A call to dentistry’s front line, by Sara Hurley
For too long, dentistry has waited in the wings of national health strategy—acknowledged, but rarely prioritised. That has changed. With the publication of England’s 10-Year Health Plan, oral health has finally moved from the margins to the main stage.
This isn’t a passing mention. The Plan embeds dentistry into a fully integrated, prevention-first NHS. It sets a clear ambition: by 2035, NHS dental care will be high-quality, prevention-driven, digitally enabled, team-led, and equitably accessible – especially for children and those most in need.
That’s bold. And it’s not accidental. It is the result of years of advocacy, research, and collaboration across public health, education, and clinical practice. It’s a testament to those who made the case – loud and clear – that oral health is health.
Yet behind the headline ambition lies a crucial truth: this Plan won’t deliver itself. Its success – or failure – rests in the hands of Integrated Care Systems (ICSs) and on our profession’s readiness to act with unity, ambition, and purpose.
A national system poised for renewal
In 2023/24, NHS England reclaimed £392 million in undelivered dental activity – the highest in a five-year trend that has seen an average of £182 million returned annually (NAO, 2024). That’s not just a financial statistic – it represents lost care, missed prevention, and unmet need in our communities.
As we experience every day, this isn’t about falling demand – it’s about a system struggling on every level. Outdated contracts, overburdened commissioners, and rigid procurement frameworks are holding innovation back. Too many practices remain bound to outdated models that fail to reflect the reality of modern, multidisciplinary care. Therapists, hygienists, and dental nurses are underused. Digital tools are fragmented. Innovation is sporadic and under-supported.
But change is not only possible – it’s already happening. Where teams embrace digital triage, role optimisation, and community-focused care, we see improved access, better outcomes, and higher morale.
The 10-Year Plan gives us the policy platform to scale what works. The rest is up to us.
Five critical asks: From the front line up
As we turn vision into action, we need national and local leaders—professional bodies, LDCs, commissioners, and educators—to rally behind five essential enablers:
A clear ICS commissioning mandate
ICSs must be empowered to commission flexible, community-based delivery: therapist-led clinics, mobile outreach, school programmes, sessional contracts. Give them the rules – then let them play.
Agile contracting tools
Current frameworks stifle innovation. We need adaptive, outcome-focused contracts that enable new providers to scale proven models.
Workforce models that retain and inspire
Graduate tie-ins alone won’t solve the workforce crisis. We need local retention plans, funded CPD, and career pathways that support team-based models – expanding scope without burning people out.
Use the underspend – don’t lose it
Let ICSs reinvest clawed-back dental funds into local prevention initiatives, particularly for Core20PLUS5 communities. It’s the fastest route to access and equity.
Embed oral health in ICS strategy
Dentistry must be core to ICS priorities – from school readiness to healthy ageing. Oral health isn’t a side project; it’s a key determinant of population health.
What Can You Do?
This is a call not just to policymakers but to every dental professional. Your actions, your leadership, and your voice matter. Whether you’re a practice owner, therapist, nurse, student, or commissioner, there are levers you can pull.
At neighbourhood level:
- Connect with family hubs, schools, and primary care networks.
- Deliver oral health education.
- Signpost, refer, and document unmet need.
At place level:
- Join local health and wellbeing forums.
- Invite ICB leaders, local MPs, and councillors to see what modern dental care looks like.
At system level:
- Respond to consultations.
- Speak up for reforms that reflect your reality.
- Back your professional body in pressing for change.
We now have a clear and ambitious mandate from government – a platform grounded in prevention, equity, and digital transformation. But the next chapter belongs to us. This is no time to wait and see – it’s time to act.
Dental care and oral health must be central to building a fairer, healthier, more prevention-focused NHS. If we don’t shape that future in our own backyard, others will, and we may not like the result.
The 10-Year Plan has cracked the door open. The question is: do we step through it or stand by while it quietly closes?
