As financial pressures grow, Neel Kothari warns that neither NHS nor private dentistry is immune to rising costs and reduced patient spending.
For as long as I can remember, the perception of dentistry has always been one of wealth and prosperity. For many years, we’ve been fortunate to see good demand for NHS and private services leading banks and lending institutions to consider our sector a safe bet.
While, for many, this will remain to be the case, it’s impossible to ignore the difficulties families in the UK are now facing with high inflation and interest rates culminating in a cost-of-living crisis that, for many, will obliterate their disposable incomes. Through conversation, many colleagues are now starting to see gaps in their diaries which were previously full, and fewer patients opting for bigger treatment plans. Perhaps this was simply January blues, but increasingly the general public is feeling poorer.
The British Dental Association (BDA) estimates ‘dental’ inflation to be at 9.2%, with utility costs rising by 10% in the last financial year, staffing costs by 15% and laboratory costs by 16.5%, making the 4.64% NHS contract uplift effectively a real time pay cut – again. Perhaps this will see an increase in private practice conversions, but is this really the right time? And is the grass greener on the other side?
Dr Grant McAree, dentist, author and business mentor told Dentistry magazine: ‘The public will always need dentistry. There will always be a demand to have those pearly whites to eat, to smile and to live!’
Dwindling disposable income in 2025
What do I think will happen in 2025? Well, I always think back to the immediate aftermath of COVID-19. The public had little option but to stay at home and cut back on spending, leading to a lot of spare furlough money and time spent talking to people online and not in person.
No holiday fund requirements, just a lot of time to reflect and that nagging insecurity with every Facetime and Zoom call looking at their smile and thinking, ‘I have always wanted my teeth done.’
Fast forward to a possible recession in 2025, prices of everything up with the cost of living crisis and wages rising, but not quite matching inflation. With disposable income plummeting for many, teeth are now not so high on the ‘must have’ list.
I am sure this will upset a large number of dentists who often say, ‘if they can afford Netflix, they can afford a £1500 crown,’ but the ugly truth is that patients need to live. They need to have a balanced life away from a nice shiny crown. So, people will apportion their funds to a balanced happy life. Some will have budgeted for dentistry, holidays and other ‘must-haves’, but not everyone will. When you see parents in tears due to not being able to afford their child’s fillings, it’s clear that everyone doesn’t have that available cash.
The ugly truth
Dr McAree went on to tell Dentistry: ‘So, in 2025, I wouldn’t be opening an Invisalign, Bleach & Bond clinic. But you know what? I wish I was 18 again. I wish I had the energy – I would open an affordable private dentistry clinic. Based on trust. In my case, I’m at the end of my game doing 100% Invisalign.
‘Yes, I am noticing that my waiting list is getting shorter. Late cancellations. Patients only taking out finance. All signs that there will be a bump in the road in 2025. Am I worried!? No. Life is about resetting. Life is about change. I will just need to reinvent myself again. The ugly truth is that in 2025 cosmetic dentistry, pricey molar root treatments, and expensive crowns will not be a priority as the public tightens their belts.’
I wholeheartedly agree with Dr McAree’s sentiments. I’m not suggesting for one moment that the demand for high-end dentistry will disappear, but it’s worth noting that a 20% drop in patient numbers could change a thriving business into a loss-making one. This is particularly bad news for those practices who carry out high volumes of treatment but with low profit margins.
It’s not great news for the private sector, but let’s be clear: the situation with NHS dentistry isn’t much better. A 2023 Yougov poll showed that nearly a quarter (23%) of patients reported avoiding NHS dental treatment due to cost. While demand for NHS dentistry remains strong, if patients opt for fewer band 3 items (or alternatively decline private alternatives), this could have a significant impact on profit margins and the viability of running an NHS dental service.
It isn’t entirely clear if dentists can afford to move away from the regular monthly income and steady flow of new patients that NHS dentistry has to offer in 2025, or whether the year-on-year pay cuts have now made the NHS contract unserviceable.
Apologies folks, a lot of doom and gloom in this article. I’ll try to be more cheerful next time!
Read more from Neel Kothari:
- The dangers of ‘bad science’ in dentistry
- What exactly can we say on social media?
- Was it right to force the COVID vaccine on healthcare workers?
- Are universities adequately preparing new dentists?
- Why we need more regulation from the GDC.
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