Hilary Freeman was in pain and made numerous calls to her dentist to make an appointment.

Hilary, 50, had developed toothache in her lower right molar in January this year after biting down on a hard piece of food — but her usual NHS dentist said that, as she hadn’t had an appointment with them in the past two years, they wouldn’t prioritise seeing her.

Hilary called NHS Helpline to request an appointment at the Urgent Dental Care Centre, which is about half an hour away from Hilary’s home. This centre was established during lockdown to accommodate patients who were unable or unwilling to see other dentists.

Figures show how the pandemic has had a seismic impact — and there is little sign of it abating

Figures show how the pandemic has had a seismic impact — and there is little sign of it abating

Finally, the mom-of-one found out that she had broken her tooth. This can usually be treated with fillings.

However, all Hilary could be offered as emergency treatment was a temporary filling to stabilise and desensitise the tooth until a treatment slot to put in a permanent solution was available — but there was no way of knowing when that would be.

Hilary from East London, who is a journalist and broadcaster, says, “I asked for to be added on the dentist’s own waiting lists so that treatment could be complete and a permanent crown could be put in,”

“But, there wasn’t room on the surgery’s waiting list so I couldn’t choose but to have temporary fillings.

Emergency cases: Six week wait

This is what happened next. Six months of pain, complications and stop-gap treatments were the result.

‘I developed an infection that may have arisen because the tooth wasn’t treated properly in the first place, and I ended up spending nearly £1,000 on private treatment to sort the problem out,’ says Hilary. It was completely unacceptable and absolutely horrible.

Her experience is just one example of the wide-scale difficulties patients — mainly NHS but in some cases private, too — are experiencing in accessing dental care.

Figures show how the pandemic has had a seismic impact — and there is little sign of it abating.

The British Dental Association (BDA), a trade union, claims that 35 million NHS appointments in England have been lost since March 2013, when lockdown began. This is due to extra time needed to clean between each procedure.

Problems accessing NHS dental care are now the number one complaint raised with Healthwatch England, accounting for 25 per cent of all calls (compared with 5 per cent pre-pandemic)

Healthwatch England reports that problems accessing NHS dentistry are the most common complaint. This is 25% more than 5 percent pre-pandemic.

Dental care was almost completely shut down by the pandemic. Healthwatch England reports that 83,000 NHS dentists performed treatments in May 2013, compared to the normal average of 3.33 million.

This has created a large backlog and patients have been warned that they will need to wait for up to 3 years before being able for routine appointments or for emergency care for as little as 6 weeks.

Healthwatch England now has 25% of all complaints about NHS dental care. That’s compared to 5% pre-pandemic. A letter was also published by 40 MPs on both sides of Parliament calling for the government to take action.

According to MPs, “Dentistry has become the top issue with Healthwatch. Our own mailbags have attested that access to dentistry is an ongoing problem in all parts of the country.”

Following a request from Healthwatch England and the BDA, this is to ensure that the Treasury provides the necessary building blocks to support a sustained recovery after the pandemic.

Worst crisis in dental history

Jacob Lant (head of policy, public affairs and research at the watchdog), stated that there is no doubt that the dentistry sector is in the midst of the most severe crisis it has ever faced. Good Health was informed by Lant. 

“So many patients are calling us with pain, because they cannot locate an NHS dentist to treat them.

It is being feared that many NHS patients might be forced to seek private treatment to obtain the necessary care. Hilary contracted a serious infection from her mouth after receiving temporary fillings. She had to seek treatment privately because she couldn’t get the care she needed. She said, “I was in such severe pain that my face became swollen, and I was not sure what to do.”

‘In desperation, I managed to see a private cosmetic dentist close to where I live at a cost of £150 and was put on antibiotics. When the infection subsided, I was given a filling, which cost another £400. “I had to make a payment.

Two months later, the infection returned. “The filling had not sealed the crack completely, so infection was allowed to enter the tooth. My face became swollen, and it was intensely painful. It was horrible. It made it impossible to sleep and did not allow me to do much.

Hilary was prescribed a second course of antibiotics, at a cost of £20, then paid another £100 for a further check-up, where she was told that the tooth was so badly cracked that she’d probably need root canal treatment, which would cost another £1,500.

Children’s teeth health is the most vulnerable 

Dental experts worry that fewer appointments will have a devastating impact particularly on children’s teeth, with the most vulnerable at greatest risk.

NHS England figures show that 808,000 children have missed their dental appointment this year.

‘Children are hit particularly hard by this as they are often the ones most at risk of cavities owing to sugar consumption, which tends to be higher than among adults,’ says Dr Andrew Elnazir of the London-based Banning Dental Group. ‘While some families may have had the financial resources to turn to private care, others either have to rely on less regular check-ups from their NHS dentist or have none at all.

‘Everyone has the right to have good oral health, and too many people are finding that this has become more inaccessible than before Covid-19.’

Alarmingly, among children aged five to nine years old, tooth decay was the leading cause of hospitalizations.

Covid is a factor that has exacerbated this situation. From 59 percent in March 2020, to 23% in March 2019, the proportion of children who have been seen by an NHS dentist has fallen in the past 12 months.


“I was absolutely horrified.” It was unbelievable to me, she said. ‘I’d already spent more than £500 and I just couldn’t afford it. Although the pain was gone after the first round of antibiotics, it wasn’t until a few months that I decided to go ahead with the treatment. But I knew the worst. My only other option was to have the tooth out — which I did last weekIt is. It still cost £300 [again privately]. Due to my inability to see a NHS dentist I had to endure months of pain.

Jacob Lant believes it is ‘possible’ that other dentists, like Hilary’s, are using a clause of their practice contract — where if someone hasn’t been seen for two years they are no longer prioritised over routine patients seeking urgent treatment and are technically ‘off the books’ — to not see patients.

Problem is, dentistry wasn’t subject to the Covid restrictions that were in effect when dentistry was locked down.

Practices were directed to stop providing face-to-face services when lockdown started. They have maintained strict infection control protocols and have implemented restrictions which have drastically reduced the patient population since June 2020.

There will be no easing in covid policies

These restrictions require that appointments are kept apart for up to one hour in order to remove the aerosol-generating procedure (AGP), which is used in crowns and fillings to produce water sprays that can potentially transmit the virus.

Dr Michael Clarke is the chairman of Federation of London Local Dental Committees and runs a private and NHS practice in London.

“England moved into the last stage of relaxing Covid restrictions on July 19. However, dentistry has not been able to do so. The delays in obtaining treatment, such as having patients wait outside, taking their temperature on arrival and having dentists or nurses dress them up for interventional procedures, reduce productivity.

“Some practices might have methods to mitigate delays like ventilation ducting that draws out the air and then replenishes fresh air. However, it still causes a waiting period.

The NHS England informed NHS practices they have to maintain a minimum of 65 percent of pre-Covid activity level or they will face penalties. That means, even though you see 100 patients per day prior to the outbreak, 35 of them will be still struggling.

Eddie Crouch (chair of the BDA) adds, “Freedom Day” didn’t bring any changes to dentistry. Still working with restrictions from the initial lockdown, which have reduced our capabilities and created an unprecedented backlog. Rules may ease soon — but it’s unlikely to mean a return to ‘business as usual’ for dentistry.’

While the other UK nations provided capital funding to help practices increase capacity through a new ‘high-volume ventilation system’ — which can ventilate surgeries more quickly and extensively — there has not yet been such a commitment from England, and the impact has been far-reaching.

Many NHS dentists feel they must take on more private work in order to stay afloat. They say that longer waiting times mean they see fewer patients. The demand has been so low that even private practice have had to raise prices to pay for personal protective equipment (PPE) and masks.

Dr Andrew Elnazir, a dentist at the Banning Dental Group, a chain of private dentists in London, says whereas NHS clinics received help with the cost of PPE, private clinics did not, so some — not Banning — passed the cost on to patients.

‘Different clinics charged different amounts to cover PPE costs, but my own dentist at another practice charged an extra £27 when I had a filling.’

According to a survey by Healthwatch England, one patient was offered a private procedure for £1,700 which was £60 on the NHS. This combination is affecting the workforce in dentistry.

A BDA survey conducted in May found that nearly half (47%) of dentists indicated they were likely to seek an early retirement or change their career in the coming 12 months, if current Covid restrictions are not lifted.

A similar proportion said they would reduce their NHS involvement. However, the demand for NHS dentists is higher than supply over many years.

The National Audit Office estimates that there was a shortage of approximately 1000 dentists in 2002. Additionally, two million patients were not able to register at an NHS dentist they desired.

Since Covid, the horror stories about dental care — or the lack of it — have been widespread.

Dr. Lant says that some patients are remotely prescribed antibiotics when they have an infection. Others may be told to buy temporary filling kit online or to take the medication.

He adds that these are not permanent solutions and do not address the root cause of the problem such as broken teeth.

‘Dental pain is among the worst there is, and patients have told us that they have been in such pain, they have been self-medicating with alcohol and painkillers — sometimes together — which is very worrying.

“Others have taken to so-called DIY dentistry where patients attempt to solve the issue by themselves.

You should not attempt to do it yourself.

Danielle Watts (42), from Bury St Edmunds recently disclosed that she took matters into her own hands and had to treat her pain by removing 11 of her teeth with a needle.

After her former NHS dental practice closed abruptly in 2015, she tried unsuccessfully for six years to locate an NHS dentist willing to accept her, her children Oscar (12) and Eliza (8).

Private treatment was not possible for her and, even prior to lockdown, her teeth were ‘dying one at a time’. She also experienced constant pain.

“I called 911 and they said it was not serious, my face wasn’t too swollen. They told me to just get painkillers and wait and see,” she explained to BBC.

I had no other options. Every phone call was literally a blessing. [to a dentist]It was “No, we are not accepting NHS patients.” “

This was the case for Danielle Watts, 42, from Bury St Edmunds, who recently revealed she had taken matters into her own hands to resolve her toothache

Danielle Watts (42), Bury St Edmunds revealed that she took matters into her own hands and had a solution for her toothache

What does the future hold for dentists, their patients and themselves? A consultation was held recently by the Department of Health on the topic of infection prevention and controlling.

It is not clear what the future holds, particularly since the UK has been criticized for being stricter than countries like Australia and Germany that didn’t shut down their dental services immediately after the pandemic.

Martin Woodrow is the chief executive officer of the BDA. He said that the organization has been pressing for an end to the restrictions on PPE, social ditancing, and the fallow time between patients for months.

He adds that there has been controversy about the UK’s efforts in this area. There is no evidence to support claims of widespread dental infections in other countries.

The BDA is looking for a change in the way we approach dentistry. We want to break with current targets and prioritize prevention. This will ensure that all people have access to NHS dental care.

How can patients make an appointment to see a dentist if they are unable to do so?

‘Don’t go to A&E unless it is a life-threatening emergency, such as bleeding or a badly swollen face which is making it difficult to breathe,’ says Dr Clarke.

If you have severe pain, or if you need to be seen immediately by a dentist right away, dial 111. The only thing you should do if your dentist is not available to check on you, it’s best to keep up with your oral hygiene by avoiding sugary foods and flossing as often as possible.

Hilary sees the empty space between her front teeth as a reminder about the large gaps in dentistry. “It’s hard to see my gap, but I have credit and finance available for my treatment,” she said. 

“Yet months worth of pain, expense and suffering could have been avoided had I just received good treatment from an NHS dentist. The NHS dentists are able to provide the necessary treatment, but it’s not enough for everyone.

Unter dem Mikroskop

Singer Limahl (62) takes our Health Quiz

Do you have the strength to climb up those stairs?

Yes. Steve and me have been cycling off-road since I stopped going to the gym at the beginning of the pandemic. Also, I use a bench and weights.

Ever dieted?

Since I was a heart-throb I always carefully watched my diet. I don’t like the thought of appearing on stage as a fat, bald guy who’s turned into a heart-throb. My height is 9 feet 7 inches.

Do you need five daily?

About three servings of fruits and vegetables are enough for me. I have irritable bowel syndrome. My current diet is low-FODMAPs, meaning I avoid certain foods like onions, garlic, and fruit.

Comment has the pandemic affected your life?

I didn’t get Covid. I have been extremely careful. We moved in with my mum, 82 years old. I couldn’t leave her alone. My gigs were cancelled, so I started to get creative. This is my 25th album.

Do you have vices?

Fruit machines. As a kid, I used to play fruit machines and continue to do so at least once a week.

Are there any family illnesses?

My sister, mom and I have an underactive Thyroid so we all take levothyroxine.

Worst injury?

At the age of ten, I fell from a tree, dislocating my left arm seven times.

Did you have to take anything out?

Although I don’t have a basal carcinoma yet, it is happening. [a type of cancer]Taken off my forehead.

Have you ever had plastic surgery?

As a music legend, I was concerned about my hair. So I decided to have a hair transplant. It was an amazing experience.

Do you know how to cope well with your pain?

I’m a total wimp.

Ever been depressed?

When I was young, I experienced my heart break a few times. But otherwise I have never had to.

How to get rid of hangovers

When I turned 45 and noticed the long-term effects of alcohol, I cut back.

How do you stay awake at night?

Get up and go to the loo.

Any phobias?

Because I am claustrophobic I don’t like lifts or the London Underground.

Do you want to live forever?

This seems a little wasteful to accumulate all of this knowledge and then move so quickly.

Limahl’s One Wish for Christmas single is now available. Follow him @limahl_official.