In an annex to a message sent by NHS England to ICBs following rollout of commissioning for Labour's manifesto pledge of 700,000 urgent appointments, officials state: ‘This calculation gives a total estimate of 2.2m people each year (3.5% of the population) who are currently unable to get an NHS dentist appointment, and who have a treatment need. It is assumed that these are the people who would require urgent care appointments.'

The BDA said: ‘We are not surprised that - having discovered this level of need - officials stuck to a relatively modest level of delivery. Treasury pressure had already seen pledges of new money from the ‘non-dom' squeeze dropped in October, with the 700,000 appointments paid for by recycling underspends in the dental budget, which are fuelled by ongoing recruitment and retention problems.

‘At the launch of this policy last week, we stressed the extra appointments would translate into each of the 24,200 dentists recorded as doing some NHS activity last year seeing the equivalent of little over two extra urgent cases a month. Our analysis of Government data - the same data underpinning NHS England modelling for urgent care - shows total unmet need for NHS dental care in England amounts to 13 million, or one in four of the adult population.

‘It's vital that Integrated Care Boards build in capacity for follow-up care for high needs patients in these local schemes. Many patients will need further dental treatment once their immediate urgent care needs are met. Some existing local schemes allow flexibility for these patients to return for follow-up care and this good practice should be adopted elsewhere.'

In response, Cllr David Fothergill, chairman of the Local Government Association's Community Wellbeing Board, said a lack of NHS dentists could risk people choosing to forgo routine dental treatments or even resort to DIY dentistry, risking more costly emergency dental treatments being needed further down the line.

He added: ‘The Government should reform the contract it has with dental surgeries as well as develop a workforce strategy to ensure we can have affordable dental treatments for communities across the country.

‘With oral health inequality widening, the LGA would like to see more preventive programmes and investment in tried-and-tested local authority schemes.'

Liberal Democrat Health and Social Care spokesperson Helen Morgan said: ‘When you have patients pulling their own teeth out because they are unable to see a dentist, it is simply not good enough for ministers to sit on their hands like this.

‘The Conservative Party's neglect has led us to this point but the Labour government's complete apathy has been inexcusable. This cannot be allowed to continue. The Government must guarantee access to an NHS dentist for everyone needing urgent and emergency care, as the Liberal Democrats have been calling for years, to ensure patients do not have to continue to suffer.'