Ask the Dentist: NHS has made a huge contribution to oral health among public

Lucy Stock, dentist at Gentle Dental Care, Belfast, writes that 70 years adds up to a whole lot of dentures and a highly regarded oral health service

85 per cent of people rate their NHS dental experience as positive
Lucy Stock

THE poor state of people's teeth had been highlighted at the end of the 19th century by the British army's recruits for the Boer War: of 208,300, there were 6,942 hospital admissions owing to dental causes, of which one third had to be sent home unfit to serve.

The British Dental Association (BDA) is highlighting the amazing contributions dentists have made to NHS care during the 70th anniversary year of the NHS.

The launch of the NHS in 1948 meant that, for the first time-ever, dental care was free at the point of use, dramatically changing people's access to good oral healthcare, their expectations and their appreciation of looking after their oral health.

In 1948 public dental health in Britain and Northern Ireland was in a worse state than that of defeated and occupied Germany: decay, pyorrhoea, and sepsis were rife. More than three quarters of the population over the age of 18 had complete dentures.

Dentists at the time had concerns about how the new NHS system funding could be sustainable. An item of service payment system for dentists was proposed, but the complexities of how this could work and the need for prior approvals and a likely growing mountain of bureaucracy, were felt to have not been thought through.

When the NHS opened for business on July 5 1948 the BDA estimates that just over a quarter of practising dentists had signed up to work in the NHS.

The demand on the new NHS was overwhelming. Dentists went from seeing around 15 to 20 patients a day to seeing more than 100. The initial hope had been that there would be less emphasis on dentures for older people and more conservative treatment for children. However, the demand for dentures was incredible.

In the first nine months of its existence NHS dentists provided over 33 million artificial teeth, a figure that would rise to 65.5 million for the year 1950-1951.

Extractions still formed a large part of dentists' work – 4.5 million in the first nine months – but so did fillings – 4.2 million in the same period.

More people were being treated than ever before, which had been a main objective of the new service, but this success came at a huge financial cost.

By 1951 the NHS was already running out of money. To help alleviate this, charges for dentures, the first of any kind for NHS treatment, were introduced, causing much debate in government and the public arena and leading to the resignation of Aneurin Bevan, the minister who had been crucial to bringing the NHS into existence.

Satisfaction with NHS dentistry is currently at one of the highest levels seen this century, with 85 per cent rating their NHS dental experience as positive.

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