This year we look for a way forward after the significant challenges faced by the dental profession over the past 12 months.
Bouncing back following the pandemic is proving difficult and the future of dentistry in Scotland is looking uncertain. As we welcome in a new year, we recognise that NHS dentistry is in crisis across the UK, with issues that have been building for years being exacerbated by the pandemic and the backlog of care it has produced.
"Dental extractions under general anaesthetic are the most common reason for children to be admitted to hospital."
The number of practices providing NHS dental services in Scotland is in constant decline. The current funding model has made providing these services increasingly unsustainable. Since 2019 the number of dentists providing NHS care, has dropped by 10% and without a sustainable remuneration package to support them, the number moving away from NHS care will continue to rise.
Oral health inequalities have become more apparent. Access to NHS dental services has become virtually impossible in some areas due to the extensive backlog of patients, and this extends to all parts of the dental system, including hospital dental services (HDS) and public dental services (PDS).
Patients who are unable to get minor issues resolved may eventually need more advanced treatments like extractions. Dental extractions under general anaesthetic are the most common reason for children to be admitted to hospital. These services are still experiencing a considerable backlog, leaving many children and adults with complex needs waiting in pain for many months.
Mending the broken system
We have been discussing how to improve the oral health of people living in the most deprived areas. As a cost-effective and safe preventative measure, introducing water fluoridation would help to improve children's dental decay issues and would in turn reduce the incidence of children needing dental treatment in the future.
"The outlook is uncertain for patients and practitioners."
The restoration of dental services involves the entire dental system. Any reform to the General Dental Services (GDS) will systematically impact the PDS and HDS too. We need the Scottish Government to take a strategic direction that will tackle the profession's issues while maintaining the stability of the whole dental system.
Many practices are currently unable to take on any new NHS patients and some are de-registering large numbers. This means that the outlook is uncertain for patients and practitioners. You can't argue with the facts, even if the Government is claiming over five million record registrations, only half of these patients are reported to visit dental practices.
"The pressure on surrounding practices and the PDS to take up the slack becomes even more unbearable."
The economic downturn and the soaring costs affecting dental practices will continue to impact on the GDS for the foreseeable future, leaving dentists with difficult business decisions to make. The impact of recruitment and retention problems within the sector is also having a significant impact on the delivery of NHS dental care. The future of NHS dentistry will depend on there being NHS dentists available to deliver it. This is more acute in remote and rural areas of Scotland. Once a practice closes, the domino effect comes into play and the pressure on surrounding practices and the PDS to take up the slack becomes even more unbearable.
We will continue to support and advise members whatever the mix of care they provide. Part of the BDA's new three-year strategy is to make sure we build on what we do for dentists in the private sector. At the same time, we will continue to call for an appropriate funding model to enable the GDS to attract and retain dentists and dental team members, whilst providing financial stability and sustainability for practices.
We will continue to work on your behalf to ensure that the future of NHS dentistry and its financial stability is a priority to the Scottish Government and will continue to press for action on all issues affecting Scottish dentistry.
Chair of the BDA’s Scottish Council