A radical proposal to issue every person in England with a £150 annual dental voucher has been put forward in a bid to rescue the ailing NHS dentistry system and end the 'postcode lottery' in care access.
Blueprint for a National Smile
The plan, championed by former health secretary Sir Sajid Javid and published by the think tank Policy Exchange, suggests the universal voucher could be used towards dental insurance or a monthly subscription scheme covering routine check-ups and hygiene visits. The report, released as the Government confirmed it would push ahead with its own suite of dental reforms, argues this would "save NHS dentistry" and "fix our national smile".
Under the blueprint, individuals could take their voucher to any dentist registered with the General Dental Council for non-cosmetic procedures. Policy Exchange has also called for a mandate requiring all registered dentists to honour the voucher and to accept children as patients at existing NHS rates.
A System in 'Truly Shocking State'
Gareth Lyon, head of health and social care at Policy Exchange, did not mince his words, stating: "NHS dentistry is in a truly shocking state. A majority of people are not receiving NHS dental support at all – including millions of children."
He warned that the consequences extend beyond poor oral health and patient suffering, leading to far higher costs for the health system as untreated problems escalate, requiring expensive hospital treatment. The report also highlights missed opportunities for the early diagnosis of cancers and other conditions that dentists can help identify.
The report reveals that in the two years to March 2024, only 18 million adults and 6.6 million children in England accessed NHS dental services. This represents just 40% of adults and 57% of children, underscoring the scale of the access crisis.
Government Reforms and a Deepening Health Crisis
This proposal coincides with the Government unveiling its own changes to NHS dentistry, which it claims could benefit millions. These reforms, shaped by sector consultation, aim to make it easier for patients needing urgent care to get appointments.
Dentists will receive new incentives to provide urgent NHS care for issues like severe pain, infections, or trauma. Furthermore, patients requiring complex care, such as treatment for advanced gum disease or decay in multiple teeth, will be able to book a single treatment package rather than multiple appointments—a move the Department of Health and Social Care says could save patients around £225.
These changes form part of a broader government plan that includes more urgent appointments and supervised toothbrushing programmes for children aged three to five. The urgency for action is stark. Recent statistics show adult tooth decay levels in England have reverted to those seen in the late 1990s.
The latest Adult Oral Health Survey found 41% of people had visible tooth decay, up from 28% in 2009. Using a more sensitive measure that includes enamel decay, nearly two-thirds (64%) had decay in one or more teeth. Separate data indicates up to six in ten children in some areas have rotting teeth by age five.
Shiv Pabary, chair of the British Dental Association's general dental practice committee, called the announced government changes "the biggest tweaks this failed contract has seen in its history". He cautioned, however, that this "cannot be the end of the road", calling for a response "proportionate to the challenges we face".
In his introduction to the Policy Exchange report, Sir Sajid Javid argued the voucher system would "empower patients, drive up standards through genuine competition, and finally break the deadlock of the current contract". Neil Carmichael, executive chairman of the Association of Dental Groups, endorsed the need for urgent reform, stating: "We urgently need reform."
