Access to an NHS dentist in two of Suffolk's largest towns is virtually non-existent, a survey by this publication has found, revealing the difficulties facing unregistered patients.
We attempted to make contact with NHS dental practices in Ipswich and Bury St Edmunds that are listed on the NHS website, not including orthodontists (who correct the position of the teeth).
We were able to get responses from 17 of the 27 listed, and none are currently registering new NHS adult patients, and only one said they were taking on children.
A handful said they have waiting lists - with one at 400 people - and one surgery said people were getting accepted from their list.
The crisis facing NHS dentistry is leaving patients with toothache for months and some are going to extreme lengths and extracting their own teeth.
Only this month, the charity Dentaid, which offers free emergency clinics to those in need, came to Bury St Edmunds for the first time to relieve people from toothache misery.
Speaking in parliament last week, Waveney MP Peter Aldous said access to NHS dentists was a problem that had been "brewing for some time" - exacerbated by Covid - and there are now parts of the country, particularly rural and coastal areas, that are "dental deserts".
Toothless in Suffolk is campaigning for local NHS dental provision for everyone and has just gone national in its fight.
Mark Jones, spokesman for Toothless in Suffolk, described the lack of NHS dental services as a "disgrace, a complete dereliction of duty to the general public by not providing access to NHS dentistry where there’s a need".
He said, unfortunately, our survey shows "the norm" across the country where access to an NHS dentist is "no longer a postcode lottery: the postcode is England".
He said: "We have got to bring dentistry into the 21st century now with a greater level of funding that will ensure treatment is available for everyone."
He said the impact of not seeing a dentist for years was "colossal" not only on that individual's health and wellbeing, but their whole family.
Andy Yacoub, chief executive of patient group Healthwatch Suffolk, said during the pandemic two thirds of their calls have been about NHS dentalcare, but they have not spoken with one person who has managed to find an NHS dentist.
He said there seemed to be a focus on those with urgent dental needs, who are being told to call 111 and referred to an urgent dental centre, but added: "That's fine as long as they are meeting those needs, but the problem is dental care is almost all about prevention and self-care.
"If we are going to be in the situation where our oral health deteriorates gradually until the point where we can only access emergency care, that's a horrible situation to be in."
Healthwatch Suffolk has published a report on people's experiences, including one person on a low income who was in "excruciating pain" but could not find an NHS dentist.
What is causing the dental crisis?
A range of factors including how the NHS dental contracts work, recruitment problems and underfunding, plus further pressures and backlogs caused by the pandemic, are all said to be behind the current crisis.
Eddie Crouch, chairman of the British Dental Association (BDA), said: “The access crisis in the East of England predates Covid.
"It’s the net result of a decade of failed contracts and savage cuts that have left practices struggling to recruit and retain staff and even remain viable.
“Patient groups and a growing number of MPs are joining with us to press government for change.
“Until we see real reform and investment patients across the region will be left with few options.”
There is widespread criticism of the way in which dentists are paid to deliver NHS work, Healthwatch Suffolk said.
It is centred around the fact that dentists are paid the same for a course of treatment that might include an examination as they are for a course of treatment that includes much more work.
The report by Healthwatch Suffolk said: "Dentists attribute closures and service changes to problems with recruitment and increased running costs.
"They say the money they receive from the NHS, and the contract requirements (including financial penalties), make it impossible to provide dental provision in a financially-viable way.
"So, practices often use private work to offset the cost to them of delivering on their NHS contract."
Mr Jones added: "We go to great pains to say it's not the dentists' fault. They have got to earn a living at the end of the day."
Toothless in Suffolk recently issued six demands of the government and NHS England including reforms to the NHS dental contract that will encourage dentists to provide NHS treatments and revenue to cover the 50% of the population that are unfunded by the government.
What does the government say?
A Department of Health and Social Care spokesperson said: “Dental practices have been able to deliver their full range of face-to-face care since last June and, thanks to their hard work, urgent care is back to pre-pandemic levels.
“We continue to work closely with the NHS to allow more patients to be seen, prioritising urgent and vulnerable patients and children, while minimising the risk of infection for staff and patients.”
More than 700 urgent dental centres remain in place to support the provision of urgent face-to-face care.
We contacted NHS England for a comment. Previously, a spokesperson said they were "working closely with dental providers to improve access to services".
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