Our new report, Behind the Wait: Exploring Dental General Anaesthetic Waiting Times in Scotland, shines a light on the fact that some child patients are waiting up to three years for a general anaesthetic (GA). This scandalous issue needs to be addressed.
In my time in dentistry, I have seen the impact these waiting times have on our patients many of whom are kept waiting for months, sometimes years, for treatment.
We can’t accept that tooth decay remains the number one reason for hospital admissions among young children in Scotland. Adults with special care needs are also facing unacceptably long waits. These patients are often unheard, and we have a duty to advocate for them.
Our report seeks to offer solutions to address these unacceptable waiting times and is a call to action. It is time to make change happen.
Urgent action is needed
BDA Scotland committee members, along with wider voices from the dental profession, have told us they are concerned about the impact of these waiting times on their patients. To ensure their voices were heard we facilitated a stakeholder discussion, which provided invaluable perspectives from the profession which fed into our new report.
We hope the report’s recommendations will provide a helpful framework for future engagement of the Scottish Government and system leaders.
This report underscores the urgent need for comprehensive reforms in dental workforce planning, the need for appropriate funding, and service delivery development, to ensure timely and equitable access for all of our patients.
We believe it is a shared responsibility - we need cross-sectoral engagement within both dentistry and medicine, in collaboration with Health Boards and the Scottish Government.
What we found
In quarter ending March 2025, around one in four patients were waiting over a year to receive their dental treatment under a GA, often experiencing pain and dental infections whilst they wait. With the longest waiting times exceeding three years.
One huge concern is the stark inequalities faced by children from the most socioeconomically deprived areas, as these are the hardest hit. Children with tooth decay miss on average five more half-days during their first primary school year than those with healthy teeth.
In 2023, over 6,500 paediatric dental extractions were carried out under GA, costing the NHS an estimated £8.4 million. However, it is very clear these numbers do not begin to capture the huge unmet need for these treatments.
The waits also impact on other parts of the NHS, patients may go to their dentist, pharmacist, GP or accident and emergency department, for treatment or advice whilst they are on a GA waiting list, as they are in pain, or having trouble eating and drinking, and losing days at school, nursery or work.
How can we solve this?
We are often asked to make efficiency savings in the health service, and we strive to try to do more with less, but the Public Dental Service dentist workforce headcount has declined over the course of the last decade by 24% - there is clearly a gaping hole.
The Royal College of Anaesthetists has said that across the UK, the number of anaesthetists is 15% lower than required. They estimate that this shortfall is preventing roughly 1.4 million operations and procedures from taking place per year.
Workforce planning and recruitment and retention issues need to be addressed, and we need an available cohort of special care and paediatric dentistry specialists to meet the needs of the population in Scotland. Appropriate and sustainable funding is needed to ensure the availability and capacity of dental GA lists to meet the needs of the population now and in the future. Dental services shouldn’t be left fighting for priority and theatre space in hospitals.
Prevention first
We know that prevention is the answer. Investing in good oral health will save us resources in the future.
We are calling for an expansion of universal and targeted preventive measures, which are already part of our oral health improvement programmes. For example, an evaluation of the Childsmile supervised toothbrushing programme, showed that for every £1 spent the health service benefit at five years was £3.06.
We all have a moral duty to put prevention first. The costs of leaving patients waiting or untreated, comes at great financial, emotional and physical cost.
Our report paves a way forward, we hope stakeholders and partners will join with us to meet these challenges and find the solutions.