Healthy NHS dental patients in Wales could soon face waits of up to two years between routine check-ups under sweeping reforms set to come into force in April 2026.
The Welsh government has confirmed that regular six-monthly appointments will no longer be the norm for patients with good oral health. Instead, those with no obvious dental problems may be recalled every 18 to 24 months, even though this is in line with the maximum interval recommended by NICE guidelines.
Patients will typically see a dental hygienist every 6 to 12 months.
However, earlier proposals to place patients on a central waiting list and allocate them to any available dentist within their health board area have now been scrapped. Patients will remain linked to individual practices rather than being assigned a different dentist at each visit.
Ministers say the revised policy will allow dentists to focus more time on those who need urgent or complex treatment. But many within the profession have raised concerns that extending the time between check-ups risks creating deeper inequalities in access to care.
Fears of a Growing Social Divide
The British Dental Association (BDA) Cymru acknowledged what it described as “some important wins” in the updated approach. However, it warned that longer recall periods could reduce opportunities to detect early signs of tooth decay, gum disease and even oral cancer.
Dr May Bassett, an NHS dentist based in Abercynon, Rhondda Cynon Taf, said the changes reflect a wider shift in how NHS dentistry is now delivered. She said NHS services have increasingly become focused on emergency care rather than prevention.
“We work a lot on an emergency care basis now,” she said.
Dr Bassett explained that when patients were seen more regularly, dentists had the chance to spot early signs of decay and intervene before problems became severe. Now, she says, many patients arrive with teeth “beyond the point of repair”.
“We’re getting to a point where it’s no longer an option to treat with fillings or root canal treatment. It tends to be going towards an extraction-only service,” she said.
She warned that some patients only manage to see an NHS dentist when they are already in significant pain. More advanced treatments such as root canal therapy often require multiple appointments, which are not always possible within emergency settings. As a result, some patients opt to have the tooth removed instead.
Extraction, she said, can have wider health consequences, particularly when ongoing professional oversight is limited.
“It’s going to create a social divide, where people who can afford to keep their teeth healthy will have good teeth,” she said.
“People who can’t afford it will have poor oral health, and subsequently poor general health as a result.
“It seems like a final nail in the coffin for NHS dentistry.”
Financial Pressures on Practices
Dr Bassett said she previously worked exclusively within the NHS but now combines NHS and private dentistry after gaining further training in orthodontic and aesthetic procedures.
Dental practices in Wales are privately owned businesses rather than state-run services. Many rely on private income to remain financially viable.
“The amount of patients you’ve got to see in the time you’re given within the NHS – it’s an impossible workload to sustain,” she said.
Under the most recent NHS contract model, dentists were paid a fixed amount per patient, regardless of how much treatment that individual required.
“A lot of people are making a loss on their NHS work currently,” she said. “If that changes and the losses become worse, you’re looking at a mass exodus from the NHS.”
The Welsh government has proposed increasing the general fee paid to dentists from £135 to £150 per patient. Patients who are not exempt will continue to pay half the cost of NHS treatment, capped at £384 regardless of how much care they require.
Around half the Welsh population is exempt from charges, including children, pregnant women and certain benefit recipients.
Access Still Below Pre-Pandemic Levels
Access to NHS dentistry in Wales remains significantly below pre-pandemic levels. Before Covid, around 45% of the population received NHS dental treatment.
The latest figures, published in March, show that only 33% were treated by an NHS dentist in the previous 12 months.
Many patients continue to struggle to register with a practice. Samar Salih said she has been on a waiting list for two years without success.
“I’ve got very bad teeth and I’m struggling with infections,” she said.
“One tooth half is lost – when I smile I feel so embarrassed because I can’t fix it and financially it’s hard to go to a private dentist.
“All the time I’m going and trying to get an NHS dentist. They say my name is on the waiting list, but I’m not getting any answer.”
Calls for Clarity from Ministers
Responding to the reforms, the BDA warned that partial adjustments would not address deeper structural problems.
“Plastering over a few of the biggest cracks is just superficial repairs,” the association said, arguing that the true cost of dental care is still not reflected in funding arrangements.
Russell Gidney, chairman of the BDA’s Welsh General Dental Practice Committee, said: “We need to see the small print.”
“Ministers are taking forward the biggest changes NHS dentistry in Wales has ever seen via a route that will all but rule out fixes once draft laws reach the Senedd,” he said.
“The Welsh government must ensure real threats to this service don’t make the final cut of their plans.”
As the reforms move closer to implementation, both dentists and patients are waiting to see whether the new system will stabilise NHS dentistry — or deepen concerns about access, prevention and long-term oral health.
