Feature Data Briefing

Dentistry: should it be in the NHS at all?

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5986 (Published 10 November 2016) Cite this as: BMJ 2016;355:i5986
  1. John Appleby, chief economist
  1. Nuffield Trust, London W1G 7LP, UK
  1. John Appleby examines the link between deprivation and use of dental services
  1. john.appleby{at}nuffieldtrust.org.uk

When the NHS opened for business in 1948 two of its biggest product lines quickly became the supply of spectacles and dentures. According to the British Dental Association, in the first nine months of the NHS, dentists provided over 33 million artificial teeth, 4.5 million extractions, and 4.5 million fillings. Dental surgeries were overwhelmed by the demand for treatment.1 Since then dentistry has moved on from drilling, filling, and extraction—but so too has the public’s dental demands. Are we approaching a point where it will become increasingly hard to justify tax funding for dentistry? Is the perfect smile a medical necessity worthy of public subsidy?

There is no doubt that the nation’s gnashers have improved tremendously over time. In 1968 a staggering 37% of the adult population of England and Wales had no teeth.2 A decade later, in England, this proportion had fallen to 28%, and by 2009 it was just 6%.3 Over …

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