Getting to the root of London’s dental problems

• One quarter (25.8 per cent) of 5-year-olds in London experienced tooth decay in 2021-22 – which is higher than the English average of 23.7 per cent.
• More than 5,000 children aged 0 to 9 in London were admitted to hospital for tooth extractions in 2022-23.
• 47.1 per cent of children in London did not access an NHS dentist between March 2023 and March 2024.
• Nationally, the tooth extraction rate for children and young people living in the most deprived communities was nearly 3 and a half times that of those living in the most affluent communities.
• Water is not routinely fluoridated in London. Since 2022, the Government has had new powers to introduce water fluoridation schemes across the country.
• In the two years to March 2024, just 39 per cent of adults accessed an NHS dentist in London, while just 53 per cent of children accessed an NHS dentist in the previous year.
• The current NHS dental contract is severely flawed and needs fundamental reform.
• Funding for NHS dentistry has not kept pace with inflation. There is currently not sufficient commissioned NHS activity to meet the needs of London’s population.

The London Assembly Health Committee report ‘Decay & Delay: The state of Dentistry and Oral Health in London’ makes a number of recommendations including:

• The Mayor should lobby the Government to start the process of dental contract reform as a matter of urgency, setting out how the current contract is not serving Londoners, with the aim of reforming the contract by the end of 2025.
• The Mayor should work with NHS England (London) and London’s Integrated Care Boards on a public messaging campaign in 2025 to highlight the importance of visiting the dentist and to publicise the fact that dentistry is free for certain groups, particularly children. This should be targeted at the areas of highest need in London, and at demographic groups who are less likely to access appointments.
• The Government should provide funding for local authorities to expand the provision of supervised toothbrushing in primary schools in London, targeted at areas with the greatest need. Schools must be provided with the necessary level of support to deliver these programmes. The Mayor should lobby the Government to do this.¹
• The Mayor should carry out a review of the feasibility of fluoridating London’s water in 2025. He should submit the findings of this review to the Government, with a recommendation as to whether the Government should introduce fluoride into London’s water.

Chair of the London Assembly Health Committee, Krupesh Hirani AM, said:

“The Health Committee undertook a comprehensive investigation into various aspects of oral health. We examined the current state of dental education in schools, as well as the challenges faced by Londoners in accessing NHS dental services and receiving quality care.  We found much that was successful, but the gaps in preventative work and emergency treatment are significant and people must have access to emergency care when they need it.

“The Committee urgently supports a new dental contract, and it also believes that the feasibility of fluoridating London’s water should be investigated.

“Good oral health is essential for overall wellbeing. There are things we can do to look after our teeth, but we should be able to get an appointment when it is needed.  Access to healthcare should be a right not a privilege, and that includes dentistry.

“London should smile with pride at its dental care – that sadly isn’t the case at the moment.