The research shows one in ten NHS dental practices have stopped NHS care since 2017.

Nuffield Trust policy analyst, Mark Dayan, said access increasingly depended on what people could afford and where they happened to live, adding the Government faced a choice of making NHS work attractive or giving up on the promise of a universal service.

The analysis shows the proportion of dental practices offering general NHS dentistry fell  from around 65% in 2017 to around 56% in 2026 with the number of practices holding an NHS general dental contract dropping by around 600.

At the same time, the number of practices without an NHS contract, largely private or specialist providers, increased by almost 1,000.

The decline has been seen in 41 of the country's 42 ICBs, with the  South West and East of England seeing particularly steep falls.

The analysis suggests the trend has accelerated since Covid, as growing pressures within the NHS dental contract have continued to push practices away from NHS work.

While reforms introduced in April, including making urgent dental care a contractual requirement and increasing payments for some complex treatments, should improve access to urgent care, the authors argue they do not address the underlying incentives driving practices away from NHS dentistry.

Professor Martyn Cobourne, dean of the Faculty of Dental Surgery at the Royal College of Surgeons of England, said: ‘We have consistently called for fundamental reform of the NHS dental contract, and the Nuffield Trust's analysis reinforces the need to move beyond incremental changes. We need a sustainable NHS dental service that improves access for patients and puts prevention at the centre.'

A Department of Health and Social Care spokesperson said: ‘Too many people are struggling to get the dental care they need. After years of decline, the Government has been rebuilding a broken NHS dentistry system, delivering 1.8m more dental treatments and maximising the treatments provided for taxpayers' money.

‘We are changing the NHS dental contract to make NHS dentistry more sustainable and are training more dentists in areas where they are most needed.

‘We will also make it a requirement for newly qualified dentists to practice in the NHS for a minimum period of at least three years. That will mean more NHS dentists, more NHS appointments and better oral health.'