Jason Wong, chief dental officer (CDO) for England, shares some insight on incoming changes to the NHS dental contract and what practices can expect from them.
This April sees the roll-out of a series of important reforms to the NHS dental contract.
These reforms mark a significant step forward for NHS dentistry and are designed to provide better support for practices and deliver improved care and outcomes for patients.
Dentists and dental teams have continued to deliver care in challenging circumstances with rising demand, long waits for appointments for patients and growing complexity of needs. Those pressures made clear that change was needed to reform modern practice and support teams to deliver NHS care effectively.
Building on previous reforms
The package builds upon the initial reforms from 2022, taking those principles even further.
The 2022 reforms helped us turn a corner thanks in part to the integrated care boards’ efforts to improve access, but we recognise that there is more work to be done.
Latest figures show, in 2024/5, there were 35 million courses of treatment delivered, 4% more than in 2023/24.
Treatment for adult patients increased by 2% to 23 million, and by 7% for child patients to 12 million.
There were 24,543 dentists in England with NHS activity, 1.4% more than in 2023/24.
Shaped also by what you told us over the summer, feedback from the profession and patients was clear about where the contract wasn’t working as intended and where reform could make a real difference. That input has been central to the changes.
The reforms introduce new complex care pathways for adults with higher needs, with higher fees to support longer-term treatment for conditions such as advanced decay and periodontal disease. These pathways are designed to support better outcomes for patients and to give greater weight to your clinical judgement over the course of treatment.
Remuneration matters
We know remuneration matters. The changes aim to better align payment with the care you provide, which includes additional payments for denture work, funded annual appraisals for clinicians and greater use of tariff-based payments to improve consistency and fairness across England.
The reforms also support better use of the full dental team. New claiming options will allow suitably trained dental nurses to apply fluoride varnish without the need for a full dental examination, and fissure sealants for primary prevention will be better recognised.
Alongside wider work on water fluoridation, this reflects a stronger focus on prevention and improving children’s oral health.
A new quality improvement scheme will offer funded support for practices that choose to take part, embedding audit, peer review and learning within NHS dentistry. Detailed clinical guidance will follow, and practices will be kept regularly updated ahead of implementation.
Practice teams and commissioners will be regularly updated as the implementation date approaches, and new clinical guidance to support the complex care pathways as well as details of the new quality improvement domain will be published in early 2026.
These reforms are an important and positive step towards a more sustainable NHS dental system, supporting both patients and the profession.
