Oral health inequalities widening in Scotland, warns association

24 October 2023

The British Dental Association (BDA) has warned that decades of progress on children’s dental health risks going into reverse following the release of a public health report.

The publication of the National Dental Inspection Programme on October 24, 2023, shows that inequalities are widening in Scotland, says the BDA. Just 68.1 per cent of Primary 7 (P7) children in the tenth most deprived areas were found to be decay-free – compared to 89.7 per cent in the tenth least deprived – a gap of 21.6 per cent up from 20.1 per cent in 2019.

Over four out of five P7 children (81.9 per cent) in 2023 had no obvious decay experience in their permanent teeth – up from barely half (52.9 per cent) in 2005. The BDA celebrate the huge progress made in recent decades, but it warns that the gains made may not be sustainable given ongoing access problems and disruption to preventive programmes.

Earlier this year, the BDA warned the Scottish Parliament’s Covid Recovery Committee, that Scotland has lost more than a year’s worth of NHS dentistry since lockdown, and levels of activity remain lightyears from pre-pandemic norms.

Reform to the system NHS dentists work to is being rolled out from November 1. While the BDA has secured some improvements, the Scottish Government was unwilling to make a decisive break from the discredited low margin/high volume model that has proved incompatible with work post-pandemic. There remain question marks as to whether the level of change will be sufficient to keep practices sustainable and narrow inequalities of both access and outcomes.

The BDA understands that the pioneering Childsmile Programme is not universally accessible across all nurseries in Scotland and that some nurseries are expressing “hesitancy” to implement it in the covid recovery period.

David McColl, chair of the British Dental Association's Scottish Dental Practice Committee, said, “Our children are paying the price for the crisis in NHS dentistry hard won gains are going into reverse.

 “Certainly, there is no room for complacency at Holyrood, as the oral health gap between rich and poor shows little sign of closing.

“It remains to be seen if coming reforms will be enough to bring this service back from the brink. The Scottish Government cannot pretend it is ‘mission accomplished’ for NHS dentistry.”