'Poorer children will suffer' as Scotland’s oral health gap widens, dentists warn

The oral health gap between rich and poor children in Scotland will widen in a “national scandal”, dentists have said.

As families face issues accessing dental care and practitioners choose to leave the NHS system, the British Dental Association (BDA) said the service is at a tipping point.

“The oral health gap between rich and poor kids is set to widen,” said David McColl, chair of the BDA’s Scottish Dental Practice Committee.

“It’s a national scandal. Prevention is better than cure, but dentists are losing the chance to nip problems in the bud. The growing exodus from the NHS may make that permanent.

“It will take real reform to bring this service back from the brink”
David McColl, dentist

Data from Public Health Scotland shows the gap in child participation between the most and least deprived areas was three percentage points in September 2008.

In 2010, it had grown to seven percentage points and in September 2021 the gap had increased to 18 percentage points (55.3% compared to 73.1%).

The most recent figures show a twenty percentage point gap (55.9% compared with 75.8%).

Dentists say lower participation will reduce the chance of picking up early signs of decay at routine check-ups, and delays in treatment will mean higher costs to the NHS as well as worse outcomes for young patients.

Mr McColl, who runs a NHS practice in Govanhill in Glasgow, said: “Tooth decay is already the number one reason for hospital admissions among young children.

“It will take real reform to bring this service back from the brink.”

Almost half of patients registered with an NHS dentist in Scotland have not attended in the past two years, and 10% haven’t visited for more than a decade.

The average waits for NHS outpatient dentist treatment have increased in 12 health board areas since 2019.

With fewer patients getting to the dentist, the BDA has warned of more widespread dental disease.

This, along with the cumulative impact of lockdown diets, limited access to services and the temporary suspension of public health programmes, will mean deep oral health inequalities are expected to widen even further.

A recent BDA survey found more than half (59%) of high street NHS dentists reported having reduced the amount of NHS work they did since lockdown.

More than four in five (83%) said they plan to reduce or further reduce their NHS commitment in the year ahead.

The BDA said NHS dentistry will go from crisis to collapse if urgent reform is not taken.

A Scottish Government spokesperson said: “Last year more than 660,000 child examinations were provided by NHS dentists. We have also increased funding to child dental services by introducing, for the first time, an enhanced examination fee from February 1, 2022.

“Attendance at the dentist is only one way we are delivering improvements in child oral health. Our flagship Childsmile programme offers every child attending nursery in our most deprived communities free daily supervised tooth brushing and fluoride varnish application.

“Additionally, despite the pandemic, the National Dental Inspection Programme showed that 73% of primary one children had no obvious tooth decay in 2021/22 compared with only 45% in 2002/2003.”