New figures reveal depth of Scotland's access crisis
24 January 2023
The British Dental Association has called on the Scottish Government to fix the broken system underpinning NHS dentistry, as new data reveals little sign of a recovery in attendance and ever-widening health inequalities.
Figures from Public Health Scotland show participation rates – contact with a dentist within the past two years – continued to fall. On 30 September 2022 just 50.4% of all registered patients had seen an NHS dentist within the last two years, still down on the 52.6% seen in 2021, and a considerable reduction from almost two-thirds (65.1%) in 2020. The participation rate among registered children was higher than for adults (65.7% compared to 47.2%).
The gap between the most and least deprived areas in Scotland continues to grow, with the new data showing record inequalities in participation rates. In September 2008, the gap in child participation between the most and least deprived areas was three percentage points; this had increased to seven percentage points by 2010, eighteen percentage points (55.3% compared to 73.1%) in September 2021. The figure now stands at twenty percentage points (55.9% compared with 75.8%).
The BDA has warned that lower levels of participation will inevitably translate into a higher dental disease burden, with deep oral health inequalities expected to widen even further given the cumulative impact of limited access to services, the temporary suspension of public health programmes, and the impact of lockdown diets. Lower participation will reduce the chance of picking up early signs of decay and oral cancers at routine check-ups, and delays in treatment will mean higher costs to the NHS and worse outcomes for patients.
Registration rates remain high due to lifetime registration – over 95.4% of the Scottish population were registered with an NHS dentist in September 2022– but the percentage of children registered fell marginally.
Free NHS dental for all remains a key Scottish Government policy. BDA Scotland has long warned that a return to a 'business as usual model' – low margin and high volume – will put practices under unsustainable financial pressure, with soaring running costs raising the risk of closure or movement to the private sector. BDA Scotland stresses that Ministers must continue with additional financial support for practices, set to end on 1 April 2023 to support dentists and their teams as they work through the historic backlog of dental care and until a new, sustainable funding arrangement for NHS dentistry is in place. This data follows recent reports of a growing exodus of dentists from the NHS.
David McColl, Chair of the British Dental Association's Scottish Dental Practice Committee said:
"Patients in Scotland's poorest communities are paying the price for the crisis in dentistry.
"The Scottish Government must not try to hide behind positive sounding registration figures. The reality is patient participation remains on the floor, and inequalities are set to widen.
"Dentists are reconsidering their futures working in a broken system. NHS dentistry is on the critical list, and real reform won't wait."