Dentists in Wales have warned that reforms to NHS dentistry will make access even harder and leave a difficult legacy for the next Welsh government.

The British Dental Association Cymru describes the reform that come into force on 1 April as utterly untested, the new contract is a source of deep concern on the frontline and has been dogged by poor communication with both the profession and with patients.

Dental labs - key to the NHS supply chain - have been kept completely in the dark.

Many already struggling practices are unclear if the new system offers a sustainable future for them and have handed back their NHS contracts. The success of the first year of operation will be crucial to ensure more don’t follow. The BDA have pushed hard for conditions to allow for a learning year, and not a year where practices may suffer penalties due to an untested system.

Some health boards have recently seen 10% or more of their contract allocations returned to them by practices quitting the NHS. The remaining NHS capacity may be hard pushed to improve the situation.

Reforms will mean rationing of care, with less frequent appointments for many patients. At present recalls for healthier ‘green’ patients are already at 12 months with existing contract reform measures. New reforms will mean pushing this out for these patients to 18 or even 24 months.

The reforms will also see NHS dental charges increase by a large margin in many cases.

With recent increases in the cost of living, these new charges could be unaffordable for many.

A simple examination (check-up) for a new patient will be going up from £20 to £27.21 – a 36% increase.

An urgent appointment for a new patient will increase from £30 to £37.50 – a 25% increase.

A patient with poor gums and high plaque scores in need of a periodontal package will first have to sufficiently reduce these scores themselves before they will be offered the care package at circa £48.

While a simple restorative package at £36 is well below the current band 2 charge of £60, an extensive restorative package is £68.75 – an increase of 14.5%.

The profession and the public have emphasised the need for much clearer communication about how the system will work.

In an approach, that the BDA stress is indicative of the whole process, a long-awaited patient information leaflet which has been in production since last autumn has not yet been published.

The BDA has published its own manifesto at what it describes as a ‘make or break’ moment for the service in Wales.

The professional body say a safety net is now needed to make these reforms sustainable for struggling practices, including a pause on full implementation until 2027 while a package of needed improvements is worked up.

The BDA is also seeking a decisive break from chronic underfunding, protections for the most vulnerable patients in Wales, and a wholesale change of tone from a new administration. This is not a negotiated contract, with any meaningful dialogue over the final package ending over 16 months ago.

Russell Gidney, Chair of the BDA’s Welsh General Dental Practice Committee, said: “From today, many patients across Wales will have to get used to more costly, less frequent dental care.“But the risk all now face is that utterly untested reforms will push more practices out of the NHS, taking the access crisis from bad to worse.

“Whoever forms the next administration in Cardiff Bay will inherit a service on the very brink. They will need to put together a rescue package if NHS dentistry in Wales is going to have a future.”