by Dr Jan Harris
The increasing number of missed NHS dental appointments are worsening the ongoing crisis in NHS dentistry, placing further strain on an already overstretched system. As a result, thousands of clinical hours are lost due to non-attended appointments, compounding the challenge of accessing timely dental care for patients. This issue is not only impacting the efficiency of NHS services but also contributing to growing waiting lists, further obstructing patient access to vital care.
Across the UK, dental practices are reporting significant numbers of missed appointments each month. These lost opportunities could have been used to treat patients with urgent needs, adding to the mounting pressure on dental professionals and the NHS system.
Financial and Staffing Consequences
The financial repercussions of missed appointments go beyond the immediate impact on individual dental practices; they reflect a broader, systemic issue within NHS dentistry. Rising operational costs and underfunded NHS contracts mean many treatments are provided at a financial loss, placing further strain on dental services. Many NHS dentists have expressed concerns that current government reimbursements fail to cover the true cost of care, making it increasingly difficult to sustain NHS services.
In response to these pressures, some practices are being forced to reduce their NHS commitments or transition to private care models, further limiting NHS appointment availability. This shift is contributing to increased treatment delays, staff burnout, and worsening retention rates within the dental profession.
“Missed appointments not only disrupt waiting times but also hinder our ability to manage resources effectively. With many dentists already stretched to their limits, every missed appointment represents a patient who could have received much-needed treatment. The growing pressures are driving some professionals away from NHS work entirely.
In the past, NHS dental practices had the ability to charge for failed appointments, a measure that helped deter non-attendance. Before the 2016 contract changes, many practices would take a small deposit to secure an appointment, which was retained if the patient failed to attend. This system was an effective deterrent and helped keep the failed appointment rate low, allowing for better use of limited resources. The removal of this option has only exacerbated the challenges faced by NHS dentistry today.”
Risks to Dental Health from Delayed or Missed Appointments
Missed or delayed dental appointments can also have significant consequences on a patient’s oral health and overall well-being. Failure to attend routine check-ups or treatment appointments may result in undiagnosed or untreated dental conditions such as cavities, gum disease, or oral infections. These conditions can progress, leading to more severe issues that may require more complex interventions.
For example, untreated cavities can advance into deeper decay, potentially necessitating more invasive treatments such as root canals or extractions. In cases of untreated gum disease, patients may experience irreversible bone loss or tooth mobility. Furthermore, untreated oral infections can escalate, potentially leading to systemic complications such as bacterial endocarditis, which affects the heart, or other life-threatening health conditions.
Delaying dental care also contributes to prolonged pain, discomfort, and a diminished quality of life for the patient. Chronic oral health issues can significantly impact a person’s ability to eat, speak, and maintain a positive self-image. Additionally, for dental professionals, failure to provide timely care can result in legal and ethical consequences, especially if it leads to irreversible oral health damage or systemic health complications.
It is crucial for both dental professionals and patients to prioritise timely appointments, as early intervention plays a key role in preventing further complications, ensuring effective treatment, and preserving both oral and overall health.
A Wider Crisis in NHS Dentistry
Missed appointments are just one factor in the broader crisis facing NHS dentistry. Across England, many dentists are stepping away from NHS contracts due to insufficient funding and rising operational costs. The British Dental Association (BDA) estimates that NHS practices lose hundreds of millions of pounds annually by providing care at a financial loss.
This underfunding has created a shortage of NHS appointments, resulting in the emergence of so-called “dental deserts” where patients struggle to access both routine and urgent care. The severity of the crisis has been acknowledged by the government, with Health Secretary Wes Streeting warning that “NHS dentistry is at death’s door.” Despite repeated calls for urgent reform, many dental practices are still waiting for meaningful policy changes to address the issue.
Patient Responsibility & Addressing Missed Appointments
While systemic reforms are essential for the sustainability of NHS dentistry, patient behaviour plays a crucial role in alleviating the pressure on the system. It is imperative that patients attend scheduled appointments or notify their practices in advance if they are unable to attend. While emergencies can cause missed appointments, these have a significant impact on the ability to provide care. By informing practices ahead of time, patients help ensure that the appointment slot can be offered to someone else who urgently needs it. Even small changes in patient behaviour—such as advance notice of cancellations—can significantly reduce wasted clinical time and allow appointments to be reallocated to other patients in urgent need.
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