In December 2007 Citizens Advice commissioned Ipsos MORI to undertake research into access to NHS dentistry, in order to clarify the size and nature of the problem.
Questions were placed on the Ipsos MORI Omnibus. A nationally representative quota sample of 1813 adults aged 15 and over was interviewed throughout England and Wales by Ipsos MORI in 169 sampling points. Interviews were conducted face-to-face in people’s homes, using CAPI (Computer Assisted Personal Interviewing) between the 7 and 13 December 2007. Data were weighted to the known population profile of England and Wales. Extrapolated population figures quoted in this report were calculated using ONS 2006 Mid-Year Population estimates, taking the total adult (15+) population of England and Wales as the total.
Respondents were asked whether they had been to a dentist since April 2006. Sixty-five percent had done so, and of these, 64% had had NHS treatment on their last visit and 31% had had private treatment. There were income differences between those who had had NHS and private treatment, with people with annual household incomes of less than £30,000 being more likely to have had NHS treatment. Young people aged under 25 were also significantly more likely than those aged 65 or over to have had NHS rather than private treatment on their last visit.
Difficulties in finding an NHS dentist
Approximately 54% of the adult population had not had NHS treatment since April 2006 - either because they had had no treatment or because they had gone privately. These respondents were asked for the main reasons why they had not been to an NHS dentist. Two reasons dominated the replies. Firstly 31% of respondents who had not had NHS treatment since April 2006 said that the reason for this was that they could not find a dentist to provide NHS treatment. This equates to approximately 7.4 million people. Of these, the equivalent of approximately 4.7 million people had sought private treatment instead, and around 2.7 million had gone without any dental treatment.
There is evidence that problems finding an NHS dentist are not uniformly spread across England and Wales. In the south west, 53% of those who had not had NHS treatment since April 2006 cited this as a main reason for not having been to an NHS dentist, and the percentage was also above average in the North West (39%). In contrast, this reason was given by only 19% of respondents in Greater London and 21% in the West Midlands.
Perceived need for dental treatment
Problems with accessing NHS dentistry are not however the only reason why people have not had dental treatment since April 2006. The other common reason, given by 30% of all those who had not been to an NHS dentist, was that they considered they had not needed treatment. This reason was disproportionately given by people in typically disadvantaged groups. Thirty-nine percent of people in social grades DE stated that they had not needed treatment, a significantly higher proportion than the 25% and 27% of people in social grades AB and C1 respectively who stated the same. This reason was also given by 35% of those with annual household incomes of less than £17,500 per year (a significantly higher proportion than the 22% of people with annual household incomes of £17,500 or more who stated the same). Not feeling a need to see the dentist was also stated by 57% of non-white respondents, compared to just 26% of white respondents.
Although not an issue covered in this research, it seems unlikely that these groups had better oral health than the rest of the population. Rather their response may indicate a difference in perception about the importance of regular visits to a dentist in order to receive preventive dental care, as opposed to waiting for a problem to occur before making an appointment.
These responses were not evenly spread geographically either, with respondents in Yorks/Humberside (46%) and the West Midlands (40%) being particularly likely to say they had no need for dental treatment.
NHS Dental charges
Only 4% of respondents mentioned the cost of NHS treatment as one of the main reasons why they had not been to an NHS dentist.1 There was some indication that younger people (aged under 35) were more likely to give the cost of NHS treatment as a reason for not going to the dentist, but the numbers giving this as a reason were too small to make further analysis possible.
1. However the 2007 CAB online survey showed that many people do find the NHS charges difficult to afford.
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