The British Dental Association has told the Department of Health and Social Care that a package of capital funding now offers the only hope of restoring routine services to millions of patients across the East of England, as a new survey indicates a service in crisis is incapable of delivering investment to meet new rules that could boost access.
In an open letter to Health Secretary Matt Hancock the BDA has set out the case for urgent support.
According to new survey data from practices across the region:
63% of practices are now operating at less than half their pre-pandemic capacity, with over half (55%) reporting less focus on ‘routine’ dentistry, as urgent and emergency cases receive needed priority.
The number one barrier to increasing capacity is ‘fallow time’– the time gap mandated between procedures to minimise risks of viral transmission – with 89% of practices reporting it as a major obstacle. PPE availability – formerly the key challenge – is now cited by 27% of practices as supplies have improved. Financial and cash flow problems are cited by 59% of practices, and patients’ unwillingness to attend by 35%.
While new regulations may enable practices to slash their fallow time, many practices (49%) now lack the funds to invest in the new equipment required to do so.  Industry sources estimate costs for mechanical ventilation for meeting required levels of ‘air change’ at £10,000 for a typical practice. 51% of practices also lack data on air change levels to even establish their compliance with new rules.
At present 56% of practices estimate they are able to maintain their financial sustainability for 12 months or less.
Between the March lockdown and September in England over 14.5 million fewer NHS treatments were delivered in 2020 compared to the same period last year – a figure the BDA now estimate to have reached 19 million.  With practices remaining open during the current lockdown, dentists have stressed the focus remains on managing an unprecedented backlog of urgent cases, often limiting scope for essential routine dentistry, particularly in NHS care.
The BDA has warned of widening inequality, as patients face poorer outcomes given the huge barriers to early detection of conditions from decay and gum disease through to oral cancer.
It has been over a decade since dentists in England received any capital investment from central government. The BDA has estimated government would rapidly recoup costs through increased patient contributions as a result of rising patient volumes. Since lockdown the Treasury has lost nearly £400 million from the patient contributions that are increasingly relied upon to fund NHS services in England, with around £50m in revenues now being lost per month. 
British Dental Association Chair Eddie Crouch said:
“COVID restrictions have left dentists across the East of England firefighting with huge backlogs, unable to see more than a fraction of our former patient numbers.
“We now face a Catch-22. New rules could bring back a dose of normality, but come with a multi-million-pound bill for new kit that practices simply cannot afford. “On paper we have a chance to restore services to millions, but without support from Government it won’t translate into better access.
“The clock is ticking on an oral health time bomb, as dentists lose the chance to act on the early signs of decay and oral cancer.