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A growing number of people in England are turning to private dental services as access to NHS dentists continues to decline, according to new findings from Healthwatch England. The patient watchdog revealed that nearly one-third of adults now rely on private dentistry, highlighting a worsening access crisis within the public system.
The proportion of patients paying for private dental treatment rose significantly from 22% in 2023 to 32% by late 2025, largely because many people cannot secure an NHS appointment. As a result, Healthwatch warns that dental care is increasingly becoming a single-tier system dominated by private providers for many communities.
The shift is particularly affecting people with lower incomes. Data shows that the share of financially struggling individuals using private dental services has almost doubled from 14% to 27% in recent years. Healthwatch says these patients often face a “double penalty”: they pay much higher fees for private treatment while also missing out on the free NHS dental care they are entitled to, including benefits available to low-income patients, pregnant women, and new mothers.
Private dental costs are substantially higher than NHS charges. For example, a routine dental check-up that costs £27.40 under the NHS may cost around £64 privately, placing additional financial pressure on those already struggling.
Rebecca Curtayne, acting head of policy, public affairs and research at Healthwatch England, warned that vulnerable people are bearing the brunt of the shortage of NHS dental appointments. She said many individuals are either forced to pay for private treatment they can barely afford or go without care altogether, demonstrating serious weaknesses in the current system.
The findings come from a survey of 2,593 adults conducted in October and November last year, which will form part of Healthwatch’s upcoming annual report on patient experiences within the healthcare system.
Healthwatch is urging the government to address the crisis by giving everyone the right to register with an NHS dentist, similar to how patients can join a GP practice. The recommendation comes as the organisation itself faces abolition as part of a controversial restructuring of NHS oversight led by Health Secretary Wes Streeting.
Patient advocacy groups say the situation highlights deep structural problems in NHS dentistry. The Patients Association argued that for many people the NHS dental service effectively exists “in name only.” Chief executive Rachel Power said the lack of affordable dental care can have serious consequences for both physical and mental health, leaving patients in prolonged pain and distress.
Concerns about the private dental market have also drawn the attention of regulators. The Competition and Markets Authority (CMA) recently launched an investigation into the UK’s £8.4 billion private dentistry sector to examine whether it is operating fairly for consumers.
CMA chief executive Sarah Cardell said many patients face confusion about treatment costs, availability, and their entitlements. While some people choose private dentistry, she noted that for many others it has become a necessity rather than an option.
The regulator estimates that around one in five people in the UK use private dental care, a figure lower than Healthwatch’s estimate for England. The CMA’s inquiry will examine competition in the sector, access to services, and rising prices. For instance, between 2022 and 2024 the average cost of an initial consultation increased by 23% to £80, while a standard check-up rose 14% to £55.
Dentists argue that the crisis is driven largely by underfunding in the NHS system. According to the British Dental Association (BDA), government payments for certain NHS procedures are so low that dentists often perform them at a financial loss. The BDA claims dental practices collectively subsidise NHS work by around £400 million each year just to break even.
BDA chair Eddie Crouch said patients who feel forced into private care are experiencing the consequences of long-standing government funding decisions.
Recent figures have also revealed unused NHS funding. A BBC investigation found that dental practices in England returned £936 million of allocated NHS dental funding over the past two years, partly because they lacked the capacity to carry out the planned treatments.
In response, the Department of Health and Social Care said the current government inherited a dentistry system that had been neglected for more than a decade. Officials say efforts are underway to improve access, including delivering 1.8 million additional dental treatments within the first seven months of this year, with a focus on children and people in the most deprived areas.
The government also plans to reform the NHS dental contract, aiming to increase patient numbers and prioritise preventative care, with the goal of ending the growing divide between private and public dental services.
