'21st century dental service' needed for Scotland

The British Dental Association Scotland said an increase in vacancies in Scottish dental practices led to patients being unable to find dental care and said further change was needed to attract dentists to the roles.

The investigation from the BBC found six areas - Argyll & Bute, Dumfries & Galloway, Inverclyde, Orkney, Perth and Kinross and Shetland - are unable to take on new adult NHS patients within three months.

Reform to the low margin/high volume model NHS dentists worked to was rolled out in November 2023.

Two thirds of respondents to BDA polling published in July said the new system represented an improvement on the previous model, but 9 in 10 said more needed to be done.

Only 22 per cent said the new system enabled a move to a preventive model of care. Only seven per cent believed it would enhance access for NHS patients, and just 5 per cent said it would support a reduction in oral health inequality.

David McColl, chair of the British Dental Association’s Scottish Dental Practice Committee said: “The Scottish Government delivered needed reform, but we have been clear this can’t be the end of the road. 

“The simple facts are many patients are unable to access NHS care, while practices have vacancies they can’t fill. It two sides of the same coin. 

“Scotland needs a 21st century service in which dentists would choose to build a career. Ready to shift the focus from treatment to prevention.”

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said: “These damning figures expose the scale of the crisis engulfing dentistry in Scotland under the SNP. 

“The Nationalists’ woeful workforce planning and failure to agree a satisfactory funding model with practices has made it next to impossible for many Scots to access basic dental care. This is forcing those who can afford it to go private, and those who can’t, to go without essential dental treatment.”

He added: “We risk becoming a nation with poor oral health, and our overwhelmed A&E departments will be left to pick up the pieces when desperate patients turn up in agony there. Liam McArthur, Liberal Democrat MSP for Orkney, said the situation was particularly acute in rural areas of Scotland.

He said: “Toothcare should be universally accessible - it cannot just be for those who can afford to go private.

“A concerning number of dentists are no longer offering NHS services because of the low rates they receive for that work.

“There are also clearly issues specific to rural and island areas which are impacting on recruitment and retention. In the past there were incentive schemes to encourage dentists to take up posts in these areas but those incentives are now being spread so thin that any benefits are being undermined.”

He added: “The low-margin, high-volume funding system does not work in island and rural settings. Certain treatments are, de facto, loss making unless they are delivered in high numbers, which simply cannot be achieved in places such as Orkney.

“No wonder that the British Dental Association insists that NHS dentistry has been in crisis for a generation.”

A Scottish government spokesperson said it recognised that in some areas, particularly rural ones, access to dental services remained "challenging".

They said: "Almost one year on from dental payment reform, NHS dental services are responding well to the changes with the latest figures showing over one million courses of treatment were delivered to patients in the quarter ending June 2024."