Colin D Gordon

“In one of the richest nations on Earth, people are extracting their own teeth, making their own fillings, improvising dentures and sticking them to their gums with superglue, and overdosing on painkillers”. The Guardian columnist, George Monbiot, on 2^nd March, attributed what he depicted as the catastrophic plight of NHS (National Health Service) dentistry across the UK to the “ridiculous contract” under which dentists have had to work since 2006. The state funding package that’s been imposed on them, he asserted, simply doesn’t cover their costs, so the only way they can stay in business is to subsidise their public earnings with income from private clients.

The result has been, as research by both BBC News and the Independent newspaper has revealed, that the majority of NHS dental practices in Britain are now extremely reluctant to accept new adult patients for treatment under the health service. The refusal rate is apparently worst in the south-west of England, the north-west, Yorkshire and the Humber (98%) followed by the East Midlands (97%), Wales (93%), Northern Ireland (90%) and Scotland (82%). According to the BBC News report, the lack of NHS appointments has led people to drive hundred of miles in search of treatment, pull out their own teeth without anaesthesia, make their own dentures and eat little more than soup.

The Healthwatch organisation has warned of an impending dentistry crisis unless the Government takes urgent action and has cited examples of dentists advising sufferers to buy dental repair kits to treat themselves. In one case, states Healthwatch, “an individual was recommended to use a nail file to deal with the sharp edges of a broken tooth”. The basic problem, as Healthwatch has noted, is that the many UK residents now already under pressure from rising costs can’t afford even the lower NHS fees (if or when that option is available) hence “going private” is clearly way beyond their means.

The consumer protection organisation “Which” has provided a comparison of the NHS and private dentist charging structures. It emphasises that the prices should always be communicated clearly in advance, but this isn’t always what happens. On the contrary, one in five of the respondents to a survey conducted by “Which” confirmed that they’d started a course of treatment without being at all sure what the ultimate expense would be. A table provided by “Which” highlights the considerable disparity between NHS and private fees: The price for an initial consultation or a check-up with the NHS is £23.80, but anywhere between £20 – £120 if it’s private;For an amalgam/metal filling: £65.20 NHS / £30-£175 private; Root canal treatment: £65.20 NHS / £45-£970 private; Tooth extraction £65.20 NHS/ £50 – £370 private; Crowns £282.80 NHS / £250-£1,180 private; Dentures & Bridges – £282.80 NHS / £55-£2,520 private.

The solution, as Dentaly.org points out, is to take as much care as we can of our teeth. It advises, for example, that they should be brushed at least twice a day, before or after eating breakfast and before going to bed and that the brush should be placed “at an angle of 45 degrees below the gum line to ensure that plaque doesn’t accumulate”. Each individual, Dentaly observes, has different preferences regarding the flavour, texture and ingredients of the toothpaste they use, but whichever one is selected, it “should be effective, which usually means it should contain fluoride”.

A survey of dental hygiene habits by Hive, a company based in Cornwall, south-west England, cited by Dentaly, has found that 39% of 25-34 year-olds brush their teeth less than once a week, whereas 63% of millenials (those born between 1981-1996) do so three times a day. Dentaly data indicates that 74% of adults in Britain have had at least one tooth removed, 84% have had at least one filling (the average is 7.2 fillings per person) and 6% have no natural teeth left at all. The percentage of those with none increases by age: 15% between 65-74, 31% from 75-84, 47% of the over 85’s. It’s “dental phobia statistics” show that 22% of UK adults admit to avoiding dental visits because of anxiety, particularly regarding having a tooth drilled and getting an anaesthetic injection, but 81% have never attempted any DIY (Do It Yourself) dentistry.

Once we manage to overcome or suppress our concerns and do decide to visit the dentist, there’s still, Dentaly asserts, a big network in the UK ready to help, consisting of more than 12,000 dental practices, 35,000 dental practitioners and 53,000 dental nurses. The number of female dentists now exceeds male (50.4% vs 49.6%).

Teeth, of course, are not just used for eating: 41% of adults in Britain use them to tear sellotape, 28% for biting their nails and 16% for chewing pens & pencils. Most adult have 32 teeth (before any are removed), but some people are born with extra ones: The Guinness World Record holder is a man in India who has happily lived with 37.

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