Where next for dentistry in Scotland?

It’s always a privilege to stand before the conference of Scottish Local Dental Committees (LDCs).

Every year, it’s where dentists come together with honesty and purpose. A space where we acknowledge the pressures we face, the progress we’ve made, and set a clear direction for the future.

So now, on the cusp of an election, it’s the right time to consider something that affects every dentist in Scotland, every member of our teams and every patient who walks through our doors: the future of NHS dentistry in Scotland.

Setting out a plan

We’ve set out our own manifesto, Future-proofed: a manifesto for dentistry in Scotland. And the message at its heart is simple.

If Scotland wants an NHS dental service in the years ahead the next government must act, and act decisively.

If you glanced at The Herald back in March, you’ll have seen dentistry taking a prominent place in the national spotlight, not once, but twice.

On the front pages and in the chamber at Holyrood.

Stark warnings about the pressures facing NHS dentistry, and the urgent need for meaningful reform to protect both patients and dental services.

Behind every headline and every parliamentary question are real people, dentists and dental teams who care deeply and work tirelessly for their patients.

That’s why we want to ensure our profession’s voice is heard with clarity and conviction. The attention we’ve seen since the launch of our manifesto shows that the public is listening, policymakers are being pressed to act, and the BDA is steering the debate with purpose. If you’ve not sent a message to your MSP candidates, do so today.

Stronger together

The spotlight is firmly on dentistry. And it’s up to us to make sure it stays there for all the right reasons.

Polling we released as part of the manifesto shows that 65% of Scots believe the Scottish Government should be doing more on dentistry and only one in five think it’s doing all it reasonably can.

Dentistry now ranks alongside crime as a doorstep issue. And that tells us something important, the public is feeling the pressure too.

Nearly one in five adults in Scotland now has unmet dental need. 12% couldn’t secure an appointment in the last two years. 7% have simply given up trying.

And we all know the stories, families travelling miles for care, children waiting over a year for treatment under general anaesthetic. These aren’t outliers.

They’re symptoms of a system that is stretched and, in some parts of the country, close to breaking point.

Our manifesto sets out a clear plan for the next government. First, they must improve access and reduce inequalities.

That means a National Dental General Anaesthetic Recovery Plan, restoring and expanding theatre capacity so children aren’t left waiting in pain. This follows on from the BDA report on dental GA waiting times which was published last year.

It means measuring access by attendance, not lifetime registration. So, we stop pretending the system is healthier than it is, and it means ending the postcode lottery by strengthening recruitment and retention where it’s needed most.

Building the workforce

Secondly, we need to build the workforce Scotland needs with a fully costed, fully funded dental workforce plan.

Only 10% of dentists now describe the NHS as an attractive place to build a career and that should alarm every policymaker in Holyrood.

We need to look at undergraduate places, guarantee vocational training for every graduate from a Scottish dental school and invest properly in enhanced skills training, from paediatrics to oral surgery.

We need fair pay for dentists, and sustainable funding that reflects the real cost of delivering NHS care.

Thirdly, we must ensure there is appropriate support for NHS dental practices.

Rising costs, from National Insurance increases to the National Living Wage, are eroding viability.

Nearly half of practices fear they “may struggle to remain financially sustainable”.

The National Insurance hike poses a significant risk to dental access and the improvements enacted through Dental Payment Reform.

We have continued to push for full reimbursement of these increases to avoid eroding the impact of investment in NHS dentistry, to improve access nationally, and reduce oral health inequalities.

Payment reform was a step forward, but it is not “mission accomplished”. We need ongoing review and appropriate investment in primary dental care.

Focussing on prevention

And finally, we must double down on prevention.

Childsmile is a Scottish success story. We want supervised toothbrushing to be extended further. We want more investment in the adult oral health programmes under Caring for Smiles too. We want stronger action on smoking and vaping, and we want healthier retail environments that don’t push sugary products to children.

These aren’t abstract policy ideas. They are practical, achievable steps that would make a real difference to the profession and to the public.

This is not just about dentistry. It’s about fairness. It’s about health.

It’s about ensuring that every family in Scotland, regardless of income, postcode, or circumstance, can rely on a service when they need it.

Ahead of the Scottish Parliamentary elections the message we have been sending to government and political parties is clear, if we want NHS dentistry to remain a sustainable, accessible public service, we must work together to future‑proof it.

Not in theory, not in the distant future, but now.

This is why we have been so clear in our message to political parties ahead of the 2026 Scottish Parliament elections: future‑proof the service or lose it.

This is not a warning. It is a statement of fact. And the public understands this too. Dentistry is now a doorstep issue.

People want to see action and equitable access to be available to NHS dental services when they need it.

Looking back

Over the past year, several significant policy announcements have been made by the Scottish Government.

The Scottish Government has confirmed that from November 2026, prior approval will move from a financial threshold to a clinical based system. This is a major shift. We have long argued that the current prior approval system created unnecessary delays and administrative burdens. A clinically focused model has the potential to be more efficient, more transparent, and more aligned with patient need. But the detail matters.

We worked constructively with the Scottish Government to ensure the detail of this policy was reasonable and we will continue to work closely with government to ensure the new system is workable, fair, and genuinely reduces bureaucracy and if amendments are required in the future, we will be pushing for these too.

Also, from January 2026, the mandatory training requirements for dentists joining a health board list have been updated and provisional listing has been brought forward. We support the principle of ensuring that all clinicians are appropriately trained and supported. But we have been clear that any new requirements must be proportionate.

The Scottish Government has also announced the introduction of a Declaration of Compliance of Terms of Service, to be completed every three years. We understand the intention, to ensure clarity and consistency across the system in relation to compliance with the Terms of Service. But we have emphasised that this must not become another administrative burden. It must be simple, fair, and aligned with existing processes.

The detail of this process is yet to be brought forward. And we will continue to engage with the Scottish Government to ensure the new arrangements are transparent and proportionate.

Working together

We will always challenge and hold Government to account where necessary, but we also recognise that progress is only possible when we work together in good faith.

We are fast approaching a national election. We are facing significant workforce challenges and not just in rural areas. We are confronting widening oral health inequalities.

And we are fighting to preserve a service that millions rely on.

But we are not powerless. We have a clear manifesto. We have evidence, and we have public support.

We have a profession that cares deeply about the people it provides care for.

Our message to government is simple. We want to work with you.

We want to build a sustainable service. We want to secure the future of NHS dentistry in Scotland.

But partnership requires commitment and although payment reform brought forward some positive changes, this will require sustainable funding and investment.

Conference of Scottish LDCs was a chance to strengthen our resolve, deepen our collaboration, and ensure that the next Scottish Government understands exactly what is needed to secure the future of NHS dentistry.

And we stand ready to work together to future‑proof it.