Scotland’s dentists express concerns over plans for improving oral health
28 August 2019
In response to BDA Scotland’s survey into the state of oral health provision and other issues, many dentists expressed concerns over the Scottish Government’s Oral Health Improvement Plan (OHIP).
As with previous surveys that we have carried out, dentists say they have major concerns about some of the proposals in the OHIP, particularly relating to clearer details on the proposals and funding, including:
- Three quarters say they have concerns about the proposed introduction of an Oral Health Risk Assessment (OHRA). There is some recognition of the benefits of an OHRA, but major concerns about whether sufficient additional funding would be available that reflect the time taken to carry out an assessment.
- Over 80 per cent say they have concerns about the possible introduction of a 24-month recall interval for dental checks. While there was some support among dentists for checks every 24 months for low-risk patients, most respondents favoured a shorter recall interval. Dentists emphasised the risk of oral cancer, and that oral health can change rapidly, therefore more frequent checks are essential.
- Over three quarters have concerns about the proposed reduction in scale and polish treatments. While there were mixed views about the evidence of the clinical effectiveness of scale and polish treatments, most dentists were in favour of providing regular treatments, as they believe it helps to encourage good oral hygiene. There were also some concerns about the effect of reducing scale and polish treatments on dental practices’ finances.
In 2018, we called on the Scottish Government to ensure that any new initiatives were accompanied by appropriate new investment. In our recent survey, over 90 per cent of respondents had concerns that the Scottish Government will use the NHS dentistry budget to fund aspects of the OHIP.
With the Scottish general dentistry budget falling in real terms, and with almost 70 per cent of Principal dentists in Scotland and 60 per cent of associates thinking about leaving general dentistry, the Scottish Government needs to ensure that NHS dentistry remains sustainable. There have been recent examples of NHS practices closing and worrying implications for waiting times and patient care.
Respondents also expressed concerns about:
- Water fluoridation, with almost three quarters considering that the Scottish Government should provide strong leadership for local areas that consider introducing water fluoridation. Most dentists were in favour, as they regard it as the most effective and cost-effective way of reducing dental decay as they believe it helps tackle health inequalities. Political difficulties were acknowledged, and the need for public education on the issue.
- Practice management systems, with over 40 per cent of respondents regarding the integration of practice management systems with Practitioner Services Division as ineffective, and a similar figure regarding their local patient referral system as inefficient.
- Pensions, with over one third of dentists having reduced their workload and/or had made plans to take early retirement (or were considering these actions) to avoid breaching their pension allowance, and two thirds regarding the material provided by the Scottish Public Pensions Agency as unclear or unhelpful.
- Local management, with over half of respondents having no awareness of their local Director of Dentistry.
We will continue to engage with the Scottish Government and other stakeholders on these, and other issues to ensure dentists’ views are effectively represented.
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