Patients in England who need emergency dental care are being turned away by the NHS despite official guidance stating they should receive urgent treatment, forcing some to take dangerous measures such as pulling out their own teeth, according to new findings from Healthwatch England.
The patient watchdog warned that the NHS dental access crisis has reached a critical point, with people in severe pain unable to secure appointments and increasingly resorting to private care, long-distance travel or unsafe self-treatment.
Emergency care increasingly unavailable
Under NHS rules, patients experiencing urgent dental problems such as severe toothache, abscesses, broken teeth or swelling should be able to access care through their NHS dentist or via NHS 111.
However, Healthwatch England found that many patients are being denied urgent appointments altogether. In some cases, people reported being forced to travel more than 100 miles for treatment, pay hundreds of pounds for private care or even seek dental treatment abroad.
The watchdog also documented cases where patients pulled out their own teeth or took unprescribed antibiotics in desperation, raising serious health and safety concerns.
Routine care breakdown fuels crisis
In a blog post accompanying the findings, Healthwatch England said the inability to access routine NHS dental care is driving the surge in emergencies.
The organisation said people across England are struggling to register with NHS dentists, and even those who are registered often face waits of several months for routine appointments.
As a result, preventable dental problems are left untreated until they become emergencies, making urgent care the only option for many patients.
Urgent appointments fail to meet demand
The government has pledged to deliver an additional 700,000 urgent NHS dental appointments per year through to 2028–29 in an effort to relieve pressure on services.
In dental emergencies, NHS guidance states that patients should be offered an urgent appointment within 24 hours or within seven days, depending on the severity of symptoms. These appointments may be provided by a patient’s regular dentist or arranged via NHS 111, which is meant to direct callers to practices accepting urgent cases.
Healthwatch England said that in practice, many patients are unable to access these services.
Calls to NHS 111 surge
Data from NHS 111 shows a sharp rise in calls related to dental problems. Between July and September 2025, dental-related calls were around 20% higher than during the same period the previous year.
In the north-east of England, local Healthwatch teams conducted mystery shopping exercises, with volunteers making up to 15 calls to urgent dental services without finding a single available appointment.
Patients reported exhausting efforts to obtain care, including spending hours on hold to NHS 111, being referred to urgent dental providers and then being told no appointments were available.
Temporary relief and worsening health
Even when patients managed to secure urgent dental treatment, Healthwatch England found that care was often limited to temporary fixes rather than long-term solutions.
The watchdog warned that urgent services are increasingly being used as a substitute for routine care, undermining prevention and leading to repeated dental crises.
Patients described extreme pain, sleepless nights and worsening oral health, with many feeling forced to borrow money, use pensions or rely on benefits to pay for private treatment.
Long journeys and risky self-treatment
Healthwatch England also highlighted the geographical barriers facing patients. Practices offering urgent NHS dental appointments are often located far from where people live.
Patients described round trips of up to 110 miles, journeys lasting several hours and, in some cases, travelling abroad to access affordable treatment.
Others reported resorting to self-treatment or unprescribed antibiotics, which the watchdog warned carries serious medical risks and could contribute to antibiotic resistance.
Calls for reform and accountability
The watchdog has issued a series of recommendations to address the crisis, including urging the NHS Business Services Authority to publish monthly progress data on the government’s 700,000 urgent appointment target.
As part of wider dental contract reform, Healthwatch England is calling for a legal right for patients to register with an NHS dentist, arguing this would improve access, strengthen prevention and support long-term workforce planning.
Government response
A spokesperson for the Department of Health and Social Care said the government inherited a dental system damaged by years of underinvestment.
The spokesperson said ministers are rolling out extra urgent dental appointments and reforming NHS dental contracts to increase capacity and bring more dentists back into NHS work.
They added that while more action is needed, the government is committed to fixing what it described as Britain’s broken dental sector.
