Meeting of the Parliament 21 February 2024
Two years ago, the Scottish Conservatives held a debate called “Preventing the Collapse of NHS Dentistry in Scotland”. Two years on from that debate, NHS outcomes in Scotland have worsened, waiting times for all sorts of NHS treatment have increased, and here we are explaining that dentistry has got no better in that time.
It is clear that the SNP Government has failed to do what is necessary to restore NHS dentistry activity levels to pre-pandemic rates. That raises further concerns that rural and more deprived areas are likely to suffer disproportionately from negative oral health as a result. Indeed, 90 per cent of respondents to a recent BDA survey said that they believe that oral health inequalities in Scotland are on the rise.
Oral health can tell us a lot about our general health. Regular monitoring identifies and deals with problems early—not just oral issues but oral cancers. We heard from Willie Rennie about the catastrophic effect that late presentations can have on survival. There are also bacterial and fungal infections that can cause sepsis, and gum disease is linked to a higher risk of heart disease and dementia, both of which cause a disproportionate number of deaths in Scotland.
However, dentistry is becoming harder to access, with waiting times increasing. The 2023 BDA survey of general dental practitioners showed that nearly 60 per cent had reduced the amount of NHS work that they undertook since lockdown, and four in five said that they plan to reduce their commitment further in the year ahead. All the while, patient numbers are increasing. Dental practices are abandoning the NHS in droves for private practice, leaving many Scots without an NHS dentist. Failure to act risks sparking an exodus from the workforce that will leave families across Scotland losing access to NHS dentistry for good.
Many Scots are not having dental treatment, with almost half of the people registered with an NHS dentist in Scotland not having seen a dentist in the past two years and 1.2 million people not having had a dental examination or treatment in five years. The crisis in access to NHS dentistry in Scotland has resulted in many desperate patients taking matters into their own hands with DIY dentistry, or heading overseas for care, as we have heard from many members. Hearing that people are resorting to putting Super Glue on their dentures should be a wake-up call to all of us.
It is worrying that, on the number of children who have seen a dentist in the past two years, the gap between the most deprived and the least deprived children has widened. In 2021, 55 per cent of the most deprived children had seen a dentist, compared with 73 per cent of the least deprived children; in September 2022, that percentage had risen, and 56 per cent of children from the most deprived backgrounds had seen a dentist in the past two years, compared with 76 per cent of the least deprived children.
Let us remember that NHS dentistry in Scotland was in crisis long before Covid hit, so the SNP must get a grip on the situation and bring forward a credible plan to restore routine dental care and tackle the enormous backlog. I said earlier that Robert Donald, who is the chair of the BDA’s Scottish council, has warned that there could be a “wholesale exodus” of the profession from the NHS if ministers fail to make a “serious long-term commitment” to the sector.
For too long now, people have gone without access to full NHS dental services. To tackle that unprecedented challenge, dental practices need support from the Scottish Government. The new cabinet secretary, Mr Gray, and the SNP must offer more solutions. Healthcare staff and patients have been repeatedly let down.
The recovery plan is not fit for purpose. We want a plan that is clear to deliver a modern and efficient local NHS. For dentistry specifically, that means an end to drill and fill; it means the prioritisation of prevention, and a plan that reflects modern dentistry.
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