Mohammed Malik, who runs Clifton Dental Practice in Newtown, says underfunding and rigid targets are pushing practices to breaking point.

Dr Malik qualified as a dentist in 2021 and took over the predominantly NHS practice, off New Road, in 2024, alongside his lifelong friend, Dr Usman Ahmed.

They wanted to continue serving the community with NHS care, but two years on, they believe the current contract makes community care increasingly difficult to deliver that care.

“The system isn’t failing because dentists are walking away – it’s failing because the structure makes it almost impossible to keep going,” said Dr Malik.

“Yet, increasingly, dentists are portrayed as the villains in the story of NHS dentistry – accused of abandoning the NHS, prioritising private work and turning patients away.”

Under the NHS dental contract in Wales, practices are funded through activity-based targets known as Units of Dental Activity (UDAs). Dentists say these targets value numbers over outcomes, and once a practice reaches a quarter of its UDA goal, extra treatment brings no additional funding.

The fear, that the dental system in Powys could be on the brink of collapse, has been raised by Mohammed Malik, who owns the Clifton Dental Practice in Newtown. (Image: Matt Jones)

“Work beyond the minimum requirement is often effectively unpaid,” Dr Malik explained. “It’s arithmetic, not healthcare.

“Success is measured not by overall oral health outcomes, but by hitting those figures. The flaw in this structure is stark.

“In Wales, a practice is required to achieve only 25 per cent of its UDA target to secure its contract value. Once reached, additional treatment does not generate further payment.

“This creates a system where activity is measured, but meaningful treatment is not necessarily supported.”

Mohammed Malik, of Clifton Dental Practice in Newtown. (Image: Supplied)

In Powys, communication with health boards can be inconsistent, and rising costs for staff, materials and laboratory work means NHS treatments are often delivered at a loss.

“Many of us chose to run NHS practices because we believe in public dentistry,” said Dr Malik. “But goodwill alone can’t keep a practice open.

“As healthcare professionals, we repeatedly raise concerns that NHS dentistry across the UK is in serious decline. In parts of Powys, it feels perilously close to collapse.

“This is not dramatic language; it is the lived experience of practitioners trying to balance patient care with financial viability.”

Dentists across the county are now calling for transparency and meaningful reform of the system.

“If the current model continues, NHS dentistry in Powys won’t just be struggling – it could collapse altogether,” warned Dr Malik.

“Many of us chose to run NHS practices because we believe in public dentistry,” said Mohammed Malik. “But goodwill alone can’t keep a practice open.” (Image: Matt Jones)

“We are not seeking to abandon the NHS. Many of us chose to buy NHS-focused practices precisely because we believe in public healthcare. We want it to succeed. But good intentions cannot compensate for structural flaws.

“We need transparency about how contracts operate, honest conversations about funding, and a shift away from models that reward activity figures while neglecting long-term oral health outcomes.

“Dentists are not the problem. We are an essential part of the solution. But solutions require structural change, not just improved numbers on a report.

“Support the system properly, or be prepared to accept responsibility for its decline.”

A Welsh Government spokesperson said: “The new contract arrangements are the result of extensive negotiations with the British Dental Association (BDA) and the NHS.

“We have consulted widely on the proposed changes, listened to feedback and worked with the profession to make improvements based on that feedback.

“We have published clear operational guidance, which was developed with the BDA. The regulations put all that work into law.

“From April 1, Wales will have a new dental contract with patient, preventative care and public health at its heart.

“It will take dentists off the current treadmill contract and pay them for the time they spend providing treatment. This is what the dental profession has asked for.

“We are proud to have developed this in partnership with the BDA, the NHS and the people of Wales.”