Abstract
Aims Demographic change may affect access to National Health Service (NHS) dentistry unevenly. This study assessed how fixed provider geography performs under population growth, ageing, and deprivation-focused growth.Methods A scenario-based spatial analysis was conducted using lower layer super output area-level population, age, and index of multiple deprivation (IMD) data. Dental deserts were defined as areas located >5 km from the nearest NHS provider; high-need deserts were those in IMD deciles 1-3. Three scenarios were modelled: 5% general population growth, ageing, and 10% growth concentrated in IMD deciles 1-3.Results At baseline, 2.34 million residents lived in dental deserts, including 189,542 in high-need deserts. General growth increased desert population by 117,135 and high-need desert population by 9,477. Ageing had minimal impact. Concentrated deprived-area growth increased high-need desert population by 18,960, approximately double that seen under general growth. The largest increases occurred in rural and semi-rural authorities.Conclusions Population growth expands exposure to dental deserts, while growth in deprived areas disproportionately increases high-need burden. NHS dental access appears unevenly resilient to demographic change.