THE number of dentists offering treatment on the NHS in Gwent has been slashed in the past year.
Unions have warned NHS dentistry in Wales and England is "hanging by a thread", with some patients facing two-year waits for routine check ups - or face shelling out for private treatment.
Figures show that in Gwent's health board area last year, there were 25 fewer dentists completing NHS work than in 2020.
That reduction of eight per cent is largely in line with national trends, although other parts of Wales have been hit even harder by the loss of available NHS dentists.
The pandemic has played havoc with dental treatment. In Wales, routine dental care has been suspended for prolonged periods, over concerns about hygiene and the spread of coronavirus.
But the figures, obtained by the BBC Shared Data Unit, show that the decline in the number of dentists offering NHS treatment predates Covid-19.
What's causing the decline?
The British Dental Association (BDA) believes unhappiness with the NHS dental contract is a key factor.
Shawn Charlwood, who chairs the BDA's General Dental Practice Committee, warned significant numbers of dentists were planning to leave the NHS.
“NHS dentistry is hanging by a thread, because, without NHS dentists, there will be no NHS dentistry,” said Mr Charlwood.
“It’s a really serious situation and every dentist that is lost or every vacancy for NHS dentistry that remains unfilled affects thousands of patients in terms of care and their ability to access care.”
In Wales, six per cent of NHS dental posts were lost last year, with 83 fewer dentists working across health boards than the year before.
The worst-affected area was the Swansea Bay University Health Board, which had 22 per cent fewer NHS dentists compared to the previous year.
A system of measuring dental activity may also be playing a part in the decline of NHS treatment.
Until last year, NHS dentists in Wales and England had been using the Units of Dental Activity (UDA) system, which counts how many courses of treatment each practice performs.
Practices are set targets of UDAs to achieve, and if that target is missed, the contract holder and the practice can be forced to pay back money, known as 'claw back'.
Critics have claimed the UDA system does not incentivise preventative work, and is a key reason for dentists leaving the health service.
Wales moved away from the UDA system in 2020 – a decision Mr Charlwood said the BDA "broadly welcomes" and "is something we would really like to see in England".
He predicts the number of NHS dentists in Wales will increase in the coming years.
What does the Welsh Government say?
Healthcare is devolved in Wales, meaning NHS treatments here are the responsibility of the Welsh Government.
Responding to the findings of the investigation, a spokesperson for the Welsh Government said: "We are committed to meeting the needs of NHS dentistry patients in Wales through preventive care and increased access, supported by contract reform. This will see a gradual move away from using Units of Dental Activity targets.
"While the pandemic has paused some of this work, we will continue to support practices during the recovery period as focus is placed on increasing access to those most at risk.
"As Covid-19 is still in circulation, public health measures such as physical distancing, enhanced PPE, and infection control requirements mean fewer patients can be seen in person and practices have been asked to treat people according to need.
"We are providing health boards with £3 million in 2021-22 to boost access to NHS dental services, and £2 million recurrently from 2022-23 to support increased provision."
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