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The Missing Piece: BDA manifesto for oral health

The NHS was a hotly contested battleground in the General Election. We've been outlining the key issues for NHS dentistry to politicians, and we are now putting the case forward for dentistry to no longer be the missing piece to MPs and other key stakeholders.

The Missing Piece - toddler image 


Tooth decay and gum disease are the most prevalent – but preventable – diseases in Britain.


The oral health gap between rich and poor isn't closing, patients are struggling to secure access, and the service faces a mounting recruitment and retention crisis.


It's time for a joined-up approach.


NHS dentistry needs:

  • A valued workforce: we want to be able to attract and retain a talented workforce. We want NHS dentists to be properly recognised and their commitment rewarded.

  • Remove barriers to care: we need a long-term funding settlement for NHS dentistry so our patients can get the best care possible.

  • Put prevention first: successive governments have talked about prevention, but none have shown any real commitment to funding it. We need sustained investment for prevention.

We will be making dentistry's case strongly to all the newly-elected MPs and other key stakeholders.


Our patients deserve better, and that requires the next government to value our workforce, lift barriers to care, and get serious about putting prevention first.


What you can do

We need you to stand up for dentistry in your local area, please speak to your MP about the issues facing your practice and your patients, and use our manifesto to help make the case:


  • Share with colleagues, and on your social media channels: We will be making the case for dentistry strongly on Twitter and Facebook. Please join in and share, using the hashtag #MissingPiece.

  • If you do plan to speak to your MP: do get in touch with us and we can provide you with facts and figures for your area or region, to help you make a strong case for the need for investment.



Our manifesto for oral health

Here is our manifesto for this Government to ensure our workforce is valued and our patients get the best deal.


​A valued workforce

Take action to attract and retain talent. Make NHS dentists part of the NHS family, through tried-and-tested initiatives that recognise and reward commitment.


The Government must:


  • Revamp contracts: Abandon the appalling 2006 NHS English dental contract once and for all in favour of a system with prevention, not targets, at its heart. Restore patient registration to ensure continuity of care for patients.
  • Safeguard pensions: Extend the same tax flexibilities offered to medics for the NHS Pension Scheme to stop dentists being forced out of the workforce.
  • End a decade of pay cuts: Commit to above-inflation pay uplifts, and draw a line under a 35% fall in real incomes that have no parallel in the public sector. Ensure these are passed on to all dentists.
  • Reward commitment to the NHS: Reintroduce commitment payments in general dental practice, and rollout programmes that have succeeded in addressing acute recruitment and access problems in other NHS services. Extend state-backed indemnity to cover NHS dental services – equivalent to our medical colleagues.
  • Tackle over-regulation: End the culture of fear that encourages 'defensive dentistry' through legislation to deliver 'Right Touch' regulation

Remove barriers to care

Remove the obstacles standing in the way of patient care, through a long-term funding settlement for NHS dentistry.


The Government must:


  • End the budget freeze: End the decade-long squeeze in dental budgets, provide funding that keeps pace with demand. Ring-fence and reinvest funds lost when dentists do not hit their targets, so budget allocated to NHS dentistry is spent on NHS dentistry. Ensure the service has support to cover the costs of a phase-down of dental amalgam.
  • Re-evaluate patient charges: End inflation-busting patient charge increases, and maintain charges as a stable or declining proportion of the NHS budget. Charges are the wrong way to fund NHS dentistry. Extend and simplify exemptions, to ensure free care is available to those who need it.
  • End unfair fines: Scrap the heavy-handed NHS fines system in England, and stop punishing innocent people, vulnerable patients and their carers, and those who have made honest mistakes. Deliver a fair and focused approach to NHS fraud.
  • Scrap competitive tendering: End the wasteful competition within NHS dentistry that has encouraged a 'race to the bottom', wasted precious clinical time, and impacted hugely on patient care.

Put prevention first

Invest to save: tackle inequalities and focus on prevention, not just cure


The Government must:


  • Set children up for a lifetime of good oral health: Tackle inequalities head on and give all children the best start through a national programme including supervised brushing. Ringfence proceeds from an expanded Soft Drinks Industry Levy to support these initiatives.
  • Give adults and older people the care that they need: Integrate oral health into adult social care, with properly resourced mainstream and dedicated provision. Support a national campaign to encourage dental attendance and oral health best practice for all.
  • Make sugar the new tobacco: Protect children from junk food marketing everywhere. Extend the Soft Drinks Industry Levy to include sweetened milk-based, sports, and energy drinks, and also to sweets and other foodstuffs. Set mandatory targets for sugar reduction: voluntary targets are not delivering results.
  • Step up the fight on oral cancer: Recognise the dental workforce as the first line in the battle against oral cancers. Keep a common-sense approach to recall intervals to support early detection, and deliver a catch-up vaccination programme to extend protections against HPV to over a million school-aged boys.
  • Don't abandon oral health surveys: Guarantee the future of high quality national research to ensure that a strong evidence base underpins all future investment in dentistry.



​What to know more?

If you have any questions about this work or our campaigning and public affairs work, please get in touch.