Gwasanaethau deintyddol GIG: Ebrill 2023 i Fawrth 2024
Nifer y cleifion sy’n derbyn triniaeth ddeintyddol ar y GIG, y math o driniaeth a ddarparwyd a’r nifer o ddeintyddion GIG ar gyfer Ebrill 2023 i Fawrth 2024.
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Background
This statistical release provides analyses of three main components of NHS dental services: the patients treated; the activity performed by the dentist; and the workforce who provided the dental activity.
When every course of treatment is provided by an NHS dentist, an FP17W form (NHS Business Services Authority) is completed, documenting information about the patient and the treatment they received. This form is submitted by the dentist to NHS Business Services Authority so that the dentist can be reimbursed for the service provided. The majority of statistics in this release are based on the information recorded on that form.
Any privately funded dental activity is not included.
Definitions of terms used in the release are available in the quality report.
Main points
Patients
The latest statistics show that the percentage of both adults and children in Wales who received NHS dental treatment increased modestly over the year; there was a 2.0 percentage point increase for adults (24-month reference period) and a 1.1 percentage points increase for children (12-month period).
While the percentage of the population treated increased, it remains below the pre-pandemic level.
A higher percentage of the female population were treated than male; a higher percentage of the white ethnic group population were treated than any other ethnic group; while there was a more even spread of the percentage of population treated by age group.
A higher percentage of adults who lived in the most deprived areas of Wales were treated compared to less deprived areas. Conversely a lower percentage of children who lived in the most deprived areas were treated compared to less deprived areas.
Assessments of Clinical Oral Risks and Need (ACORN) suggested patients seen this year had slightly better oral health and lower risks than patients seen in the previous year.
The large majority of patients treated in Wales lived in Wales, but a little more than twice as many adults living in Wales had treatment outside of Wales (23,823), compared to the number of non-Welsh residents that were treated in Wales (11,692) in the 24-month period ending March 2024.
In the financial year 2023-24, 146,670 new patients were treated, and there were 87,916 new urgent patient treatments. The same patient could be counted in both measures depending on their circumstances.
NHS dental activity
In 2023-24, close to 1.4 million courses of treatment were recorded, an increase of 3.0% from the previous year, but 40.2% lower than in the pre-pandemic level (2019-20).
More than half (55.6%) of treatments were in Band 1 (check-ups and simple treatments), which increased by 6.9% from the previous year. Urgent treatments increased by 15.4% from the previous year, bringing this number broadly in-line with the number in the pre-pandemic period. Treatments for all other bands decreased from the previous year.
The most common course of treatment for both adults and children was fluoride varnish, and a quarter of adult treatments and one in seven child treatments included a filling.
Just more than 10,100 orthodontic treatments started in 2023-24, the second highest number on record.
NHS dental workforce
1,398 dentists performed NHS treatments in 2023-24. While this is a decrease of 2.6% from the previous year, the number of dentists who performed any NHS work during the year has remained broadly similar for the previous ten years.
Each dentist completed an average (mean) of 1,000 courses of treatment in 2023-24. This is 5.8% higher than in 2022-23, but markedly lower (39.4%) than ten years ago.
The percentage of female workforce has increased in each of the last ten years and in 2023-24 just more than half (51.4%) of dentists were female.
151 dentists joined the workforce in 2023-24, 10.8% of the total NHS dental workforce in 2023-24.
189 dentists left the workforce in 2022-23, 13.2% of the total NHS dental workforce in 2022-23.
Patients treated
This section focusses on data relating to patients treated at NHS dental practices. The National Institute for Health and Care Excellence (NICE) recommends that adults are recalled for dental check-ups at intervals of three months to 24 months depending on the individual’s oral health status. The guidance also recommends that the longest recall period for children (aged under 18) is no longer than 12 months.
Therefore, statistics on adults treated are based on the previous 24-month period; statistics for children refer to the previous 12-month period.
Each patient is counted only once even if they have received multiple episodes of care during the reference period. Patients may be treated outside of their resident health board and orthodontic patients are included.
There has been a quality improvement in the way Welsh patients are counted in this release. Previously published statistics were based on all patients treated by NHS dentists located in Wales, but from this publication onwards, Welsh resident patients are counted if they had treatment at NHS dentists located in Wales or England. Any non-Welsh resident patients who were treated in Wales are not included in the patient count. Data has been revised back to June 2019 based on this method and the scale of the revision is shown in the quality and methodology section.
Further information on patient count methodology is available in the quality report.
Figure 1: Percentage of adults and children treated in the reference period ending March each year, 2019 to 2024 [Note 1]
Description of Figure 1: Line charts showing the percentage of both adults and children treated was affected markedly by the COVID-19 pandemic reaching low points in the 24-months ending March 2022 for adults and in the 12-months ending March 2021 for children. The percentage of both adults and children treated has increased since then, but has levelled out at a lower percentage than before the pandemic.
Source: FP17W form, NHS Business Services Authority
[Note 1] Adult refers to the resident population aged 18 years or over. Children refers to the resident population aged 0 to 17 years.
In the 24-month period ending March 2024, just over 1,038,000 adults (or 40.8% of the adult population) were treated by NHS dentists. This is an increase of 62,401 patients, or 2.0 percentage points from the 24-month period ending March 2023.
In the 12-month period ending March 2024, fewer than 284,000 children (or 45.8% of the child population) were treated by NHS dentists. This is an increase of 7,162 patients, or 1.1 percentage points from the 12-month period ending March 2023.
While the percentage of patients treated by an NHS dentist increased in the short-term, the percentage of the adult population who saw an NHS dentist in the previous 24-month period was 11.1 percentage points lower than the pre-pandemic rate (24-months ending March 2020). Similarly, the percentage of children treated by an NHS dentist in the latest year was 12.9 percentage points lower than the percentage seen in the 12-months ending March 2020.
Characteristics of patients treated
Statistics on the characteristics of patients are based on those treated at dental practices in Wales. This means that the total number of patients is slightly different to those included in Figure 1, as this section includes non-Welsh residents treated in Wales but does not include Welsh residents treated outside of Wales. This is because Welsh Government has access to FP17W data from dental practices in Wales only.
Figure 2: Gender analysis of adults and children treated in the reference period ending March each year, 2022 to 2024 [Note 1]
Description of Figure 2: Line charts showing the percentage of adult females treated by an NHS dentist was higher than the percentage for adult males in both time periods where data is available. While a higher percentage of female children were also treated by an NHS dentist than male children in all three years for which data is available, the difference was narrower than in the adult population.
Source: FP17W form, NHS Business Services Authority
[Note 1] Data by gender only available for the financial year ending in March 2022 onwards. As the adult measure is based on a 24-month reference period, the first year of available data is the 24-months ending March 2023.
Adults and children treated by gender (StatsWales)
In the 24-months ending March 2024, 44.5% of adult females were treated by an NHS dentist, 2.4 percentage points higher than in the 24-months ending March 2023. This compares to 37.9% of adult males, which also increased by 2.4 percentage points over the same period.
In the 12-months ending March 2024, 48.9% of female children were treated by an NHS dentist, 1.3 percentage points higher than in the 12-months ending March 2023. This compares to 46.5% of male children, which increased by 1.2 percentage points over the same period.
Figure 3: Ethnic group analysis of adults and children treated in the reference period ending March each year, 2022 to 2024 [Note 1]
Description of Figure 3: Bar charts showing the large majority of both adult and child patients were of white ethnic group for all years where data is available, though this percentage has decreased marginally over time.
Source: FP17W form, NHS Business Services Authority
[Note 1] There is a relatively large proportion of patients where ethnic group information has not been recorded. In 2024, 35.0% of adults and 39.9% of children either had missing data or declined to provide their ethnic group.
Adults and children treated by ethnicity (StatsWales)
In the 24-month period ending March 2024, 96.7% of adults treated were from White ethnic background, a decrease of 0.2 percentage points from the 24-month period ending March 2023. The second largest percentage of adults treated were from Asian or Asian British backgrounds (1.6%).
In the 12-month period ending March 2024, 93.9% of children treated were from White ethnic background, a decrease of 0.4 percentage points from the 12-month period ending March 2023. The second largest percentage of children treated were from Asian or Asian British backgrounds (2.5%).
When combining patients treated data with ethnic group population estimates from the 2021 Census (ONS), the percentage of each ethnic group’s adult population treated by an NHS dentist in the 24-months ending March 2024, ranged from 28.0% for the White ethnic group to 13.0% for the Black or Black British ethnic group. Note that this analysis is limited by the 35.0% of adults treated where their ethnic group was not known.
Similarly for children, the percentage of each ethnic group’s child population treated by an NHS dentist in the 12-months ending March 2024, ranged from 30.0% for the White ethnic group to 13.4% for the Black or Black British ethnic group. Note that this analysis is limited by the 39.9% of children treated where their ethnic group was not known.
The percentage of people from each ethnic group treated by an NHS dentist increased for both adults and children compared to the previous reference period.
Figure 4: Age group analysis of adults and children treated in the reference period ending March 2024 [Note 1]
Description of Figure 4: Bar chart showing the percentage of the population treated by an NHS dentist in the latest reference period was highest for children aged between 6 and 17. While the percentage was very similar for age groups between 36 and 75, it was lower for the youngest and oldest adult age groups.
Source: FP17W form, NHS Business Services Authority; 2023 mid-year population estimates, Office for National Statistics
[Note 1] Data based on the 12-months ending in March 2024 for age groups between age 0 and 17; and the 24-months ending March 2024 for all age groups of 18 and older.
Adults and children treated by age group (StatsWales)
The percentage of children treated by an NHS dentist in the 12-months ending March 2024 ranged from 38.2% in the 0 to 5 age group to 54.7% for the 6 to 11 age group.
The percentage of adults treated by an NHS dentist in the 24-months ending March 2024 ranged from 43.7% in the 36 to 45 age group to 36.9% in the 76 years and over age group.
The percentage of people seen by NHS dentists increased for all age groups when compared to the previous reference period, ranging from a 0.6 percentage point increase in the 0 to 5 age group to a 3.7 percentage point increase in the 76 years and over age group.
Figure 5: Deprivation analysis of adults and children treated in the reference period ending March each year, 2022 to 2024 [Note 1] [Note 2]
Description of Figure 5: Bar charts showing the percentage of adults treated by an NHS dentist was highest for those who lived in the most deprived areas of Wales (deprivation quintile 1) and in the least deprived areas of Wales (deprivation quintile 5). The trend was different for children with the highest percentage of children seen in the least deprived areas (deprivation quintile 5) and lowest in the most deprived areas (deprivation quintile 1).
Source: FP17W form, NHS Business Services Authority; Welsh Index of Multiple Deprivation (WIMD) 2019, Welsh Government
[Note 1] Analyses based on patient resident LSOA. If the patient resided in a lower level super output area (LSOA) (ONS) which was ranked among the most deprived 20% of LSOAs in Wales according to WIMD 2019, the patient was allocated to deprivation quintile 1. This allocation continues for each 20% category, ending with patients that resided in LSOAs ranked among the least deprived 20% of LSOAs being allocated to deprivation quintile 5.
[Note 2] Analyses based on patients residing in Wales only. For the 24-months ending March 2024, the resident LSOA was not known for 2.9% of adults treated; for the 12-months ending March 2024, the resident LSOA was not known for 2.5% of children treated.
Welsh resident adults and children treated by WIMD deprivation quintile (StatsWales)
A higher percentage of adults were treated by an NHS dentist in both the most deprived and the least deprived areas of Wales, compared to those living in the middle-most deprived areas, for both reference periods where data is available.
In the 24-month period ending March 2024, 43.6% of adults who lived in the most deprived 20% of areas in Wales were treated by an NHS dentist, the highest percentage of any deprivation quintile. This compares to 43.0% of adults living in the least deprived areas (the second highest percentage) and 38.1% of patients living in deprivation quintile 3 areas, the lowest percentage.
The pattern is different for children. There is a linear trend showing the percentage of children treated by an NHS dentist in each year was lowest in the most deprived areas. The percentage increased in each quintile as the level of area deprivation decreased.
In the 12-month period ending March 2024, 53.2% of children who lived in the least deprived 20% of areas in Wales were treated by an NHS dentist, the highest percentage of any deprivation quintile. This compares to 45.4% of children living in the middle-most deprived areas (deprivation quintile 3) and 43.7% of children living in the most deprived areas, the lowest percentage of all quintiles.
The percentage of both adults and children treated in the latest reference period was higher than in the previous reference period ending in March 2023 for all deprivation quintiles. The most deprived quintile had the largest increase for both adults (3.5 percentage points) and children (3.1 percentage points) respectively.
Assessments of Clinical Oral Risks and Need (ACORN)
ACORN (NHS Wales primary Care One) is a programme that allows NHS dentists to carry out risks and needs assessments in a systematic way. Dentists use a colour-coded scoring system to assess various aspects of a patient’s dental health and risks in-line with the toolkit guidance (NHS Wales primary Care One), with green signifying low risk/need and red signifying high risk/need. ACORN data has been collected and validated from April 2022.
Figure 6: Assessment of Clinical Oral Risks and Need (ACORN) analysis of adults treated in the 24-month period ending March each year, 2023 to 2024 [Note 1] [Note 2]
Description of Figure 6: Bar charts showing that adult patients’ risks and need varied between assessment type. While more than eight out of ten patients scored green for dental history, fewer than six out of ten patients scored green for tooth decay, periodontal health and other clinical need.
Source: FP17W form, NHS Business Services Authority
[Note 1] Of the adult patients treated in the 24-months ending March 2024, the percentage of adults with missing or not-applicable data was 29.0% for dental history and other clinical need; 29.4% for tooth decay and 30.0% for periodontal health. Therefore these patients are not included in this analysis.
[Note 2] Dental history is scored with only green and yellow categories as per the ACORN guidance.
The percentage of patients who scored green for all measures increased and the percentage of patients who scored red for tooth decay, periodontal health and other dental need all decreased compared to the last year. This suggests that the patients treated in the latest year, had on average, slightly lower oral risks and dental needs than patients treated in the previous year.
Bar charts showing the majority of n were scored as green for dental history, tooth decay, periodontal health and other oral need. The percentage of children scored as green has increased for all assessments apart from periodontal health over the three years for which data is available
Of the adults who were treated by an NHS dentist in the 24-months ending March 2024 where an ACORN was recorded, 83.3% were recorded as green for their dental history, an increase of 1.5 percentage points from the previous year.
52.2% were recorded as green for tooth decay, an increase of 3.5 percentage points from the previous year; while 25.0% scored red, a decrease of 3.6 percentage points from the previous year.
56.1% were recorded as green for periodontal health, an increase of 1.1 percentage points from the previous year; while nearly a third (30.1%) scored amber and 13.8% scored red.
56.1% were recorded as green for other dental needs, an increase of 4.2 percentage points from the previous year; while 23.7% scored red, a decrease of 4.5 percentage points from the previous year.
Figure 7: Assessment of Clinical Oral Risks and Need (ACORN) analysis of children treated in the 12-month period ending March each year, 2022 to 2024 [Note 1]
Description of Figure 7: Line charts showing the majority of children were scored as green for dental history, tooth decay, periodontal health and other oral need. The percentage of children scored as green has increased for all assessments apart from periodontal health over the three years for which data is available.
Source: FP17W form, NHS Business Services Authority
[Note 1] Of the children treated in the 12-months ending March 2024, the percentage of children with missing or not-applicable data was 25.8% for dental history, tooth decay and other dental need and 57.6% for periodontal health. Therefore these patients are not included in this analysis. Not all parts of ACORN are applicable to all children, depending on their stage of tooth development; for example, 57.6% of children treated did not have a periodontal health exam recorded.
Of the children who were treated by an NHS dentist in the 12-months ending March 2024 who had an ACORN recorded, 89.4% were recorded as green for their dental history, an increase of 1.0 percentage points from the previous year.
61.7% were recorded as green for tooth decay, an increase of 2.8 percentage points from the previous year; while 23.3% scored amber and 15.0% scored red.
88.1% were recorded as green for periodontal health, an increase of 0.2 percentage points from the previous year; while 11.1% scored amber and less than 1% scored red.
76.9% were recorded as green for other dental needs, an increase of 1.8 percentage points from the previous year; while 7.9% scored red, a decrease of 0.5 percentage points from the previous year.
Cross-border patient flows
Figure 8: Cross border flow of adults and children treated in the reference period ending March each year, 2019 to 2024 [Note 1] [Note 2]
Description of Figure 8: Line charts showing a consistently higher number of Welsh residents were treated at NHS dental practices outside of Wales than non-Welsh residents treated at NHS dental practices in Wales, over the previous 6 years.
Source: FP17W and FP17 forms, NHS Business Services Authority
[Note 1] A small percentage of patients treated in Wales have missing or invalid residence data each year. In March 2024, 1.7% of adults and 1.6% of children treated in the reference period were not mapped to a country of residence. In addition, a small number of Welsh resident patients may be treated outside of Wales without having valid residence data recorded and would therefore not be counted in these data.
[Note 2] Data on patients treated in Wales includes resident country from each UK country and the Channel Islands. Data on Welsh patients treated outside of Wales only includes those treated in England and the Channel Islands. A small number of Welsh resident patients may have been treated in Northern Ireland or Scotland which are not included in this data.
Cross border flow of adults and children treated (StatsWales)
In the 24-months ending March 2024, 23,823 adult Welsh residents were treated by NHS dentists in England and 11,692 patients were treated in Wales who lived in other areas of the UK and Channel Islands.
The flow of adult patients between the border has remained broadly stable over the past six years, with close to twice as many Welsh residents being treated in England than non-Welsh residents being treated in Wales.
In the 12-months ending March 2024, 6,222 children that resided in Wales were treated by NHS dentists in England and 2,477 children were treated in Wales but resided in other areas of the UK and Channel Islands.
Prior to the COVID-19 pandemic the number of children residing in Wales but treated outside of Wales was close to 1.6 times higher than the number of children residing outside of Wales but treated in Wales. Since the pandemic this proportion has increased and was 2.5 in the 12-months to March 2024.
New patients treated
As part of the dental contract reform programme announced in 2020, dental practices are remunerated for seeing new patients and data on new patients has been collected since April 2022. The aim of capturing new patients is to count those who are newly registered with an NHS dentist for routine treatments. There is a separate measure to count the urgent treatments of new patients, who may not be registered to an NHS dentist for routine appointments.
New patients are defined as: A unique count of patients at each NHS dental contractor who started a Band 1, 2, or 3 treatment with a complete ACORN in the year, whose previous Band 1, 2, or 3 treatment at the contractor was completed more than 48 months prior to the ACORN; or who have not previously been treated by the NHS dental contractor.
Figure 9: Number of new adult and children patients treated, 2022-23 to 2023-24 [Note 1]
Description of Figure 9: Bar chart showing the number of new patients treated decreased between 2022-23 and 2023-24. The majority of new patients treated in both years were adults.
Source: FP17W, NHS Business Services Authority
[Note 1] For 2023-24, the period to count new patients was adjusted to count Band 1, 2 or 3 treatments back to 1 April 2019, to recognise the severe disruption to NHS dental services caused by the COVID-19 pandemic.
New NHS dental patients treated (StatsWales)
In 2023-24, 146,670 new patients were treated. Of these, 88,509 were adults and 58,161 were children.
Data for ‘new urgent patient treatments’ is published on StatsWales. These are defined as: A count of urgent treatments at each NHS dental contractor that started in the year, for patients whose previous Band 1, 2, or 3 treatment at the contractor was more than 48 months prior to the urgent treatment; or who have not previously been treated by the NHS dental contractor. The same patient can be counted multiple times if they had multiple urgent treatments at the same contract.
In 2023-24, there were 87,916 new urgent patient treatments. Of these, 78,020 were for adults and 9,896 were for children.
‘New urgent’ patient treatments are not a subset of ‘new patients’ and the same patient can be counted in both measures in the same year depending on the circumstances of their treatment.
Dental activity: courses of treatment
This section focusses on the activities performed by NHS dentists in Wales in the financial year 2023-24. Activity data are based on treatments started and recorded through FP17W forms (NHS Business Services Authority). Treatments are categorised by treatment bands which are used to determine the fee paid by patients, starting with Band 1 which includes check-ups and the simplest treatments.
More information is available in the quality report.
Figure 10: Number of courses of treatment, by treatment band, each year between 2014-15 to 2023-24
Description of Figure 10: The total number of courses of treatment was broadly stable over the longer term, before falling sharply during the pandemic. The number of treatments has increased in the most recent years but remains lower than the pre-pandemic level.
Source: FP17W form, NHS Business Services Authority
Courses of treatment, by treatment band (StatsWales)
In 2023-24, close to 1.4 million courses of treatment were recorded, an increase of 3.0% from the previous year. The total number of courses of treatment was 40.2% lower than in the last period largely unaffected by the pandemic (2019-20).
Band 1 treatments were the most common treatment band, accounting for over half (55.6%) of all courses of treatment. The number of Band 1 treatments increased by 6.9% from the previous year.
Compared to the previous year there were decreases for the number of treatments in most other bands. Band 2 decreased by 8.3%, Band 3 decreased by 11.9%, and free treatments decreased by 13.7%. The number of free treatments was the lowest on record.
Around one in six (15.8%) courses of treatments were urgent and the number of urgent treatments increased by 15.4% from the previous year. The number of urgent treatments was broadly in-line with the number of urgent treatments performed in the years before the pandemic.
Patient charges
In 2023-24, there were just more than 645,000 chargeable courses of treatment for paying adults, 356,000 courses of treatment for non-paying adults and 394,000 courses of treatment for children. £21.0 million was generated from patient charges, a decrease of 7.9% from 2022-23.
Data for courses of treatment by patient type and patient charge data are available on StatsWales.
Data for Units of Dental Activity (UDA) are available on StatsWales.
Activity: clinical dental activity
In this statistical release clinical dental activity data are categorised as either physical treatments; preventative advice; items prescribed; or other activity. Data for ‘other’ activity are available on StatsWales.
An FP17W form can have more than one clinical item recorded. The sum of percentages by physical treatment will therefore not equal 100%.
See the quality and methodology section for more information.
Figure 11: Percentage of courses of treatment which had each of the five most frequent physical treatments for adults and children, 2023-24
Description of Figure 11: Fluoride varnish was the most frequently performed physical treatment for both adults and children in 2023-24. The other most frequent physical treatments were Assessments of Clinical Oral Risks and Need (ACORN); radiographs; examinations; and permanent fillings.
Source: FP17W form, NHS Business Services Authority
Clinical dental activity: physical treatments (StatsWales)
In 2023-24, a little fewer than six in ten (56.8%) adult courses of treatment included fluoride varnish, 5.9 percentage points lower than in the previous year.
55.7% of adult courses of treatment included an ACORN, while just over a third (37.2%) included a radiograph and nearly a quarter (24.3%) included a filling.
Nearly eight in ten (77.5%) child courses of treatment included fluoride varnish, 4.2 percentage points lower than in the previous year.
Nearly two thirds (64.2%) child courses of treatment included an ACORN, while one in seven (14.3%) included a filling, and 12.8% included a radiograph.
One in three of both adult and child courses of treatment included an examination. This number is low because an examination will not be recorded when an ACORN has been provided.
Figure 12: Percentage of courses of treatment with preventative advice for adults and children, 2023-24
Description of Figure 12: In 2023-24, advice on fluoride toothpaste and spit no rinse was the preventative advice offered most frequently in courses of treatment for both adults and children.
Source: FP17W form, NHS Business Services Authority
Clinical dental activity: preventative advice (StatsWales)
In 2023-24, nearly a quarter (24.4%) of adult courses of treatment included advice on fluoride toothpaste and spit no rinse, an increase of 4.3 percentage points from the previous year. One in five (20.9%) included toothbrushing advice, and 15.1% included agreed dietary changes.
Just fewer than three out of ten (28.7%) child courses of treatment included advice on fluoride toothpaste and spit no rinse, an increase of 4.5 percentage points from the previous year. 23.3% included toothbrushing advice and 20.9% included agreed dietary changes.
Figure 13: Number of courses of treatment with prescribed items for adults and children, 2023-24
Description of Figure 13: Antibiotics was the most prescribed item in courses of treatment for adults and children, followed by high fluoride toothpaste/daily rinse. The number of items prescribed for adults was larger than for children in all categories.
Source: FP17W form, NHS Business Services Authority
Clinical dental activity: prescribed items (StatsWales)
In 2023-24, just more than 30,100 adult courses of treatment included the prescribing of antibiotics, 7.0% more than in the previous year. Just over 20,300 treatments included the prescribing of high fluoride toothpaste/daily rinse, an increase of 8.6% from the previous year.
Just fewer than 4,600 child courses of treatment included the prescribing of antibiotics, 13.0% more than in the previous year. Just more than 4,400 child treatments included high fluoride toothpaste/daily rinse, a decrease of 12.5% from the previous year.
A very small number of courses of treatment included the prescription of stronger preparations. In total (adults and children combined) 337 courses of treatment included prescriptions for analgesics and 29 included prescriptions for sedatives.
Orthodontic activity
Orthodontics is a specialist area of dentistry concerned with the growth and development of the teeth and jaws and the prevention and treatment of abnormalities of this development, therefore most patients are children. Further details on orthodontics are available in the quality report.
Figure 14: Number of orthodontic treatments started in Welsh practices, 2014-15 to 2023-24
Description of Figure 14: The number of orthodontic treatments was increasing modestly prior to the pandemic, then fell sharply during the pandemic. Treatments increased since reaching a record high in 2022-23 before falling slightly in the most recent year.
Source: FP17OW form (Assessed and Accepted FP17OW), NHS Business Services Authority
Number of treatments undertaken (Assessed and Accepted FP17OWs) (StatsWales)
In 2023-24, just more than 10,100 orthodontic treatments started in Wales. While this is the second highest on record, the number decreased by 5.2% from the previous year.
Workforce
Dental workforce statistics refer to the total number of dentists with any NHS activity recorded between 1 April and 31 March each year, as per information recorded on FP17W forms. This is a headcount; full-time equivalent data is not presently available.
The production of dental workforce data has now moved from NHS England to NHS Business Services Authority. This has resulted in a slight change in data processing techniques and therefore data have been revised for 2019-20 to 2022-23. The Wales headcounts have increased slightly for these years, ranging between an increase of 2 and 7.
A new dental workforce reporting system is being introduced in Wales and it is anticipated that data from that system will be available to publish in 2025.
See the quality and methodology section for more workforce and population information.
Figure 15: Total number of dentists with NHS activity and the average number of courses of treatments provided per dentist, 2014-15 to 2023-24
Description of Figure 15: The number of dentists who performed NHS treatments was on a marginal upward trend until 2018-19, before decreasing during the pandemic and remaining broadly stable since. The number of courses of treatment per dentist has increased in recent years following a sharp fall during the pandemic, but remains below the pre-pandemic level.
Source: FP17W form, NHS Business Services Authority
Dentists with NHS activity (StatsWales)
Courses of treatment, by treatment band (StatsWales)
In 2023-24, there were 1,398 dentists with NHS activity recorded in Wales. This is a decrease of 2.6% from 2022-23 and a decrease 2.8% from ten years ago.
Each dentist completed an average (mean) of 1,000 courses of treatment in 2023-24. This is 5.8% higher than in 2022-23, but 39.4% lower than 10 years ago.
Combining workforce data with Office for National Statistics mid-year population estimates allows for analysis of the number of NHS dentists per population. This has been on a slight downward trend over the past 5 years and in 2023-24, there were 44.2 dentists per 100,000 population. This compares to 45.8 in 2022-23 and 47.9 in 2019-20.
Figure 16: Distribution of dentists with NHS activity by sex, 2014-15 to 2023-24
Description of Figure 16: Bar chart showing the percentage of female dentists has increased over the past ten years and in 2023-24 a little over half of dentists were female.
Source: FP17W form, NHS Business Services Authority
Dentists with NHS activity (StatsWales)
The distribution of NHS dentists by their sex has been gradually changing over-time in Wales. The majority of NHS dentists were male ten years ago; however, the percentage of female dentists has increased in every year since and there have been more female dentist than male dentists in the last three years.
In 2023-24, 51.4% of dentists with NHS activity were female, an increase of 0.6 percentage points since the previous year and an increase of 7.4 percentage points from ten years ago.
Conversely, in 2023-24, 48.6% of dentists with NHS activity were male, a decrease of 0.6 percentage points since the previous year and a decrease of 7.4 percentage points from ten years ago.
Figure 17: Distribution of dentists with NHS activity by age group, 2014-15 to 2023-24
Description of Figure 17: In each of the last ten years, close to two thirds of NHS dentists were less than 45 years old. The age group with the largest number of dentists has been the under 35 group, followed by 35-44. The 55 or older group had the least number of dentists in each of the last ten years.
Source: FP17W form, NHS Business Services Authority
Dentists with NHS activity (StatsWales)
The age profile of the NHS dental workforce has been broadly stable over the last ten years.
In 2023-24, a little more than one third (36.4%) of dentists were aged 34 or younger; just over a quarter (27.4%) were aged between 35 and 44; just more than one in five (22.7%) were aged between 45 and 54; and close to one in seven (13.4%) were 55 or older.
The change in each age group was marginal from the previous year; the largest increase was in the 35-44 age group (0.2 percentage points) and the largest decrease was in the under 35 age group (0.4 percentage points).
Welsh language
All dentists providing services in Wales are required to be registered on the Dental Performers’ List. When registering, a dentist self-reports their Welsh language speaking ability. This information is currently collected by a simple ‘Yes/No’ question and is not typically updated throughout the dentist’s tenure on the list.
Figure 18: Percentage of NHS dentists self-reporting that they are Welsh speakers, 2018-19 to 2023-24
Description of Figure 18: The percentage of dentists recorded as Welsh speakers has remained consistently around 10% in each of the six years where data is available.
Source: Dental Performers’ List, NHS Wales Shared Services Partnership
Welsh Speaking Dentists (StatsWales)
ONS Population Estimates (StatsWales)
There were 133 Welsh speaking dentists recorded on the Dental Performers List in Wales as of August 2024, a decrease of 11 compared to August 2023.
Welsh speaking dentists represented 9.5% of the total dental workforce, a decrease of 0.5 percentage points from the previous year.
The percentage of Welsh speaking dentists in 2023-24 (9.5%) is lower than the percentage of the Welsh population who have Welsh speaking skills. The 2021 Census (StatsWales) estimates 17.8% of people in Wales had some Welsh speaking skills, and the Annual Population Survey (StatsWales) as at June 2024 estimates 27.8% of people in Wales had some Welsh speaking skills.
These statistics may not necessarily represent the number of dentists who currently consult in Welsh or who are able to consult in Welsh.
Joiners and leavers
A joiner is defined as a dentist who recorded NHS activity in the latest year but not in the previous year. A leaver is defined as having NHS activity recorded in the previous year but not in the latest year. Therefore, data for leavers has a one-year lag.
More information about joiners and leavers is available in the quality report.
Figure 19: NHS dental joiners and leavers, 2014-15 to 2023-24
Description of Figure 19: The number of joiners and leavers have been broadly close for most of the last 10 years, with some year-to-year variation. The average (mean) number of joiners has been 153 compared to 156 leavers each year.
Source: FP17W form, NHS Business Services Authority
NHS dental leavers and joiners (StatsWales)
In 2023-24, there were 151 new NHS dentists who did not perform NHS treatments in the previous year, an increase of 7.9% from the previous year.
The 151 dentists who joined the workforce accounted for 10.8% of the total NHS dental workforce in 2023-24.
189 dentists who performed NHS work in 2022-23 did not perform any NHS work in 2023-24, a 47.7% increase from the number of dentists who left the NHS workforce in the previous year.
The 189 dentists who left the workforce accounted for 13.2% of the total NHS dental workforce in 2022-23.
Dental practices
Figure 20: General dental practices, 2023-24
Description of Figure 20: A map of Wales showing the location of dental practices which offered NHS or Community Dental Service appointments in 2023-24. There is a higher concentration of dental practices in south Wales compared to both mid and north Wales, broadly reflecting population density.
Source: FP17W, NHS Business Services Authority
Dental contracts and practices (StatsWales)
In 2023-24, there were 415 dental practices and 516 dental contracts in Wales. This includes two contracts located in England (Shropshire). This is based on at least one FP17W or FP17OW being submitted by a contract at a dental practice.
See the quality and methodology information section for contract and practice definitions.
Quality and methodology information
Detailed information about the statistics in this release are published in the quality report.
Table 1 shows the percentage points change from the percentage published previously to the revised percentage for adults and children for each reference period ending June 2019 onwards.
| Period ending | Percentage points change for percentage of adults treated | Percentage points change for percentage of children treated |
|---|---|---|
| Jun-19 | -0.7 | -0.7 |
| Sep-19 | -0.7 | -0.7 |
| Dec-19 | -0.5 | -0.7 |
| Mar-20 | -0.7 | -0.7 |
| Jun-20 | -0.6 | -0.6 |
| Sep-20 | -0.6 | -0.5 |
| Dec-20 | -0.6 | -0.2 |
| Mar-21 | -0.6 | 0.0 |
| Jun-21 | -0.5 | 0.0 |
| Sep-21 | -0.4 | -0.1 |
| Dec-21 | -0.2 | -0.1 |
| Mar-22 | -0.1 | -0.1 |
| Jun-22 | -0.1 | -0.1 |
| Sep-22 | -0.2 | -0.1 |
| Dec-22 | -0.2 | -0.2 |
| Mar-23 | -0.2 | -0.2 |
| Jun-23 | -0.2 | -0.2 |
| Sep-23 | -0.7 | -0.2 |
| Dec-23 | -0.7 | -0.2 |
Courses of treatment
A Course of Treatment (CoT) is defined as:
- (a) an examination of a patient, an assessment of their oral health, and the planning of any treatment to be provided to that patient as a result of that examination and assessment; and
- (b) the provision of any planned treatment (including any treatment planned at a time other than the time of the initial examination) to that patient.
Treatments are split into treatment bands, according to level of complexity and these bands are used to determine the charge paid by patients.
Treatment bands
Band 1
Includes a check-up and simple treatment (such as examination, diagnosis (e.g. x-rays), advice on preventative measures, and fluoride varnish).
Band 2
Includes mid-range treatments (such as fillings, extractions, and root canal work) in addition to Band 1 work.
Band 3
Includes complex treatments (such as crowns, dentures, and bridges) in addition to Band 1 and Band 2 work.
Urgent
Treatments where prompt care is provided because, in the opinion of the dental practitioner, that person's oral health is likely to deteriorate significantly, or the person is in severe pain by reason of their oral condition; and care and treatment is provided only to the extent that is necessary to prevent that significant deterioration or address that severe pain.
Free
Treatments which do not incur a patient charge and include arrest of bleeding, bridge repairs, denture repair, removal of sutures, and prescription issues.
NHS workforce
A new NHS dental workforce reporting system that mirrors the general practice Wales National Workforce Reporting System is currently being implemented for all NHS Wales dental practices. Once the system is established, data collected from it will inform a new range of NHS dental workforce official statistics. While it was hoped the system would be implemented in time for this statistical release, software delays mean that data will not be available until at least 2025.
Accredited Official Statistics status
The United Kingdom Statistics Authority has designated these statistics as Accredited Official Statistics (formerly known as National Statistics), in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics (UK Statistics Authority).
This status means that official statistics meet the highest standards of trustworthiness, quality and public value.
All official statistics should comply with all aspects of the Code of Practice for Statistics. They are awarded Accredited Official Statistics status following an assessment by the Office for Statistics Regulation (OSR). The authority considers whether the statistics meet the highest standards of code compliance, including the value they add to public decisions and debate.
Since the latest review by the OSR, we have continued to comply with the Code of Practice for Statistics, and have made the following improvements:
- Included additional open data, with more detailed breakdowns, on our StatsWales website
- Sourced individual course of treatment data to allow for more rigorous data validations and some reproducible analytical pipelines
- Included further insights into patients treated, including analysis of:
- Deprivation of the patient’s resident area
- Gender of the patient
- Age group of the patient
- Ethnic group of the patient
- Assessments of Clinical Oral Risks and Need
- Additional types of course of treatment
- Workforce joiners and leavers
- Characteristics of the dental workforce
- Updated key quality information and refreshed commentary throughout the release, including longer time comparisons of data.
Statement of compliance with the Code of Practice for Statistics
Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.
These accredited official statistics demonstrate the standards expected around trustworthiness, quality and public value in the following ways.
Trustworthiness
The published figures are compiled by professional analysts using the latest available data and applying methods using their professional judgement and analytical skillset.
These statistics are pre-announced on the Statistics and Research area of the Welsh Government website. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice for Statistics.
Quality
Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs.
Where there are data quality issues, they are stated in the release and on StatsWales.
Value
The purpose of this statistical release is to inform users about the main components of NHS dental services: the patients treated; the activity performed by the dentist; and the workforce who provided the dental activity.
These statistics are published quarterly with up to a six-month lag between the end of the reference period of the latest statistics and the publication date Statistics are published as data tables on StatsWales with an accompanying headline every quarter. An in-depth report is also published annually in HTML format with analysis, charts and commentary focusing on the latest financial year.
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.
We want your feedback
We welcome any feedback on any aspect of these statistics which can be provided by email to: stats.healthinfo@gov.wales
Manylion cyswllt
Ystadegydd: Sabir Ahmed
E-bost: ystadegau.iechyd@llyw.cymru
Cyfryngau: 0300 025 8099
SFR 101/2024
