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By Nick Triggle
Health correspondent
People in England are struggling to get dental treatment, as dentists close to new NHS patients, a watchdog says.
Healthwatch England, the NHS body representing patients, said the problem was made worse by the rising cost of living and needed "urgent attention".
It said some people were living in pain, unable to speak or eat properly, because they could not find treatment.
And it warned the poorest were suffering most as they were least able to afford to pay for private dentistry.
Healthwatch England said the issue was creating a two-tier system - dividing the rich and the poor - and called on the government to take action.
"There is now a deepening crisis," said Louise Ansari, of Healthwatch England.
"With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option - and even NHS charges can be a challenge.
"This needs urgent attention."
The government said it was increasing investment in services to improve access as well as looking to reform the system.
And a spokesman for the Department of Health and Social Care added ministers were "committed" to addressing the issues as part of the levelling up agenda.
'I'm in constant pain'
Ryan Herrmann is in constant pain. One of his fillings fell out two years ago, during the first lockdown.
Dentists were closed during lockdown, so he soldiered on. Eventually the pain became too much and he went to an emergency service and was given a temporary filling.
That filling later fell out, however. But when dental services were fully open again, he could not find an NHS dentist in the area willing to accept new patients. He had recently moved to Wiltshire from London and had not had the opportunity to register at a new practice.
"Tooth pain sends you mad," he said. "You feel irritable, can't relax and are constantly on edge. I'm angry - really angry.
"If I had money I could afford private treatment next week. It feels like we're being told, if you're poor -you're not worthy of treatment."
The recent warning by Healthwatch England comes after the NHS body commissioned a survey of more than 2,000 adults in England. The survey was then examined, alongside feedback from local NHS teams.
The poll found around half of those surveyed had visited an NHS dentist in the past two years.
- 41% said it had been difficult to book an appointment
- 20% said they could not access all the treatments they required
- 17% felt pressurised to pay privately
Of those that had not seen an NHS dentist, the majority either did not need treatment, chose not to go to the dentist or were prepared to pay for private care.
But more than a fifth - 21% - said they had wanted to get NHS treatment, but had been unable to find any dental services locally.
'Shameful inequalities'
Healthwatch said a combination of factors appear to be contributing to the problem - with a long-standing shortage of NHS provision exacerbated by more dentists closing their lists to NHS patients during the pandemic, as well as some staff retiring.
The rising cost of living was also making it more difficult for people to pay for treatment, both privately and on the NHS, which typically only subsidises treatment rather than providing it for free.
The British Dental Association said there had been inadequate funding for NHS dentistry for the past decade, calling the current contract "dysfunctional", as it provided insufficient reward for treating patients.
BDA chair Shawn Charlwood added: "Shameful inequalities are set to widen. For over a decade this services has been running on empty, with patients paying more just so the Treasury can pay less.
"Choices made by government mean dentists are now walking away from the NHS."