North Antrim dentistry crisis deepens as MLA warns of “slow collapse” of NHS care

Inset: North Antrim MLA Timothy Gaston

Mounting pressure on NHS dentistry in North Antrim has been laid bare in the Assembly, with warnings that the system is no longer sustainable and is being steadily replaced by private provision.

Speaking during a debate this week, North Antrim MLA Timothy Gaston said the current situation goes far beyond access issues, describing it as a structural failure that is already reshaping how dental care is delivered across communities including Ballymena and Ballymoney.

He told Members:

“There is much in the motion on which Members across the House will agree. The figures are stark. Only around half of adults in Northern Ireland are now registered with an NHS dentist. Registrations have fallen sharply in the past year. Treatment levels remain below what they were prior to the pandemic.

“However, I disagree with some of the ways that the issue is presented in the motion.

“This is not simply a problem of barriers to access; rather, this is the slow collapse of NHS dentistry in Northern Ireland. No amount of warm words about access will change that reality.”

Falling registrations and reduced treatment levels

The debate highlighted a significant drop in patient access to NHS dental services, with only around half of adults currently registered.

Gaston pointed to a sharp decline in registrations over the past year, alongside treatment levels that have yet to recover to pre-pandemic levels, underlining the scale of disruption still affecting the system.

These pressures are now being felt directly by patients, many of whom are struggling to secure appointments or remain within NHS care.

Practices shifting away from NHS provision

According to Gaston, the root of the issue lies in a funding and operational model that no longer reflects the realities faced by dental practices.

He said:

“The fundamental issue is that the current model is no longer fit for purpose. Dentists are not leaving the NHS out of neglect or indifference, they are leaving because, quite simply, they cannot afford to stay due to rising costs, workforce pressures and an outdated payment system that does not reflect the true cost of delivering care.”

He warned that in towns such as Ballymena and Ballymoney, smaller independent practices are increasingly being taken over by larger groups, bringing changes that often reduce or remove NHS provision.

“In areas such as Ballymena and Ballymoney, small independent practices are being bought over by larger groups. The model changes, NHS patients are dropped, and the only option offered to many people is private monthly plans, often starting at £12 per month.

“We are seeing a public service replaced by a private system.”

Workforce strain and patient travel increasing

The strain on the dental workforce was also highlighted as a key factor driving the crisis.

Gaston said increasing stress and pressure are forcing dentists to leave practices, while remaining staff are unable to meet growing demand.

“We are also seeing the strain on the workforce. Dentists are leaving practices due to stress and pressure. The remaining staff are unable to absorb the demand.”

As a result, patients are now travelling further afield to access NHS care, with local options disappearing in many cases.

“Patients are travelling significant distances simply to find a practice still offering NHS care. In many cases, the nearest option is no longer in their home town or neighbouring town. They have to travel further afield.”

Regulatory pressures adding further strain

The MLA also raised concerns about additional regulatory burdens impacting the sector at a time of already intense pressure.

He pointed to changes relating to dental amalgam, linked to EU alignment rules, which he said are increasing complexity and costs for practices in Northern Ireland.

“There is another dimension that cannot be ignored. At a time when the system is already under severe pressure, additional regulatory burdens are being layered on. We have changes relating to dental amalgam driven by EU alignment rules that will create further complexity in supply and cost.”

He added that these requirements apply differently in Northern Ireland compared to the rest of the UK, creating further operational challenges for providers.

Growing pressure with no immediate resolution

The debate underscores a widening gap between demand for NHS dental services and the system’s capacity to deliver them, with structural, financial and workforce pressures all contributing to the current situation.

With registrations falling, practices shifting toward private models, and patients travelling further for care, the trajectory outlined in the Assembly points to continued strain unless significant changes are made to how NHS dentistry is funded and delivered in Northern Ireland.

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At a glance

• Only around half of adults in Northern Ireland are registered with an NHS dentist

• Registrations have fallen sharply in the past year

• Treatment levels remain below pre-pandemic figures

• Dentists are leaving NHS provision due to costs, pressure and outdated funding

• Practices in Ballymena and Ballymoney shifting toward private models

• Private plans often start from around £12 per month

• Workforce pressures leading to reduced capacity

• Patients travelling longer distances for NHS care

• Regulatory changes linked to dental amalgam adding further strain