The British Dental Association Scotland has called on all political parties to set out an effective response to the crisis facing dentistry as new data reveals the collapse in attendance during the COVID pandemic.
While registration rates remained high and broadly stable – owing to lifetime registration – data indicates the number of children seen between May and December 2020 was around a quarter of the 2018-19 average due to the pandemic. Between September and November 2020, the number of adults seen was around a third of the 2018-19 average, before falling to 28% of the 2018-19 average in December 2020.
The traditional measure of ‘participation’ – capturing attendance at an NHS dentist in the past 2 years – has less meaning in the context of COVID, as the full impact of the pandemic has yet to filter through.
Those in more deprived communities have traditionally experienced lower levels of participation. This data shows that in 2020, children and adults from the most deprived areas were less likely to have seen their dentist within the last two years than those from the least deprived areas (73.5% compared to 85.7% of children and 55.9% compared to 67.1% of adults). These inequalities in access between the most and least deprived areas have grown since 2019, particularly in children.
The BDA has warned lower levels of participation will inevitably translate into a higher disease burden. Early signs of decay and oral cancers are picked up at routine check-ups, and delays will mean both higher costs to the NHS and worse outcomes for patients.
Dental care in Scotland is now facing crises on many fronts, with deep oral health inequalities expected to widen even further, given the cumulative impact of limited access to services, the suspension of public health programmes, and the impact of lockdown diets. The pioneering Childsmile programme has not fully resumed, with many key elements, such as supervised brushing, delivered via schools and nurseries.
Recent announcements by Scottish dental schools that many final year students will not graduate in 2021 and will also not be in a position to take on new undergraduates, are likely to have wide-ranging effects on the NHS workforce for years to come.
While both the Welsh and Northern Irish governments have set aside ring-fenced investment to improve practice ventilation – and thereby increase patient numbers while meeting tight COVID restrictions – no commitments have yet been made by the Scottish Government and the BDA await clear guidance for practices.
Robert Donald, Chair of the British Dental Association’s Scottish Council said: “These numbers underline the scale of the challenge ahead.
“Millions have missed out on dentistry. Problems that could have been caught early, from decay to oral cancer, have been missed.
“Scotland’s huge oral health inequalities cannot be allowed to widen. Every party heading into May’s election now has a responsibility to set out how they will ensure families across Scotland can get the care they need.”