It is not disputable that dentistry is an integral part of a person’s overall wellbeing and

health.The provision of a free dental service has been a matter not without its critics,claiming
it is not possible because of funding issues.The divergent opinions on this matter underscore
the complexity of the issue.However the social,cultural and economic benefits of a free
dental healthcare system cannot be overlooked and it must be treated as a basic human
right.

The cost of NHS treatment acts as a barrier and deters many people from low income
households from visiting a dental professional. In a survey conducted by the National
Association of Citizens Advice Bureaux, 43% of patients stated that they had avoided a
dental check-up in the preceding 12 months because they could not afford the
cost.[8](https://www.nature.com/articles/s41415-021-2790-9#ref-CR5360). An extended
period of time where a dentist is not visited could also increase dental anxiety in patients
because of a gap that is created in the patient-dentist relationship .Ideas of fear could be
associated with a dentist’s image because of this anxiety which ultimately makes the general
public more hesitant to visit the dentist. In these cases, the lack of dental care might have
given rise to more serious diagnoses which require more invasive procedures to solve
,ultimately supplementing the fear in the patient.

Free NHS dentistry allows for more frequent visits to the dentist without financial constraints.
The patient enters the clinic with a positive state-of-mind and sees the dentist as a
trustworthy figure as opposed to the perception of greed attached to dentists This view has
gained currency in recent years due to media
protrayal.([https://www.dailymail.co.uk/news/article-3125533/Greedy-dentists-fleece-families-
Undercover-investigation-reveals-hide-prices-restrict-NHS-treatment-force-patients-costly-w
ork.html](https://www.dailymail.co.uk/news/article-3125533/Greedy-dentists-fleece-families-U
ndercover-investigation-reveals-hide-prices-restrict-NHS-treatment-force-patients-costly-wor
k.html)).

A more sustainable alternative to a completely free of charge NHS system would be to

encourage the education of oral health. Instead of attracting the public by offering to treat
their teeth for free, we can help them understand the importance of oral hygiene and the
various comorbidities associated with it. This would be cheaper to implement and also
promotes a healthier mindset about dental hygiene that is autonomous.

By employing an economic lens, the lack of free healthcare can incur further costs that are
felt at large by the economy. Firstly when oral health condition are not prevented and
intervened at an early stage ,because of infrequent visits to the dentist, further complications
can occur which may lead to complex procedures that need to be funded by the NHS. The
complication could also result in absence from employment due to sickness which can cause
productivity losses for the general economy. Dental pain could also lead to some patients
feeling agitated and irritated, pushing them to commit crime which has negative
consequences on the wider economy.

Dental wellbeing plays a large role in the overall wellbeing of an individual. Arguably the
most relevant connection between the mouth and body is the bidirectional relationship
between diabetes and periodontal disease. Periodontal disease limits the ability of the body
to utilize insulin “Periodontal disease further complicates diabetes because the inflammation
impairs the body’s ability to utilize insulin," says Pamela McClain, DDS, president of the
American Academy of Periodontology. High blood sugar also provides ideal conditions for
infections to grow which causes gum infections.

Lack of dental care can result in the onset of various other diseases such as cardiovascular
disease (Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M. Periodontal disease and
coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med.
2008; 23(12):2079–86) , respiratory problems (Isaac S. Gomes-Filho,1,* Johelle S. Passos,1
and Simone Seixas da Cruz2 , Respiratory disease and the role of oral bacteria. J Oral
Microbiol. 2010; 2:) and generally a weaker immune system, making them more susceptible
to communicable diseases. Hence, NHS dentistry assumes similar importance to general
NHS and one could argue that it should also be free of charge.

The World Health Organization advocates that “the right to health for all people means that
everyone should have access to the health services they need, when and where they need
them, without suffering financial hardship” [1]. Healthcare can, therefore, be seen as a
fundamental human right. A paid national healthcare service treats oral hygiene as a
commodity that is only available to those who can afford it. It defies the medical pillar of
Justice which states that all patients must be treated fairly and equitably, regardless of their
circumstances or individual characteristics. The idea of a free dental healthcare service
closes the socioeconomic disparity to sustain a just system.

For example, a divide is created by the lack of dentists in some areas but a surplus of
dentists in others :the City of Westminster having over six times the number of NHS dentists
per 1000 of population compared with Ash field, the area with the lowest number in the
country. Therefore, the citizens of Ash field suffer more dental disease which can lead to the
onset of other comorbidities such as diabetes which in turn reduces the life expectancy . The
productivity of the town also decreases with more citizens taking absences from
employment. Additionally, a psychological decline is felt by the general public with signs of
low self esteem and depression that accompanies poor oral hygiene. As a result, the
economic output of the town becomes lower with the GDP per head of Ashfield being
£24,760( https://www.varbes.com/economy/ashfield-economy) but the GDP per head of
Westminster being
282,093(https://www.ons.gov.uk/economy/grossdomesticproductgdp/bulletins/regionalecono
micactivitybygrossdomesticproductuk/1998to2018).

My arguments for a free dental service in the UK are made hypothetical by a major factor
that has tormented the NHS for a few years: funding. I understand that prompt suggests a
more ethical-based approach instead of plausibility but I do think that the factors that could
prevent a free healthcare system for dentistry from successfully running. Report state that
here is already a £400 million underspend and there is only enough NHS dentistry
commissioned for 50% of the population. If we were to make the NHS free of charge for all
we must find another way of funding. Since 2010, dentistry is the only part of the NHS that
hasn’t increased in funding. The effect of this compounds over many years due to 2 main
factors: inflation and population growth. According to the BDA, dental inflation is now 11%
which is further broken down into 35% for utilities and lab bills increasing by 15%. The failure
to keep up with rising costs has made it very difficult for the remaining practice owners to
provide sufficient care for their NHS patients.The proposition of a free NHS dental system
was a reality in 1948, vastly changing people’s access to healthy oral healthcare. The idea
,however, was not sustainable and first started to charge patient for dentures in 1951 to
alleviate the lack of money in the NHS

As the population grows the demand for dentists also increases which unfortunately cannot
be fulfilled because of the number of foundation dentists that can be trained. The cost of
training dentists in their foundation year for each practice is £8,030 ,in the current economic
climate, however the funding for the training has been frozen since 2010 at
£5,347.Consequently, the number of qualified dentists in the future decreases and the
proportion of dentists to people decreases as population grows ,adding further stress on the
remaining dentists and their resources, preventing them from providing satisfactory care for
their patients. The fee that is collected from the patient is part of what helps to finance these
future dentists and if it is removed while government funding stays the same, more dentists
would be inclined to join private dentistry.

Another major issue with a free NHS dental system is an inadvertent decline in personal
responsibility for one’s oral hygiene. While free NHS treatment may seem like a force that
improves over dental health,under closer inspection, it might encourage the public to
disregard preventative methods such as brushing their teeth and flossing because of a
‘safety net’ of free healthcare without any monetary consequences. One study published in
the Journal of Dental Research found that individuals who received free dental care were
less likely to take preventive measures such as brushing and flossing compared to those
who paid for their dental care (Fiset, L., Grembowski, D., Del Aguila, M.A., et al. (2014).
Does receipt of dental care moderate the effect of preventive oral hygiene counselling in
reducing untreated caries among children with low socioeconomic status? Journal of Dental
Research, 93(7 Suppl), 58S-64S. DOI: 10.1177/0022034514537363.).However, it's important
to note that these studies have limitations and should be interpreted with caution. For
example, the study by Fiset et al. only included a small sample of individuals and did not
control for other factors that could influence dental health behaviour.

To conclude,