The U.S. and the U.K. have each built a system designed to guarantee children access to dental care — yet both continue to grapple with significant gaps in delivery, according to Barry Lyon, DDS.
Dr. Lyon, the director of provider recruiting and onboarding at Dental Care Alliance, recently spoke with Becker’s about how the two countries’ pediatric dental programs differ and the challenges facing each one.
Editor’s note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. The views expressed are those of Dr. Lyon and do not necessarily reflect those of Dental Care Alliance.
This response was lightly edited for clarity and length.
Dr. Barry Lyon:
While the U.S. and the U.K. have a common aim regarding children’s oral health, they have fundamentally different systems.
In the U.S., through Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, every state is required to provide comprehensive preventive and medically necessary dental services for children under age 21. In the U.K., the National Health Service provides dental care for children up to age 18, or age 19 if a full-time student, at no charge, regardless of the family’s income status. While the financial obstacle is removed, access to care is a burden faced by the U.K.’s children. Workforce shortages and the uneven distribution of dental services have made it increasingly difficult for patients in many parts of the U.K. to secure dental appointments. Reports from parliamentary bodies and patient advocacy organizations have identified growing inequalities in access to care, raising concerns among policymakers and professional stakeholders.
Neither system can be considered a clear winner. Medicaid’s dependence on private providers can limit access when low reimbursement rates discourage clinician participation, even though benefits are broadly available. In contrast, the NHS removes most financial barriers to care but faces ongoing challenges related to capacity and workforce shortages. This comparison underscores a fundamental healthcare tradeoff: The U.S. typically offers greater provider choice and quicker access for patients who can find participating providers, whereas the U.K. ensures universal coverage but continues to face difficulties in meeting demand for care.
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