Competing Visions for the Future of NHS Dentistry
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- Published: Wednesday, 02 July 2025 09:10
- Written by Peter Ingle
- Hits: 927
As NHS England is wound down there is no shortage of other groups eager to be involved in shaping the service‘s future. One established voice is the NHS Confederation. This is a membership organisation that supports and speaks on behalf of the whole public healthcare system in England, Wales and Northern Ireland.
A recent discussion paper from the Confederation with the title “A new front door: reimagining primary care for the next decade” has essays from leaders in the fields of optometry, community pharmacy and dentistry.
It would not be unreasonable to believe that the Confederation’s chosen contributor, and their vision, would be one that Confederation members would approve of and seek to support.
The author, Lorraine Mattis (pictured) s the Chief Executive of the University of Suffolk Dental CIC. This is the Community Interest Company set up with much input from former CDO Sara Hurley. While it presently operates from the University in Ipswich, it’s supporters see it as a reproducible template that could be widely copied and rolled out nationally.
Lorraine Mattis, who was hired by the CIC following a career in NHS Community Health Services, and latterly the CDS, gave her essay the title: “From ‘dental deserts’ to neighbourhood dentistry: rethinking dental health provision for the next decade.”
It begins setting out some of the problems, including years of underfunding, workforce shortages, and a flawed contract. There is acceptance of the current ‘critical state’ of the service and decreasing satisfaction with it. Some familiar figures illustrating the service’s failure are cited, and then a picture is drawn of how things might look in 2035, provided the appropriate action is taken now.
Some of the key ideas in this essay are summarised below.
“By 2035, England’s dental care system stands as one of the most transformed pillars of the NHS – a service once teetering on the edge of collapse, now renewed through innovation, integration and bold reforms to its funding model. Central to this transformation is the adoption of new care models that see dentistry not just as a service to be accessed in an emergency, but with oral health professionals fully integrated within a neighbourhood health model, and where oral health and education is everyone’s business, embedded in public health, education and community life.”
In 2035, “no one is talking about oral health – because it’s no longer a crisis, no longer siloed, and no longer neglected.” This is because it has been fully integrated into everyday health and wellbeing.
Key to this will be establishment of neighbourhood oral health teams. These will be adaptable to local contexts, including dental therapists, dental nurses, oral health educators and dentists, working in partnership with GPs, pharmacists, health visitors, social care workers and voluntary, community and social enterprise sector colleagues. They will manage shared patient lists together, and coordinated digital health records, offering holistic, preventative care across entire communities.
Routine check-ups, restorative treatment (within the prevailing scope of practice), and oral hygiene support are to be delivered by dental therapists, now forming the backbone of NHS dental provision, in turn supported by a wider team of oral healthcare professionals.
There will be no workforce shortage as their training, limited in 2025 by a bottleneck of placements and financial disincentives, will have been been scaled nationally through government investment in dental therapy education hubs and community-based placements.
Changes to commissioning will favour a mixed-model approach with dental therapists holding contracts. What were once ‘dental deserts’ will provide equitable access to treatment and oral health.
Dentists will have found renewed purpose. Their work will be outcome-driven, measured by reductions in disease prevalence and patient transitions from high to low risk – not the number of extractions or restorations performed.
Digital innovation and greater use of technology will ensure safe, scalable care. In 2035, a seven-year-old child in a former ‘dental desert’ can receive a digital scan at their local neighbourhood hub or community diagnostic centre, which is analysed remotely by AI and verified by a central NHS diagnostic hub. If treatment is needed, they’re referred to a nearby health centre where a dental therapist already familiar with their medical and social history –can begin care within days.
In underserved and rural areas, mobile dental units staffed by dental therapists and dental nurses visit farming villages and care homes on a rotating schedule.
Most importantly, 2035 will see prevention eclipsing intervention. Oral health and oral education is everyone’s business and will not just be provided by dental care professionals. Teams across health, social care and education will be trained as oral health educators. Oral health education will start at nursery and continue through every school year. Sugar awareness campaigns will be embedded into local authority wellbeing strategies and all medicines for children are sugar-free.
In 2035, Dental nurses have emerged as community oral health champions. From parenting classes to food banks, they teach parents how to brush their children’s teeth, interpret food labels, and access free dental packs. In 2035, the rate of hospital admissions for dental decay in children will drop under 5,000, a tenth of what it was a decade earlier, and the lowest figure in 40 years.
The vision for 2035 is clear – and achievable. To achieve it, work must start today. That will mean bold reform, smarter commissioning, investment in a diverse oral health workforce, and full integration into the wider health and care system. The prize: shifting dentistry from the margins to the mainstream of NHS care.
As it happens, in the same week that the NHS Confederation published this essay, the BDA offered some thoughts on the direction that it hoped NHS dentistry would take. GDPUK will look at that, and see what the two visions have in common, shortly.
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A new front door: reimagining primary care for the next decade | NHS Confederation
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