Future-proofed: A manifesto for dentistry in Scotland

There can be no room for complacency from any party that seeks to form our next government. If we want NHS dentistry to remain a going concern in the 21st century, it will require a sustained plan of action.

The public are clear the next Scottish government needs to go further, and faster. We must future-proof dentistry in Scotland, because failure to do so will come at a steep financial, human and ultimately a political cost.

In 2026, we need a government that will:

Improve access and reduce inequalities
Create the workforce Scotland needs
Support NHS dental services
Focus on prevention.

Download our full manifesto, Future-proofed: How to make dentistry in Scotland sustainable.

1. Improve access and reduce inequalities

Launch a national dental general anaesthesia recovery plan

Commit to restoring and expanding general anaesthesia capacity through targeted funding, additional and protected theatre time, and workforce investment.
Measure access by attendance, not registration

Due to the current ‘lifetime registration’ policy, registration rates with an NHS dentist are not a meaningful way to measure access to NHS dentistry. Focus must be on attendance rates to capture true patient contact, and target interventions in areas with poor access.
End the postcode lottery

Improve recruitment and retention incentives, such as the Scottish Dental Access Initiative grant, relevant allowances within the Statement of Dental Remuneration, and expand training opportunities to attract and retain dentists within the NHS throughout their careers.
Guarantee dental care for the most vulnerable

Ensure every care home has an assigned enhanced skills domiciliary care dentist responsible for residents’ dental care and treatment, which is supported by appropriate funding.
Expand the oral health improvement programmes

Invest in Caring for Smiles oral health scheme and the four programmes for adults – ensuring coverage reaches those most at risk of poor oral health, such as dependent older people, people with additional care needs, those with experience of the justice system, or those experiencing homelessness.

2. Create the workforce Scotland needs

Develop a fully costed and fully funded Scottish NHS dental workforce plan

Covering General Dental Services (high street dentists), the Public Dental Service, and the Hospital Dental Service, the plan should ensure Scotland has the right number of dentists and dental care professionals to meet population needs.
Expand training opportunities

Increase the number of undergraduate dental training places, with a proportion reserved for widening access intake. Monitoring of the distribution of bachelor of dental surgery students by domicile should continue, with consideration given to the required number of Scottish domicile students. This includes guaranteeing a vocational training place for every Scottish graduate.
Improve career pathways in NHS dentistry

Expand Enhanced Skills Practitioner training to include paediatric dentistry, oral surgery/oral medicine, sedation and complex restorative services, by introducing an accreditation framework for dentists developing advanced skills in these areas, with mentorship, quality assurance, and governance support.
Support dentistry in rural areas

At undergraduate level, consider introducing student intake targets for students from rural backgrounds, to increase the likelihood of graduates working in areas where workforce challenges persist.
Establish postgraduate training programmes to support workforce

The development of programmes including a funded Master of Science programme for dentists in Rural Advanced Practice at the University of the Highlands and Islands, mirroring similar programmes available for doctors.
Deliver fair pay

Ensure fair remuneration for all cohorts of dentists and funding for NHS dentistry, by committing to annual uplifts of item of service fees, capitation payment and allowances, that reflect the real cost of delivering NHS care. Pay awards must be applied to the full package of remuneration within the Statement of Dental Remuneration.

3. Support NHS dental services

Invest in primary care dentistry

Ensure there is appropriate NHS funding to reflect the fact that most dental activity happens in primary care, therefore improving patient access and relieving secondary care pressures.
Keep the NHS primary care dental payment system under continuous review

Involve us in an ongoing review to make sure the system continues to reflect the growing cost of delivering NHS dental care, and provides sustainable funding and fair remuneration for dentists.
Mitigate the impact of the National Insurance contribution increase

Follow Northern Ireland’s example by providing direct financial support and fully mitigate increased employer costs, protecting NHS access and practice viability.
Modernise with a digital dentistry fund

Introduce a fair and reasonable reimbursement scheme to help NHS dental practices invest in digital technologies, including digital imaging, intraoral scanning, and digital record systems. Such technologies can improve clinical efficiency and outcomes for patients, as well as supporting workforce retention.

4. Focus on prevention

Expand the reach of Childsmile

Build on the success of Childsmile by expanding the supervised toothbrushing programme to include P3 and P4 pupils in high-need schools, to include an additional 25,000 children.
Take action to encourage healthier choices

Introduce robust policies to prevent uptake of both smoking and vaping, and support those seeking to quit. There should be an increased focus on smokeless tobacco, with culturally sensitive messaging available in a range of languages. Other cessation programmes, such as those targeted at alcohol, can have a positive impact in supporting people to reduce their intake. Dentists and dental teams should be supported to provide prevention, and signpost patients to appropriate programmes.
Create healthier environments

Ban the display of sugary products at children’s eye level in shops. Also ensure the timely implementation of newly announced regulations to restrict the promotion and placement of food and drinks high in fat, sugar or salt. There should be tighter restrictions on the sale of energy drinks to safeguard the dental health of teenagers. Current evidence suggests energy drinks are mainly purchased by young people, and they can lead to an increased risk of tooth decay and erosion.
Support water fluoridation

Provide NHS boards with the funding and leadership needed to carry out water fluoridation feasibility studies, along with investment to help facilitate introduction where applicable.