UK Dental Market - January 2004

January 1, 2004

UK dentistry market - January 2004

The UK dentistry market is a two-tier market. NHS dentistry provides a basic level of service that has, in the post war period, both contributed substantially to increased oral health and opened the way to more elective and specialist dentistry in the private sector. Private dentistry offers a superior product and level of service at a higher price.

Around 25% of adult dental patients in the UK have opted to be treated wholly on a private basis. Additionally circa 20% of NHS adult dental patients receive some dental treatment privately. Nearly all children, who are entitled to free NHS dental treatment, receive dental care under the NHS.

Around 28 million people in the UK receive NHS dental treatment on a regular basis, and around 8.5 million people regularly attend private dental practices each year. There are nearly 10,000 dental practices with an average of 2.25 principles practising at each address.

LCS estimates that the annualised value of the general practice dental market in the UK for dental services as at October 2003 is of the order of £3.35 billion. Private dentistry makes up around 38% of this figure (circa £1.3 billion including around £175 - 200 million spent on hygienist provision).

The largest component is the NHS GDS – projected to reach over £2 billion in 2003. Government however does not fund the total cost. Co-payments by NHS patients themselves are of the order of £575 – 600 million.

Total UK expenditure on dentistry represents about 0.3% of GDP, little more than £60 per capita, compared with 0.7% in the USA and significantly higher amounts in a number of major European countries.

Private dentistry's share of the market has increased in recent years, growing by around 8-9% per annum, as shown by the chart below:

The shift towards private dentistry as a gateway to more specialist treatments has in part been as a result of poor remuneration levels offered to NHS dentists, and the limitations, which NHS scale rates impose on the range of treatment and the quality of care that NHS dentists can offer to patients. As a result many NHS dentists have closed their lists to new adult NHS registrations, giving patients in some areas little option but to seek private treatment.

It has also been driven by:

a) patient demand for the greater range of treatments offered by private dentistry, many of which are unavailable from the NHS;

b) superior quality treatment, access to new materials and better service offered by private dentistry, including more time with the dentist;

c) rising consumer awareness of oral health issues and treatment options, including demand for treatments to improve the aesthetic appearance of teeth, fuelled by increased ability and willingness of consumers to pay for private dentistry;

•  demand from patients with private medical insurance or private capitation plans; and

•  the fact that NHS dental treatment is not free, with most adult NHS patients required to pay 80% of the cost of NHS dental treatment (albeit with a ceiling of £372).

 

Shortage of dentists and dental auxiliary staff in the UK

At present there are around 32,000 qualified dentists in the UK , registered with the General Dental Council, of which an estimated 27,000 to 28,000 are currently active.

The number of active practising dentists in the UK (working in the General Dental Service, Community Dental Service or Personal Dental Service) represents less than one per 2,500 of population. This proportion is significantly lower than in the USA , (one per 1,700 of population), France (one per 1,500 of population), Germany (one per 1,300 of population) and Italy (one per 1,200 of population). Sweden (one per 700 of population) currently has a significant surplus of dentists.

Compared with most OECD countries, there is currently a shortage of dentists in the UK . The shortage has been further exacerbated in recent times in this country by dentists who have moved from NHS practice (where patient lists are typically around 2,700 to 3,500 persons registered) to predominantly private practice (where an equivalent active list would typically only be around 1,200 to 1,500 persons).

The average age of dentists within the profession is rising, with older dentists tending to work fewer hours. Furthermore, similar to trends elsewhere in Europe, North America and the Pacific Rim countries, the proportion of female entrants to the profession is increasing, a higher proportion of whom are likely to take career breaks and/or work reducm are likely to take career breaks and/or work reduced hours than their male equivalents. These demographic trends are reducing the number of WTE dentists working in the sector.

The number of newly qualified dentists emerging from the 14 dental colleges in the UK each year averages around 800 to 850. In recent years, qualified dentists with overseas qualifications arriving in the UK represented a net inflow of around 100 a year, mostly working as assistants to practising dentists.

While the entry of dentists into the UK from other EU countries is expected to expand, the net inflow is likely to be constrained by increasing restrictions on non-EU dentists entering the UK . The phenomenon of a shortage of dentists in the UK underpins current levels of prices for private and specialist dental interventions.