The BSSPD 2025 debate: sustainability of dentistry and prosthodontics – is this an emergency?

OPINION The BSSPD 2025 debate: sustainability of dentistry and prosthodontics – is this an emergency? Peter Briggs,1 Jennifer Gallagher,2 Nick Barker,3,4 Eddie Crouch,5 Nicolas Martin,6 Sana Movahedi7 and Shiyana Eliyas*8 Key points This debate discussed the acute and current challenges faced by dentistry in the UK, with an open and bold debate making suggestions for improvement for all stakeholders. Prevention of dental disease is the most effective way to reduce costs for the National Health Service, through education and investment. Understanding of the impact of political change on the sustainability of the workforce, and impact of travel on the sustainability of the environment are important considerations in future decision-making. Abstract Background Twenty-first century dentistry in first world countries should be based on sound evidence-based prevention and timely access to relevant dental care, but is not the picture currently portrayed of dentistry within the UK, by and for the key players involved (e.g., patients/public, government/commissioners, National Health Service, contract providers and performer workforce). Aims To summarise the issues that face the public, dental educators, dental workforce and commissioners of dental care in the UK (England) that were formally discussed at the British Society of Prosthodontics (BSSPD) Conference 2025. Method A panel was selected to include experts and spokespeople for the Department of Health/Chief Dental Officer, dental public health, the British Dental Association, postgraduate dental education and training, and workforce research, to debate five themes of sustainability in front of an audience of foundation dentists, dental core trainees and educational supervisors, speciality trainees, as well as general dental practitioners, specialists and consultants in prosthodontics and restorative dentistry. Conclusion The discussions of this debate on sustainability confirmed the need for novel approaches/offers with better understanding, funding and delivery of effective prevention models, urgent contract reform, with suggestions for education and health systems that can support (new and existing) dental workforce challenges. Introduction Dental disease is common, but for the majority, preventable. Dental caries and periodontal disease are leading causes of tooth loss1 and oral health has now been described as alarming and urgent, due to the significant impact on the quality of life as well as life chances.2 Oral diseases have been ranked as the most prevalent conditions globally, and Hodsoll House Dental Practice, Farningham, Kent, UK; Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, UK; 3NHS England, East of England Region, UK; 4University of Essex, Essex, UK; 5British Dental Association, London, UK; 6School of Clinical Dentistry, University of Sheffield, UK; 7Postgraduate Dental Dean, London and Kent, Surrey and Sussex (KSS), NHS England, UK; 8 St George’s Hospitals NHS Foundation Trust, London, UK. *Correspondence to: Shiyana Eliyas Email address: 1 2 Refereed Paper. Submitted 22 September 2025 Revised 17 January 2026 Accepted 22 January 2026 https://doi.org/10.1038/s41415-026-9622-x across countries of all levels of income.2 With an ageing population, polypharmacy and treatment such as radiotherapy to the jaws may lead to xerostomia and increased risk of dental disease.3,4,5,6,7 There are emerging links between oral health and chronic diseases.8 For the last few decades, national population oral health surveys have consistently shown increasing tooth retention, potentially due to improvement in population oral health. Some aspects appear not to have improved, such as pre-school caries and the number of hospital-based general anaesthetics, as well as poor oral health in areas of deprivation for teenagers and adults. These, along with life expectancy and quality life years, are closely related to deprivation indices and impact the economy.9,10,11 These issues may also be confounded by the National Health Service (NHS) dental workforce distribution, with shortages in areas of highest need and more rural areas. These have been referred to as ‘dental deserts’ in the UK.12,13 Many vulnerable individuals in deprived areas in the UK are currently unable to access the NHS care that they need. Evidence suggests that dentists and dental care professionals (DCPs) often originate from, and therefore, gravitate to live and work in urban environments, where there are both NHS and private dental care opportunities.14 Unfortunately, although health policies are changing, significant barriers remain for dental therapists to work to a full scope of practice in NHS practice, presenting a missed opportunity to optimise their potential for patient benefit.15,16,17 It is important to understand that private care and activities for dentists and DCPs do not solely involve what was traditionally thought of as dentistry. There is now an established market and demand for facial and tooth aesthetics, which dental registrants can develop skills to provide for patients, thus diverting resources from routine dental care. The sustainability of dentistry, especially NHS dentistry, is dependent upon a BRITISH DENTAL JOURNAL | VOLUME 240 NO. 10 | May 22 2026 © The Author(s) under exclusive licence to the British Dental Association 2026. 659 OPINION workforce that is fit for purpose, accessible and adequately funded. The cost of delivery of this care is increasing and as such the current model of care is unsustainable. The issues facing the sustainability of dentistry within England was discussed in a panel debate at the British Society of Prosthodontics (BSSPD) Conference in London, in April 2025. Mr Peter Briggs (PB) chaired the debate. The panel (Fig. 1) consisted of: • Mr Eddie Crouch (EC): Elected Chair of the British Dental Association (BDA) Board, previous Deputy Chair of the BDA • Professor Jenny Gallagher MBE (JG): Newland-Pedley Professor of Oral Health Strategy and Honorary Consultant in Dental Public Health in the Faculty of Dentistry, Oral and Craniofacial Sciences at King’s College London; President Elect, International Association for Dental Oral and Craniofacial Research • Professor Nick Barker (NB): Deputy Chief Dental Officer for England and Joint Regional Chief Dental Officer for NHS England East of England Region and Professor of Oral Health Sciences for University of Essex, and is also a dental practice owner and a provider of level two endodontic and periodontic services in Colchester, Essex • Ms Sana Movahedi (SM): Regional Postgraduate Dental Dean for London and Kent, Surrey and Sussex (KSS), who is also responsible for NHS England Work Force Education and Training • Professor Nicolas Martin (NM): Professor of Restorative Dentistry and Consultant in Restorative Dentistry, School of Clinical Dentistry, University of Sheffield. All panel members and delegates agreed to recording of the (...truncated)