An overview of adult dental fee exemptions in NHS primary dental care in England.

Aims To explore the current landscape of NHS primary dental care services for fee-exempt adult patients and observe attendance, band claiming and geographical patterns.Materials and methods Data were analysed from FP17 claims submitted to NHS Business Services Authority from 2006-2019.Results Fee-exempt adult patients in 2018-2019 account for 23.7% of all adult claims in NHS primary dental care. This percentage has decreased year-on-year since 2011-2012 from 31.5%. In 2018-2019, there were significantly fewer band 1 claims for fee-exempt adult patients (36.0%) compared to their fee-paying counterparts (58.3%). Treatment needs appear to be higher for fee-exempt adult patients since more band 2 and 3 treatment claims were completed (49.0%) compared to fee-payers (30.8%). Band 3 claims were three times higher for fee-exempt adult patients.Discussion Adults with fee exemptions must be able to access timely oral health services since they appear to have higher treatment needs than fee-payers. The areas with the highest proportion of fee-exempt adult patients reflect relative levels of deprivation across regions in England. Barriers to access must be reduced to fully engage all groups of patients and improve oral health.Conclusion Oral health inequalities appear to exist between fee-paying and fee-exempt adult patients. The post-pandemic world will offer a unique opportunity to reassess NHS dental services.