow established clinical and professional guidelines
- Poor communication of treatment options and costs
In its July report, the all-party Committee described the state of NHS dentistry in England as "totally unacceptable in the 21st century" and said the current dental contract was "not fit for purpose". MPs called for the Government to break with the "discredited system of targets" for NHS dentistry and commit to "a properly resourced service that is prevention-focused and patient-centred".
According to the Committee's website, the Government should have responded to the report by 14 September but had not yet done so.
Mr Behrens said, "Poor dental care leaves patients frustrated, in pain, and out of pocket. They, and dental professionals, deserve a better system that leads to quality care."
The PHSO recommended that integrated care boards should "take the lead in removing barriers to accessing dental services". These included poor information about local dental services on the NHS website and 111, as well as "unnecessary private costs" for procedures that could have been completed on the NHS. In addition, the website should give "clear and current information" on emergency and out-of-hours dental treatment.
Ombudsman Wants Greater Transparency on Costs
"There also needs to be complete transparency over the costs of care," the Ombudsman said, including more public information about criteria for NHS treatment, cost-of-treatment bands, and options for private referral.
Mr Behrens said, "Like many other areas of the NHS, dentistry is suffering from low morale, underfunding, and a recruitment and retention problem." However more needed to be done to tackle the "serious issues" in dentistry, and patients "must be able to access quality care".
William Pett, head of policy, public affairs, and research at Healthwatch England, welcomed the all-party Committee's call for a national information campaign to tackle misconceptions about registration, give patients a clear picture of where and how to access services, and the charges involved.
"Deep-seated Problems" Require Contract Reform
"NHS dentistry is the second most common problem the public tells Healthwatch about," he said. Over the past 3 years, local services had produced more than 400 research reports exposing experiences of "people suffering in pain, performing DIY dentistry, and struggling to pay treatment costs".
The "deep-seated problems" could only be tackled by "fundamental and fully resourced dental contract reform", he added, and Healthwatch eagerly anticipated the Government's long awaited dental recovery plan.
A spokesperson for the BDA told Medscape News UK it believed the increase in complaints "is to be expected, and the overwhelming majority will be the result of the ongoing access crisis".
A report by ITV News in August revealed that 90% of practices were not taking new adult NHS patients.
Dental practices were under "huge pressure", according to the BDA, and the Government had yet to deliver the recovery plan promised in the spring.
BDA Chair Eddie Crouch told us: "With the service on the brink and millions struggling to access care, it's no surprise complaints are through the roof. The Prime Minister ran for leadership on a pledge to 'restore' NHS dentistry. Things won't change until that promise is kept."
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