For many years, British adults have been offered “free” dental care under the National Health Service (NHS). This is just what many Canadian public opinion polls are saying is wanted in Canada.

But while dental care in the UK is “free”, it is increasingly undesirable. Dental attendance at NHS clinics has declined steadily, and pre-pandemic, less than half of adults use this service

Why might “free” dental care be so unpopular?

Here are some reasons: First, the NHS surgical model has never progressed to a preventive model. UK dentists are paid to fill cavities and put on crowns so that is their focus. Prevention is not rewarded the same way or at the same level. Second, surgery is laborious and expensive (and commonly not very effective), so “co-pays” by the patient have had to be imposed. Lastly, UK dentistry remains resistant to embracing new models of care. When the community avoids going to the dentist, UK dentists blame the government for not educating the public about this “free” service.

The lesson here is oral healthcare is about affordability for sure, but it is also about perceived value and about a new preventive model. The UK community has turned away from dentistry as it knows it. It is likely Canadians will too if “free” dental care is all about filling cavities and putting on crowns.