England's most deprived places have 29% more residents per NHS dental site than places of the same size, and a quarter fewer practices competing online

From April 2026, most NHS dental contract holders in England have to deliver 8.2% of their contract value as urgent care, and those urgent patients can be new to the practice (NHS England, 22 January 2026). NHS capacity to meet that is not spread evenly. Within two miles of England's most deprived places there are 7,109 residents for every NHS-registered dental practice site, against 5,151 around the least deprived. Children in the most deprived areas are also more than twice as likely to have tooth decay at five, 32.2% against 13.6%, comparing IMD 2019 fifths (National Dental Epidemiology Programme, 2024 survey, first published 11 February 2025, updated 5 March 2025). We wanted to know whether the same divide shows up where patients now look for a dentist: on Google.

It does. We took the 1,130 English places in our UK dental search index, measured how deprived the people within two miles of each one are, and split the places into five equal groups. Three terms used throughout. A map pack place is one of the three practices Google shows on the map at the top of a search. The first ordinary result is the top result below the map and the adverts. Deprivation is the government's Index of Multiple Deprivation 2025, which combines income, jobs, health, education, crime, housing and living environment.

"Patients in a stretched town rate the whole experience, including the wait," said Jack Henty, co-owner of Bollington Dental Practice and founder of Practice Radar. "Answer every review, and say plainly whether you can take them."

How the places were grouped

Each place's catchment is every neighbourhood whose population centre lies within two miles of it. England has 33,755 of these neighbourhoods, each home to about 1,700 people, and every one has an official deprivation score. We weighted each neighbourhood by its mid-2024 population and took the average. That gives every place one number, and the 1,130 places were then cut into five groups of 226.

Look at the fourth column before anything else. The most deprived places are three times the size of the least deprived. Seven in ten are in the three northern regions. Both of those change a dental market on their own, so every comparison below is also run holding size, type of place, number of competing practices and region steady. Where a difference disappears or changes when we do that, we say so.

1. More residents per NHS-registered site, and fewer practices online for a place that size

Within two miles of the typical place in the most deprived fifth there are 7,109 residents for every dental practice site on the NHS's organisation register. In the least deprived fifth there are 5,151. That is 38% more residents for each site. These are registered sites, not appointments or contract activity: the register does not say how much NHS care each site provides or whether it is taking new patients.

Part of that is size, because big places have more residents per practice wherever they are. Compare places of the same population and the same kind of settlement, and the most deprived still have 29% more residents per site (18% to 41%). Add region and it is 23% (11% to 35%). Smaller, but real.

The same shows up in search. The median place has five practices ranking for its own name in the most deprived fifth and six in the least. But the deprived places are three times bigger. Compare places of the same size and a deprived one has 26% fewer practices competing for it on page one (20% to 32%).

Put plainly, a practice in a deprived place has more residents around it, and fewer rivals online for a place of its size.

2. In deprived places the first result is less often a local practice's own site

In the least deprived fifth, the first ordinary result for "dentist" and the place's name is the own website of an independent practice in that place 78% of the time. In the most deprived fifth it is 55%. In the other 45% the top result goes to a dental group's site, a directory, the NHS, the regulator or a social network.

It holds when you compare like with like. With the same competition, size and type of place, the most deprived fifth is 17 points less likely to have a local practice's own site on top (8 to 27 points). Adding region makes it 19.

That top position is the most clicked result on the page after the map. In almost half of the most deprived places, no local practice's own site holds it. A practice with a proper page for its own town is competing for it with group sites and listings.

3. Google ratings are lower in deprived places

A Google rating records how patients felt about their visit, including how long they waited and whether they could get in. It is not a measure of clinical care, and nothing here says care is worse.

With that said, the ratings differ. In our national study, 72% of practices on the map sat at 4.6 or better. Split the 2,498 English practices holding a map pack place by where they are, and the picture divides. In the least deprived fifth of places, 66% are rated 4.8 or better and 14% sit below 4.5. In the most deprived fifth, 40% reach 4.8 and 35% sit below 4.5.

It is not a dental group effect. Group branches hold more of the map in deprived places, 21% against 14%, but independent practices show the same split: 46% at 4.8 or better in the most deprived fifth, 71% in the least. And it survives controls. With the same number of competing practices, the same population, the same kind of settlement and the same region, the most deprived fifth sits 0.2 stars lower (plausible range 0.13 to 0.27).

Ratings alone can't tell us why. Access is one possible reason, but our count of residents per NHS site does not account for the gap, and it rates the South West as well supplied. Across the English towns Practice Radar measures in detail, practices with an NHS listing reach 4.8 less often than those without one: 65% against 80%, across 234 rated practices. That sample is small and the range is wide (a gap of 3 to 28 points), so read it as a pointer, not proof.

4. Reviews: about the same as places are, about a third fewer like for like

Across places as they are, the review counts look the same. The median practice holding a map pack place in the most deprived fifth has 150 Google reviews, and in the least deprived fifth 157. Every range overlaps.

But that hides a difference. The deprived places are bigger and, for their size, have fewer practices competing, and our national study found that competition sets the review bar. A practice owner knows both things about their own town, so the like-for-like comparison is the one that matters. Compare places with the same population, number of competing practices and type of settlement, and the typical map pack practice in the most deprived fifth holds 39% fewer reviews (range 24% to 50%). Hold region steady too and it is 32% fewer (14% to 46%). Within the competition bands, the most deprived places come in lower in three of the four.

The tests disagree on how big the gap is. Comparing within competition bands alone, without holding population steady, the gap is small and a shuffle test cannot separate it from chance. So treat the like-for-like figure as a direction, not a target. Use the review count for your competition band as the floor.

5. Facebook and the NHS website: no difference worth acting on

We expected Facebook and nhs.uk to be more common on page one in deprived places. Neither is.

Facebook is actually less common in the most deprived fifth, on page one in 71% of places against 82% in the least deprived. But Facebook's presence is almost entirely about competition. It is on page one in 92% of places where three to five practices compete and 15% where twelve or more do. Once competition, size and type of place are held steady, the deprivation gap shrinks to 6 points, and its range runs from 13 points lower to 2 points higher. That is not a finding.

The NHS website is on page one in 96% to 100% of English places in every group. When it is nearly everywhere, there is no difference left to exploit. The same is true of dental group websites: on page one in 69% of the most deprived places against 57% of the least, a gap that disappears once competition is held steady.

6. What patients search for: no clear link across the 30 shire counties we could measure

This is the weakest of our measurements, so it comes with its limits first. Google only prices search volume by county, not by town, and in rounded steps. The metropolitan counties are missing, which means the most deprived urban areas are not included. The 30 English counties with enough searches to compare run up to a deprivation score of 27.9, while the most deprived fifth of our places starts at 29.1.

Across those 30 counties, private treatment searches (implants, Invisalign, veneers, aligners, whitening and their costs) take between 44% and 54% of dental searching, with no clear link to deprivation. Searches for getting seen at all (appointments, registering, toothache, check-ups) take a larger share in the more deprived counties. But they are small either way, 3% to 6% of the total.

So we can't say what happens in the most deprived cities. Across the shire counties, private treatment searching does not fall away as deprivation rises.

Region by region

For readers who want their own patch, here are the same measures by region. Read them with care. Our national study found that regional differences in dental search are mostly town size and competition wearing a regional label, and the same applies here. The South West has very few deprived places, 3% of its total, yet 27% of its map pack practices are rated below 4.5, close to Yorkshire at 29% and the North East at 33%. Ratings alone can't tell us why. Access is one possible reason, but our count of residents per NHS site does not account for the gap, and it rates the South West as well supplied. London appears only through the 22 places outside its boroughs, so its row is thin.

What to do about it

Start by finding out which market you are in. Look up your practice postcode and the streets around it in the English Indices of Deprivation 2025. Then count how many practices appear on page one when you search "dentist" and your town's name.

If your catchment is deprived:

• Say clearly whether you are taking NHS patients. There are more residents per NHS-registered site around you, and more of the searching is about getting seen. Put your current NHS position, including urgent appointments, on your site, your Google profile and your nhs.uk profile, and keep all three matching.
• Answer every review. Ratings on the map around you are lower, and reviews record the wait as well as the treatment. A reply that explains how to get an appointment helps the next patient as well as the last one.
• Use your competition band as your review floor. Like for like, practices in deprived places hold fewer reviews, but the tests disagree on how many fewer. Aim for the figure for your number of competitors in our national study.
• Go for the top result. In 45% of the most deprived places the first ordinary result is not a local practice's own site. A page built for your town's name, with your address, services and fees, can compete for it.
• Don't assume the demand for private treatment is gone. Across the shire counties we could measure its share of searching has no clear link to deprivation. Show prices and finance options on your treatment pages.

If your catchment is well off:

• Expect 4.8 around you. Two thirds of the practices on the map around you have it. Your review count, set by your competition band, decides your place.
• You face more competitors for a place your size. The top result is already a local practice's own site in 78% of places, so you are competing with other practices for it. Your treatment pages need to be better than theirs, not merely present.
• Private treatment searching is not a bigger share of demand around you. Across the counties we could measure, a wealthier county did not bring a larger share of cosmetic searching.

How we did this

The places. The Practice Radar UK Dental Search Index: one live mobile Google search for "dentist [place]" in every UK city, town and suburban area, run on 13 September 2026. This article uses its 1,152 English rows, less the 22 London boroughs, which carry no single centre point to draw a catchment from, leaving 1,130 places. Scotland, Wales and Northern Ireland are left out because the English Indices of Deprivation cover England only. Macclesfield, Wilmslow and Congleton were never in the index, because they are live Practice Radar markets.

Deprivation. Ministry of Housing, Communities and Local Government, English Indices of Deprivation 2025, File 7, Index of Multiple Deprivation score for each of 33,755 Lower Layer Super Output Areas (2021 boundaries). A place's catchment is every such area whose ONS population weighted centroid (December 2021) lies within two miles of the place, and its score is the average weighted by ONS small area population estimates for mid-2024, read from Nomis (dataset NM_2014_1). We re-ran everything at one mile and at three miles. The rating gap, the per-head gap, the fewer-practices gap and the first-result gap hold at both. The Facebook gap clears its range at one mile but not at two or three, which is why we do not report it as a finding.

NHS-registered sites. Every active organisation with the primary role "general dental practice" (RO110) on the NHS England Organisation Data Service, read through its ORD API on 24 September 2026. The register is not England-only: it returned 9,796 records, including Wales and the Isle of Man. Each postcode was looked up with postcodes.io and only English postcodes kept. 19 register postcodes are no longer live, so they could not be placed in a country and were dropped. That left 8,732 distinct sites. A site is a distinct postcode, so two contracts at one address count once. The register is of practices with an NHS link. It is not every private practice, and it does not say how much NHS care a site provides or whether it is taking new patients. Places with fewer than 5,000 residents within two miles, or no registered site, are left out of the per-head figures, leaving 1,051.

Map pack ratings and reviews. Every map pack occupant recorded in the same index run with a rating, in the 902 English places that had one. A practice holding a pack place in more than one place is counted once, removing 172 repeats and leaving 2,498. Dental group branches are identified from the index's hand-built list of 37 group domains. The first ordinary result counts as a local practice only when it is a practice in that place and not a dental group's site, as defined in the index.

Ranges and controls. Every range is a 95% bootstrap interval, from resampling places 4,000 times (2,000 for the controlled comparisons), so that the three practices in one town's map pack are not treated as independent. Controlled comparisons are regressions of each measure on the five deprivation groups, with the log of population within two miles, the log of the number of practices ranking, settlement type and, separately, government region as controls. The like-for-like review figure uses each place's median map pack review count, for the 920 places with at least two map pack practices. The competition-band comparison uses a stratified permutation test, which does not separate the groups (it produces a gap as large as the real one 64% of the time). At three miles, the competition-only comparison shows 19% fewer reviews (1% to 34%).

The closer look. 53 English towns Practice Radar measures in detail, with the fictional demo town and our own live markets removed. Each practice's NHS flag means an active NHS dental entry at its postcode on the ODS register. No town or practice is named or published.

Search demand. Google Ads average monthly search volume for 20 dental searches in each English county, collected through DataForSEO on 15 September 2026 for our national study, with no new data bought. Counties with at least 720 monthly searches for "dentist" are used, 30 in all. None is a metropolitan county. A county's deprivation is the population weighted average of the index places inside it. Spearman correlations: private treatment share against deprivation -0.21 (range -0.56 to 0.16), getting-seen share 0.49 (0.15 to 0.73).

What this is not. It is one search on one day per place, and place-level deprivation, not the deprivation of any practice's own patients. It shows what goes together. It does not show what causes what.

For editors

The figures in this article are free to reuse with attribution to Practice Radar, September 2026. Sources: Practice Radar UK Dental Search Index (Google, 13 September 2026), English Indices of Deprivation 2025, ONS mid-2024 small area population estimates, and the NHS Organisation Data Service register of dental practices (24 September 2026). Regional and county cuts are available on request.

Contact: hello@practiceradar.co.uk

Questions we get asked about this data

Are there fewer NHS dental practices in deprived areas?

Per head, yes. There are 7,109 residents per NHS-registered dental practice site within two miles of the typical place in the most deprived fifth of 1,130 English places, against 5,151 in the least deprived fifth. Comparing places of the same size, the gap is 29%. These are registered sites, not appointments.

Do dental practices in deprived areas need fewer Google reviews?

Across places as they are, map pack practices hold about the same number: a median of 150 in the most deprived fifth and 157 in the least. Compared like for like, with the same population and competition, practices in the most deprived places hold about a third fewer, but the tests disagree on how much. Use the review count for your competition band as the floor.

Are dental practices rated lower on Google in deprived areas?

Yes. In the most deprived fifth of English places, 35% of practices holding a map pack place are rated below 4.5 stars, against 14% in the least deprived fifth. A Google rating reflects the whole visit, including waiting and access. It is not a measure of clinical care.