Dental Statistics
Dental Statistics for England 2022-2023 (and insights).
(NOT exact figures and will vary drastically in different parts of the country)
Dental Public Health:
Only half of all children and adults have seen a dentist in the last year. This is despite everyone under 18 years of age being eligible for free NHS dental care and many adults being able to claim for free NHS care through certain benefits or applying for a HC1 certificate. 25% of NHS adult patients are exempt from paying any charges.
12% of 3-year-old children have dental caries affecting an average of 3 teeth per child.
23% of 5-year-olds have dental caries affecting an average of 3-4 teeth per child.
Tooth decay is the most common cause of hospital admissions for children aged 5-9 years of age.
50% of 8-year-olds have visible signs of tooth decay.
10% of primary school leavers are unable to brush their teeth without assistance. This problem is far worse for girls (15%) than boys (4%).
Children who watch more than 90 minutes of TV a day are 39% more likely to have tooth decay, largely because of the extra sugar they consume while they are watching.
35% of 12-year-olds are embarrassed to smile because of how their teeth look. This is mainly due to perceived mal-alignment or crowding. However, a similar proportion also have visibly decayed teeth.
67% of children and adults clean their teeth at least twice a day, 27% brush once a day and 6% brush less often. The habits of the parents are often instilled into or replicated by their children.
Children living in families with low incomes are more than twice as likely to have decay in their primary teeth as children from families with high incomes
56% of children saw a dentist in the last year. This drops to 31% for those under 5 years old. The earlier children start regular dental visits, they less likely they are to fear the dentist or to have tooth decay.
43% of adults saw a dentist in last 2 years. This drops to 37% for those over 85 years old. People who visit the dentist once a year are 40% less likely to have tooth decay than those who visit less often.
75% of adults have had teeth Extracted and 13% have to wear partial dentures. 6% have lost all their teeth from infection and disease and most have to wear full dentures. The number of people with no natural teeth increases to 15% for 65-74-year-olds and 23% for people aged 75 and above. Why do people have teeth extracted? Very often this is due to not having regular checkups or refusing advised treatments and allowing decay to destroy too much of the tooth
84% of adults with any teeth have at least 1 filling, the average being 7.2 teeth with fillings. Why do people get tooth decay? Because of poor oral hygiene and a high sugar diet.
83% of adults have gum disease. Why do adults suffer from gum disease? Because of poor oral hygiene…they are are not brushing or flossing their teeth frequently or for long enough or their technique is ineffective. This is made worse by not regularly visiting a dentist or hygienist for deep cleanings. Gum disease is also made worse by a weakened immune system such as that caused by diabetes, stress, depression and pregnancy.
45% of people use an electric toothbrush rather than a manual toothbrush. Before modern toothbrushes were invented, people used to chew frayed twigs to clean their teeth. This is still a common practice in many parts of the developing world.
33% of adults have never flossed or cleaned interdentally. Why is it important to floss or use Tepe brushes between your teeth?…brushing will not effectively reach between your teeth and so without proper interference cleaning there will be parts of your mouth that are never cleaned out. This is the most common reason for gum disease and bad breath.
Only 47% brush with a fluoride toothpaste for at least two minutes, due to concerns over flouride.
40% of adults are unhappy with the appearance of their teeth and don't feel confident showing their teeth when they smile for a photo. A third of these say it's because their teeth look discoloured and cite TV and social media as being the cause
30% of adults say they regularly experience dental pain or sensitivity and 21% say they have had problems eating because of the state of their teeth. Around 30% of adults have decayed and untreated teeth. However, dental pain can also arise from TMJ dysfunction and Myofacial pain. Tooth sensitivity is more often caused by gum disease leading to gum recession and exposure of the naturally more sensitive dentine of the root surfaces which is not covered by the harder and more protective enamel.
36% of people are not visiting the dentist as a result of money worries and 27% only attend when they are having problems with only 8% going when they are in significant pain. 22% admit to avoiding dental visits because of anxiety with 14% of adults having severe dental anxiety, and 18% because they are afraid of getting bad news. The things most likely to cause anxiety are having a tooth drilled, extracted or getting an anaesthetic injection. However, there are many instances where people will spend a similar amount of money on their clothes, phone or car maintenance and don’t see their dental health as being as important until they get severe pain which eventually brings to the dentist to accept treatment. As many patients delay treatment until the pain becomes unbearable, by the time they see a dentist to have it treated it is often too late by that stage and the tooth often needs extracting. Even if it can be saved with an RCT and future crown the prognosis is much reduced and the treatment is time consuming, difficult and potentially expensive. This all adds to people’s fear, dislike and mistrust of dentists.
19% of adults said they had attempted DIY dentistry.
90% of NHS practices are not taking new nhs adult patients and 80% are not taking on new child patients. This is because the amount of NHS treatment any practice can do is limited by the NHS due to their limitations of funding and almost all practices have their NHS lists understandably fully booked. The only way to make space for new patients is to remove the existing patients that have not attended for a number of years or continue to miss their appointments. However, this causes a problem for those patients when they try to get an appointment due to pain.
There is a lot of reporting about the “NHS crisis” as patients cannot get an NHS appointment. However, there are many days when an NHS dental list is littered with patients who fail to attend or cancel late for their appointments. This can account for hours of wasted time on any given day. Receptionists can call patients who have been placed on a cancellation list, but without proper advanced notification these spaces often go to waste. Many NHS appointments are also wasted by patients trying to convince dentists that their cosmetic treatment should be available on the NHS or that there child’s slight spacing between their teeth, crowding or rotation of a tooth needs orthodontic treatment under the NHS. Much NHS time is also wasted when patients miss their appointments at the hospital, or parents fail to bring their children to the community dental services or sedation clinics, following a referral from the dentist.
Many patients are deciding to go abroad to get advanced or cosmetic dental treatment at a lower cost to that available in the UK. Some treatments are successful, but around 75-85% need remedial work due to being ill-conceived or poorly executed such as bridges on poor-prognosis and periodontally affected teeth, implants that perforate through the maxillary sinus, RCT's that are poorly condensed or well short of the root apices, or multiple veneers/crowns on sound healthy teeth. Clinical judgment in these cases is made on the basis of the patient being able to pay for the treatment rather than it being beneficial for the patient. Aftercare and warranty on such treatments is then difficult if not impossible as patients can not easily return to the dental practice that did the treatment. Such patients are then left with remedying any problems privately in the UK or trying to convince NHS dentists to fix the problems caused by dental treatment done abroad. The NHS cannot act as the warranty or insurance policy for ill-advised dental treatments done abroad.
Dental Practice Recruitment and Retention:
There are around 14,000 dental practices in the UK, with 44,000 dentists, 58,000 nurses, 9,000 hygienists and 6,000 therapists. This means the average dental practice has 3 dentists and 4 nurses. Hygienists are found in 2 out of 3 dental practices. Therapists are found in half of all dental practices. This does not take into account that many will be working part-time in two dental practices. Most dental practices employ 11 or fewer staff, including clinicians, the vast majority of whom are female.
The average salary of dental nurses is £11-17 per hour.
The average salary of dental hygienists and therapists is £15-22 per hour.
The average salary of dental receptionists is £8-11 per hour.
The average salary of dental practice managers is £16-33 per hour.
There around 5 dentists for every 10,000 people…this means that the average dentist has a patient list of around 2,000 people.
The number of female dentists has been increasing year on year and in 2018-2019 they surpassed the number of male dentists for the first time. This trend will continue for the foreseeable future as women have been naturally drawn to the healthcare sector.
20-30% of dentists are qualified from abroad with the vast majority of these being from the European Economic Area. These numbers have reduced since Brexit in 2020.
70% of dentists are providing NHS services with 30% providing only Private services. From around 1990 there has been a gradual reduction in NHS dental funding from the government and the introduction of NHS "claw-back", which lead to a reduction in the profitability and number of NHS dental practices. This marked the growth of private dental practices. In 2006 when the Units of Dental Activity (UDA) system was started this pushed even more dentists into the private sector.
In 2005 changes in legislation meant that non-dentists could own a dental business. This started a rapid growth in the dental corporate sector, which now owns around 15% of all dental practices in the UK. Another 20% of dental practices are owned by multiple-site (2-19 practices) owners with a majority of 65% still being owned by independents. The trend is towards fewer independent owners and more multiple-site and corporate owners.
60% of NHS GDPs reported their intentions to leave or reduce their NHS commitment in the next five years and 40% of dental nurses are looking to quit dentistry altogether in the next two years.
An increasing number of graduates and younger dentists are investing their future in the private sector or going abroad for work.
The staff turnover rate in Dentistry is around 30%, well above the national average of roughly 20%.
The highest risk for turnover is for administrative staff. Considering their administrative experience, many of the dental admin staff looking for new jobs may seek opportunities outside of the dental industry altogether.
Most dental practice managers work for dental corporates or private practices and have over 10 years experience in dental practices, often as receptionists without any formal education.
80% of dental practices had more job vacancies during 2022 as compared to the previous year.
65% of dental practices reported having unfilled dentist vacancies, with 30% of those vacancies having been unfilled for more than a year.
30% of practices are looking for locum/temp workers to fill their vacancies. This may plug the gaps for now, but is not a long-term strategy for solving our staffing crisis.
Urban areas (particularly London) remain the easiest to recruit staff with rural parts of the UK being the most difficult to recruit. This is naturally because more people want to live and work in the cities rather than the countryside.
References:
digital.nhs.uk
statista.com
gdc-uk.org
england.nhs.uk
ons.gov.uk
dentalhealth.org
chemist-4-u.com
dentaly.org
nao.org.uk
nature.com
bda.org
dentistry.co.uk
clearwaterinternational.com
nationalcareers.service.gov.uk
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