Between July and December last year, our advice and information service helped 53 residents who were unable to access NHS dentistry. The example given below illustrates one of those cases. This resident was not well supported by NHS dental services. Many agencies had to get involved, and many organisations had to be approached before she got the care she needed.
In July last year, we were contacted by a local GP on behalf of one of their patients. The patient was about to have surgery to have all her teeth removed. Her existing dentist was unable to offer any of the aftercare support she was going to need. She had called 16 different dental practices trying to find one willing to give her this care as an NHS patient before Healthwatch got involved.
The hospital carrying out the surgery failed to make a referral for dentures. This feels like a missed opportunity
She had the surgery at the Homerton Hospital and was discharged with little information around mouth care and no support or referral to a dentist who could provide the follow-up care she needed.
The patient needed a few weeks’ recovery time. We arranged an assessment with a dentist in Hackney (This was the only dentist we could find taking on new patients, there were none in Islington). The dentist was unable to help with the needs of the client, given some complications around bone loss in the gums. We contacted London Dental Confederation for advice on dentists with a denture specialism and were advised to apply to a Dental Teaching School, but the client was anxious their denture fitting could take years.
We contacted the Community Dental Service who advised we contact the Eastman Dental Hospital. We arranged for the GP to make a referral, which was rejected. A dentist was required to make the referral. The client went back to the dentist outside Islington who made a referral for the client to the Eastman. However, we then learned there was a two-year waiting list.
Mental and physical distress
We have kept in regular contact with the client and updated the GP around events. This situation has been physically and mentally draining for the client, who is anxious and self-conscious, not able to go out or work, as it impacts their speech and eating.
We contacted the Dental Commissioner. They were contacted by Jeremy Corbyn’s office as well, as the issue was also taken up with the local MP by the client’s friend. The original dentist now arranged to see the client in early November and arranged a series of appointments to successfully fit the dentures. The client was pleased to get dentures that suit her and has been given good care by the dentist. Issues around bone loss meant it was a complicated and painful fitting over a number of appointments, as the jaw bone is uneven so the client could only have them in for an hour at a time.
What have we learned?
This case has shown the difficulties with the dental treatment pathway following the pandemic.
- Services are stretched and there have been issues finding dentists taking NHS patients.
- There is also little provision available for specialist treatment - the options have been opaque and inconsistent.
What would help?
Hospital based dental services need better integration with general dental services,
particularly when hospital treatment will necessitate after care from a regular dental
practice. It should not be left to the patient to organise the referral for follow up care,
particularly in cases where the resident is vulnerable and/or may struggle to be
accepted as an NHS patient.
Read the report
Our signposting service helped 64 residents resolve issues related to dentistry between July and December last year. 53 of these residents contacted us because they were unable to access NHS dentistry.
Healthwatch volunteers also conducted a mystery shopping exercise. 19 dental practices participated. In addition, 31 residents shared their views on dental access via an online survey.
In our report 'Experiences of accessing NHS dental services since the pandemic', we share what we have learned.