Column: Concerns over the state of local dental service

In his latest column for MyTown Media, Montgomeryshire Senedd Member, Russell George, focuses on the state of the NHS dental service in the north Powys area.

"Like many across our community, I remain profoundly concerned about the ongoing challenges facing NHS dentistry in Montgomeryshire. 

In recent years, we have witnessed the loss of NHS dental contracts in both Newtown and Welshpool, resulting in periods where neither town has had a full time NHS dentist. This has forced residents to travel unreasonable distances, sometimes up to two and a half hours round trip, for even the most basic dental care. Such circumstances are simply unacceptable in the twenty first century.
 
The Welsh Government has announced the introduction of a new dental contract, set to take effect in April 2026. This is the first significant overhaul of the system in two decades. The existing model requires dentists to recall all patients every six months, regardless of clinical need.
 
Under the new contract, appointments will be based on individual oral health requirements. Patients in need of active treatment or support to maintain good oral health will be offered more frequent appointments, while those with healthy mouths will see their recall intervals extended in line with clinical guidance and risk assessment. Additionally, the reforms aim to prioritise prevention, establish greater fairness in payments, and simplify contract terms and patient charges.

While these changes are promising in principle, experience tells us that the reality in rural Montgomeryshire often falls short of government ambition. Press releases and consultation documents rarely capture the complexities of delivering care across sparsely populated and geographically isolated communities. There remains a real risk that these reforms could inadvertently widen inequalities, leaving rural areas behind.
 
Serious questions persist about how the reforms will address the practical challenges unique to rural Wales: increased travel times, low population density, infrastructure constraints, and the high operational costs of running clinics far from urban centres. Many dentists have expressed concerns that the new performance targets are untested and may expose practices to financial risk. The British Dental Association has warned that some practices are already contemplating reducing their NHS commitment or withdrawing altogether, as they cannot afford to meet targets in areas where patients require more time and resources.
 
Rural communities like Montgomeryshire need more than well intentioned policy statements. We need a transparent, time bound plan from the Welsh Government. When will every resident in Montgomeryshire be able to access an NHS dentist in their own town or nearby locality, without facing long travel times and unnecessary expense? When will the days of being told there is no service, or only extremely limited provision, finally come to an end?
 
It is not enough to simply adjust contract terms or patient charges. The government must ensure these reforms include bespoke solutions for rural communities. Practical measures could include deploying mobile dental clinics, providing targeted incentives for dentists who serve remote areas, or introducing subsidies to offset the additional costs of running services far from larger population centres. Crucially, the new contract must be flexible enough to prevent rural clinics from being overwhelmed by unrealistic targets.
 
Ultimately, what matters to people is not the content of consultation documents, but the ability to access dental care close to home without the burden of lengthy journeys or prohibitive costs. If this contract is to succeed in rural Wales, the government must turn rhetoric into meaningful action. Only then will rural communities feel genuinely included in the future of NHS dentistry rather than left behind once again."