Dentists warn of years of delay as thousands of children are on Scots waiting lists for tooth extraction

Prior to the onset of the pandemic, some boards had waiting times of six months and the Covid crisis is expected to have made "this terrible situation" worse, according to the British Dental Association.

The union which acts as the 'voice' of dentists and dental students in the UK has now urged all candidates contesting the Scottish election to pledge to commit to tackling the "shameful inequalities" in oral health set to go "into overdrive" as a result of the pandemic.

Tooth decay remains the number one reason for hospital admissions among children aged five to nine across all four UK nations, according to a Royal College of Paediatrics and Child Health report.

And according to BDA estimates based on reports from frontline staff some 2,500 children in Scotland are now on waiting lists for dental extractions under general anaesthetic.

Officials say in some areas the numbers have doubled.

It comes as NHS dentists have seen a dramatic reduction in treatments as a result of the Covid-19 lockdown.

Between April and November, 2020, the number of courses of treatment delivered was 83% lower than during the same period pre-lockdown.

The BDA has said this has inevitably caused a "colossal backlog of unmet dental care need", along with a rise in antibiotic prescribing. While recent data show that registration with an NHS dentist in Scotland remains "high and stable" the overall attendance rate collapsed to between a quarter and a third of the pre-pandemic average.

Public Health Scotland has confirmed that the number of children seen by dentists between May and December was around a quarter of the 2018/19 average, while the number of adults seen from September to November was around a third of previous figures.

And the pandemic has also caused a sharp drop in the number of young children being registered with a dentist for the first time. The percentage of 0-2 year-olds registered fell from 47.4 per cent in 2019 to 33.8 per cent last year.

Robert Donald, chairman of the British Dental Association’s Scottish council said: “A wealthy 21st century nation shouldn't accept that a wholly preventable disease remains the number one reason its children are admitted to hospital.

Sadly, Covid risks undermining hard-won progress, while leaving our dental service a shadow of its former self. “The result is that from decay to oral cancers, Scotland’s oral health gap is set to widen, and we need all parties to offer a plan.

“In this campaign we need candidates to do more than talk about ‘prevention’. From helping practices boost capacity, through to expansion of the sugar levy, we have set out simple steps that can put that principle into action, addressing inequality, and restoring services to millions."

The BDA called on ministers to work with NHS boards to ensure sufficient resources are available at a local level to reduce waiting times for extractions under general anaesthetic.

Its manifesto for action says that a working group should also be established to finally address "this long-standing issue" by drawing on lessons learned and best practice across Scotland.

They say improved ventilation in dental surgeries to reduce “fallow time” between treatments to reduce risk of viral transmission would cut the backlog of dental care by "dramatically increasing" the number of patients dentists can safely treat each day.

The BDA says the Scottish Government should follow the example of the Welsh and Northern Irish governments and provide capital funding, along with clear guidance, to improve ventilation in dental practices.

There is also concern that research shows primary school children from the most deprived communities experience are more than four times the level of tooth decay compared to children in the least deprived areas.

There is concern that inequalities in access between the most and least deprived areas have grown since 2019, particularly in children.

Last year children and adults from the most deprived areas were less likely to have seen their dentist within the past two years than those from the least deprived areas by 73.5 per cent compared to 85.7 per cent of children, and 55.9 per cent compared to 67.1 per cent of adults.

Dentists say the impact is now being felt in all corners of the service.

The Public Dental Service (PDS) – which treats specific patient groups including care home residents, children with additional needs and adults with disability – also faces a huge backlog, with many of its staff redeployed to urgent dental care centres.

Meanwhile, the pioneering Childsmile programme, delivered via primary schools and nurseries, has secured record-breaking reductions in decay but has been suspended for much of the last year, with many core elements like supervised brushing yet to resume.

The BDA says that restarting that programme, and providing additional support in high needs areas is at the centre of the its gameplan.

Calls have also been made for a new funding model "that reflects modern dentistry" and makes it an attractive profession to pursue.

During one coronavirus briefing in mid-March Ms Freeman said that “NHS services… should be as available now as they were before the pandemic started”.

Outraged dental practitioners hit out at the comments, pointing out the Scottish Government had made “no commitments” to help surgeries and businesses invest in ventilation equipment, despite promises of help from Welsh and UK counterparts.

The BDA pointed out the Scottish Government was only providing enough PPE to treat 10 patients per day - or five for aerosol-generating procedures involving high-speed instruments - covering just 20-30% of pre-Covid patient numbers.

The Scottish Government was approached for comment.