Concerns over North London dental backlog

Tooth decay in children under five in Enfield and Haringey “well above” London average, reports Julia Gregory, Local Democracy Reporter

A dentist examines a patient's mouth
credit Caroline LM Jibssi via Unsplash

Councillors were “horrified” to hear that some children are having to wait up to 89 weeks for hospital dental treatment in North London – with one case stretching to more than two years.

Dental surgeries had to shut in March 2020 during lockdown and prioritised the most urgent patients when they reopened twelve weeks later. A triage system took between 1,500 to 1,700 calls a day from patients needing help and dentists are still working from 8am to 1am to treat those in pain at emergency care hubs across London.

Andrew Biggadike, the NHS regional lead for secondary, community and specialist dentistry, last week told a joint health committee meeting for the North Central London NHS region that University College London Hospital (UCLH) has one child who has waited over 104 weeks for dental treatment because of clinical needs preventing them from coming in.

Most patients have been waiting less than 52 weeks for treatment under general anaesthetic, but Andrew said: “One-hundred-and-four weeks is far too long for anybody to wait for treatment. The goal for the NHS at the moment is to get rid of 104-week waits.

“Sometimes these patients can’t access care because they may be ill and can’t come in with the appointment they’ve been given. Sometimes the patients are refusing to come in or it could be because they also need treatment in another dental speciality, which makes things a bit more difficult.”

Andrew explained that theatre capacity is given as a priority to patients with cancer who need a general anaesthetic, rather than dentistry patients.

He added: “I accept that 52 weeks is far too long for any patient to wait for care, particularly a child, but the backlog has been very difficult for dentistry because quite often the priority for these patients is not high enough.”

Extra services have been commissioned to reduce the backlog, and St Bartholomew’s Hospital in the City of London has opened three procedure rooms offering children dental treatment under general anaesthetic as part of ‘Project Tooth Fairy’.

It comes as pre-pandemic figures showed that one-in-four children under the age of five in North London had tooth decay in 2019. Research also showed that in Haringey and Enfield, tooth decay in children five and under was “well above” the London average of 27%, while about one-in-four children in Camden, Islington and Barnet had some tooth decay.

The joint health scrutiny committee – which covers Barnet, Camden, Enfield, Haringey and Islington boroughs – heard that overall most dental patients who need to go to hospital have waited less than one year.

Committee chair and Haringey councillor Pippa Connor said: “I’m pretty horrified at the times that children and adults are having to wait for services.”

Seventy dental surgeries across London have applied for a chunk of a £50million cash injection from the government to help tackle the backlog in appointments over the next eight weeks. London will get £7.8m from this money for evening, weekend and early morning work, enabling dentists to see more patients.

Kelly Nizzer, NHS England’s regional lead in dental pharmacy and optometry, told the committee that she is lobbying for more money as the eight-week scheme “is a drop in the ocean”.

Urgent dental care hubs are still open – from 8am to 1am – and are seeing about 600 patients in pain every day. Kelly said: “We are not going to get everybody in, but whatever we can do we will.”

Andrew added: “If we evidence the effect it’s had on the residents of London, we may be able to ask for more on a more permanent basis.”

Cllr Connor said: “We would completely support your attempts to advocate for further funding and to reduce these really long and extensive delays and improve the access to the NHS and dental services.

“This is an area that has been woefully underfunded.”