High-need dental deserts in England: a national spatial analysis of NHS access and deprivation

Aims The aim of this study was to identify high-need dental deserts in England and quantify the population affected and profile the demographics relative to other deserts.Methods Lower Layer Super Output Area (LSOA) December 2021 boundaries were linked to Index of Multiple Deprivation (IMD) 2025 (deciles; mid-2022 population). National Health Service (NHS) dental practices were geocoded using the ONS Postcode Directory (British National Grid). Euclidean distance from each LSOA centroid to the nearest NHS-listed practice was calculated; LSOAs with no provider within 5 km were classified as dental deserts. High-need deserts were deserts in IMD deciles 1-3. Demographic profiling used Census 2021 ethnicity (TS021) and age structure (TS007a).Results Across England, 1,340 LSOAs (population 2,342,985) had no NHS-listed dental provider within 5 km. The high-need deserts comprised 112 LSOAs (189,542 residents). A further 2,153,443 residents in the IMD 4-10 group lived in dental deserts. The high-need desert population was predominantly white (97.9%) and had a similar age structure to other deserts not in the IMD 1-3 group (0-15: 19.4% versus 19.5%; 65+: 27.4% versus 26.9%).Conclusion Geographic exclusion from NHS-listed dental provision affects ~2.3 million residents. Spatial audits linking deprivation and access could support targeted service planning.