'My tooth gap feels like a goalpost - but I can't get an NHS dentist'

Joe Friel needs a dentist. He has a gap in his teeth that feels like "the size of a goalpost". The problem? He's called 20 dental practices over a four-month period and none of them will treat him under the NHS.

"I've spent an hour a week for the last three or four months ringing round dentists," the 39-year-old from Londonderry said.

Although more than 1,200 dental practices in Northern Ireland are still registered to treat health service patients, many are gradually dropping NHS work - and it's changing the game for thousands of people like Friel.

Last year, BBC News NI learned that dentists in Northern Ireland had removed more than 53,000 NHS patients from their practice lists over the past two years.

"I spent 90 minutes one day ringing round 21 dentists within an hour of Derry and no one could take me on under the NHS," he told BBC Radio Foyle's North West Today programme.

The Department of Health (DoH) said a practice must provide registered patients at least three months' notice before removing them.

More than 1,200 practices in Northern Ireland are registered to do NHS work, according to the Business Services Organisation, but BBC News NI does not have figures on how many NHS dentists are currently accepting new patients.

Some dentists told Friel he could have an appointment almost straight away as a private patient, costing him up to £175 for a consultation.

"There's not much smiling happening right now with two cracked front teeth. Imagine a goalpost, a gaelic (football) goalpost, with the gap in the middle of the two teeth - that's what I have right now," he said.

The self-employed father-of-five said if he had the money to go private, he would have it fixed, but he does not and he is worried about his children's dental health, too.

"Like anyone else we pay our National Insurance and tax every year," he said.

"Let's be honest, I don't think the health service is in a great state, but I didn't think that it was in such a bad enough state that, not just myself, but a lot of people can't get a dentist."

Stella McBreaty, 76, contacted her dental surgery of more than 30 years just before Christmas, only to be told that her regular dentist had left the practice and she would no longer be treated as an NHS patient.

"I couldn't believe it," she said.

"I know I'm the age I am, but I would like my teeth in order.

"I've worked my whole life, paid my taxes, now I'm getting this free treatment and it's taken away from you."

McBreaty is now worried about her dental health and is suffering from receding gums.

"I've no dentist and it's very upsetting. Is nobody going to get national health, is that the way they do it now - private?

"Well, that's not on because people can't afford it."

More and more dentists have decided to to remove NHS patients and do private work only, though some make exceptions for children.

During 2023 and 2024, 114 dentists handed back their NHS contracts to the Department of Health (DoH).

Enniskillen-based Rachele Crozier, who has been a dentist for 20 years, said it was no longer viable to do NHS work, both in terms of workload and financially.

She said it was "heartbreaking" that some patients who she had treated for years under the NHS could not afford to pay to see her privately.

But she said NHS fees simply do not cover the cost of treatment.

"If you're working in a model where, every time you make a denture or do a certain treatment on a person and that, actually, is a deficit, well, you can't pay your staff, you can't pay your electricity bill, so you can only sustain that for so long.

She said the reality was that "the private end of things has subsidised NHS treatment for years".

She knows of "very few" practices that are now registering NHS patients and said the system was failing dentists and the public.

"Having to pay more highly-qualified staff, increased bills and so on all adds up and made what we were doing financially unsustainable," she said.

"Once I flipped that switch in my head, I started to think about the type of dentist I wanted to be, and I couldn't do that in a system that didn't value me."

The Department of Health said patients who find themselves without a dentist may need to approach several practices or travel outside their local area.

A spokesperson said: "If you can't secure an appointment - you may be eligible for the dental access scheme."

The 1,205 practices currently registered to do NHS work are spread across Northern Ireland, according to the Business Services Organisation:

• 269 in the Belfast Trust area
• 294 in the Northern Trust area
• 216 in the South Eastern area
• 257 in the Southern (Trust area
• 169 in the Western Trust area

It is not known how many of those NHS dentists are currently accepting new patients.