The state of NHS dentistry in Liverpool

In winter 2022 Healthwatch Liverpool published a report highlighting the state of dentistry in Liverpool. Two years on that report is still their most read report and dentistry is still the most common subject the public call Healthwatch Liverpool about. They thought it was time to update the report to show the state of dentistry in 2025

The report highlights that NHS dentistry remains the most common issue raised by the public, accounting for more than half of all enquiries. This is a significant increase from around 20% before the pandemic. Access to NHS dental care in Liverpool is among the worst in Cheshire and Merseyside. Only 36% of adults and 56% of children have seen an NHS dentist in the most recent reporting period, leaving large gaps in provision.

There are severe shortages in access to NHS dental care. Few practices hold NHS contracts, and most restrict new patients to children, sometimes only those under the age of two. Adults often face years-long waits or cannot access care at all. The Emergency Dental Service provides temporary fixes such as antibiotics or fillings but does not offer ongoing care, leaving patients in repeated cycles of pain.

Financial barriers are significant. Many residents who are eligible for free NHS care cannot access it, and private costs are many times higher than NHS charges. For example, a root canal costs £73.50 under the NHS but £250–£320 privately. The lack of care leads to worsening dental problems, hospital admissions for extractions—Liverpool has one of the highest rates in the region—and serious physical and mental health consequences. Low-income groups, homeless people, carers, refugees, and those with mental health issues are disproportionately affected.

Data shows that tooth decay in five-year-olds has improved from 43.5% to 33.3%, but this figure is still above the national average. Hospital extractions for 0–19-year-olds in Liverpool are among the highest in Cheshire and Merseyside. National polling in 2024 revealed that 16% of people had not seen an NHS dentist in two years because they could not get an appointment. Of these, 20% lived in constant pain and 27% resorted to private care.

Local action includes the Cheshire and Merseyside Dental Recovery Plan (2024–2026), which introduced urgent care pathways, child-focused pilots, and targeted schemes for vulnerable groups. Public health initiatives have also been implemented, such as supervised toothbrushing programs, oral health packs, and sugar awareness campaigns.

The report recommends national reform to introduce a right to register with an NHS dentist, similar to GP registration, protect dental budgets, and reform the NHS dental contract. Locally, priorities include expanding the recovery plan, improving access in Liverpool to at least the regional average, recruiting and retaining NHS dentists, and ensuring fair allocation of resources. Vulnerable groups such as mental health patients, trauma survivors, homeless people, carers, and non-English speakers need tailored support.