- NHS dental overhaul will prioritize patients with more urgent dental needs and those requiring complex treatments
- New incentives for NHS dental contract to offer long-term treatments for major issues such as gum disease and tooth decay through the NHS
- The deep-rooted reforms are fundamental to the government’s wider dental rescue plan, including:
- completing urgent and urgent care appointments
- supervised tooth brushing for 3- to 5-year-olds;
- water fluoridation plans to reduce decay;
Patients across England will be able to get emergency dental appointments more easily thanks to a major overhaul of NHS dentistry.
The government is to push ahead with a series of reforms – the most significant modernization of the NHS dental contract for years – following consultation with the industry and the public. The Government’s response to the NHS dental contract: quality and payment reforms consultation was published today (16 December 2025).
By prioritizing patients with the greatest need, the changes, which will come into effect from April 2026, will ensure that the NHS dental budget – estimated at around £4bn – delivers value for money for taxpayers, diverting funds to better and more effective treatments for those who need them most.
For example, a patient with cavities in many teeth or severe gum disease would require complex treatment. Currently, they will have to undergo treatment in multiple appointments. For a patient, this is difficult to coordinate and book with a dentist. For a dentist, this would be costly and time-consuming.
With the changes, this patient could secure a single comprehensive treatment package with a dentist over a longer period of time, tailored to their needs and including oral health advice. This could save a patient up to £225 in charges. For the dentist, they will be incentivized to deliver as part of our new standard payment package. This will support thousands of patients to get better care on the NHS.
Patients also struggle to find dental offices that treat people with urgent needs and must choose to live with the pain or travel out of their area to find somewhere that can treat them.
These reforms will make emergency dental care a key part of what NHS dental practices must provide through the new contract, making it easier for people to access an urgent appointment at their local NHS dental practice, avoiding them having to travel out of their area.
Urgent care can be for issues such as severe tooth pain, dental infections, tooth trauma or other conditions that need rapid treatment – and dentists will be well motivated to treat them on the NHS.
The sweeping reforms run alongside the government’s wider dental rescue plan, including the development of emergency and urgent care appointments and community water fluoridation programs that have been shown to reduce tooth decay.
The government has also rolled out a pioneering national supervised brushing program for 3 to 5-year-olds, which will support up to 600,000 children this year, with over 4 million toothbrushes and toothpaste already delivered.
Care Secretary Stephen Kinnock said:
We inherited a broken NHS dental system and have worked at a rapid pace to start fixing it – making urgent and emergency appointments and bringing supervised toothbrushing for young children to the most deprived areas.
We are now tackling the deep-rooted problems so patients have faith in NHS dentistry – these changes will make it easier for anyone with a dental emergency to get NHS treatment, preventing painful conditions turning into avoidable hospital admissions.
It’s about putting patients first and supporting those most in need, while supporting our NHS dentists by making the contract more attractive and giving them the resources to deliver more.
This marks the first step towards a new era for NHS dentistry after a decade of decline, delivering for patients and our dedicated dental professionals.
Jason Wong, Chief Dental Officer for England, said:
Dentists work tirelessly to care for patients and I want to thank them for their dedication. We listened carefully to the profession and these reforms are focused on improving the patient experience, from easier access to emergency care to supporting long-term and preventive treatment, especially for children.
By recognizing the work of the wide range of professionals in dental teams and making better use of their skills, the NHS can help ensure that patients see clear benefits from the changes being made.
In a push for children’s dental health, dentists will be encouraged to apply fluoride varnish to children’s teeth, helping to maintain good oral health. Dental staff will receive fairer pay for applying fissure sealants to protect children’s teeth from tooth decay, in a move to prevent poor dental health.
To improve retention, NHS dental teams will also receive more support through annual reviews and learning and development, in addition to government funding to support sick leave and guidance on NHS contractual terms and benefits.
Neil Carmichael, Executive Chair, Association of Dental Groups (ADG), said:
We generally welcome the dental contract reforms and look forward to receiving more details as soon as possible in the new year so that practices have the time and capacity to prepare to implement these changes. THE ADG was part of the consultation process and it is good to see steps being taken to tackle the underpayment of more complex care, as well as to support urgent care.
An ongoing priority for our members, however, is to ensure that the necessary measures are taken to support NHS England’s dental workforce, which we know is small at more than 2,500 dentists. Embracing the whole dental workforce is vital, so to see the plan further encourage the team, including dental nurses to undertake treatments, with fairer pay, is a positive move.
Dr Oosh Devalia, President, British Society of Pediatric Dentistry (BSPD), said:
BSPD welcomes today’s announcement to reform NHS dental contracts as a positive step and we look forward to seeing what this means for children and young people. Having a contract with prevention must be the way forward, and the recommendations we put forward during the consultation period focus on ensuring that the children most in need are prioritized to get the dental services they deserve.
A prevention approach will have the greatest impact when it is designed to target the most vulnerable children in our communities. As always, BSPD looks forward to working with policymakers to determine the details to ensure the dental contract delivers real results for children.
Background information
The public consultation ran for 6 weeks from 8 July to 19 August 2025. It received 2,289 complete responses, with 60% from individuals sharing personal views, 33% from individuals sharing professional views and 7% from organisations.
More than half of respondents to the consultation agreed that the proposals would improve the current NHS dental contract and support practices to prioritize care for those who need it most.
The changes will require legislative amendments, which the government plans to introduce from April 2026. NHS England will work with integrated care councils and clinical experts to produce detailed implementation guidance.
The key measures taken from the consultation are:
- integrating emergency treatment into the NHS dental contract so patients can access emergency dental care when they need it
- new treatment pathways for complex needs such as severe tooth decay and progressive gum disease
- providing effective, evidence-based care, making greater use of dental expertise and knowledge
- enhanced support for the learning and development of dental professionals, benefiting patients from an improved skill set
- strengthening the NHS dental workforce by supporting retention;
Around half (49.3%) of all dental patients are entitled to free NHS dental care. These groups include people who are:
- under 18 or under 19 and in full education
- pregnant or had a baby in the previous 12 months
- you are being treated in an NHS hospital and your treatment is carried out by the hospital dentist (patients may have to pay for any dentures or bridges)
- you receive low income benefits or you are under 20 and depend on someone who receives low income benefits
Low-income patients who are not eligible for NHS dental fee waivers may be entitled to financial support for their dental costs through the NHS Low Income Scheme.
Patients can either access emergency care by contacting a dentist directly or via NHS 111. Some areas also operate a local helpline.
