The BDA is asking candidates in the election to pledge to invest in tackling poor oral health.

Candidates contesting the Scottish election have been asked to pledge to commit to tackling the shameful inequalities in oral health. It is set to go into overdrive as a result of the pandemic.

The British Dental Association has made candidates aware of the unpublished data from Public Health Scotland. This shows a dramatic reduction in NHS dentistry due to COVID-19. This is hitting those in most deprived communities the hardest.

Data from Public Health Scotland showed the number of courses of treatment delivered (April to November). It saw 3,242,754 treatments delivered in 2019, but only 564,791 in 2020. This amounts to an 83% reduction.

Deprived communities

Official figures show that primary school children from the most deprived communities experience more than four times the level of tooth decay compared to children in the least deprived areas.

Latest data also 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.

This gap has widened compared to the year before.

The Public Dental Service

You can now feel the impact in all corners of the service. The Public Dental Service treats specific patient groups. This includes care home residents, children with additional needs and adults with disability. They also face a huge backlog, with many of its staff redeployed to urgent dental care centres.

The BDA estimates that waiting lists of 2,500 children are now estimated for dental extractions under general anaesthetic. This may take years to clear. The BDA’s network within the Public Dental Service estimate around 2,500 children are currently awaiting GA extractions.

High street practices continue to face wide-ranging restrictions. This has radically reduced patient numbers. Also, including the need to maintain gaps between most routine procedures where surgeries are left ‘fallow’ to reduce risk of viral transmission. Governments in Northern Ireland and Wales have already offered millions to help practices invest in new ventilation systems to cut down this time. Hence, significantly expand patient volumes. The BDA is seeking commitments from Scotland’s parties to follow the same path.


The BDA says prevention is now more essential than ever. The pioneering Childsmile programme, delivered via primary schools and nurseries, has secured record-breaking reductions in decay. However, it has been suspended for much of the last year. Many core elements like supervised brushing are yet to resume.

Restarting that programme, and providing additional support in high needs areas is at the centre of the BDA’s plan. Alongside calls for Health Boards to be supported to conduct feasibility studies on water fluoridation.

Dentistry challenges are now likely to be exacerbated by workforce problems. None of Scotland’s dental schools are on track to graduate classes at the usual time this year. This will have a domino effect on workforce planning for years to come. The BDA has called for a long-term strategy to ensure Scotland has the dentists it needs to meet this threat, and parallel challenges – including Brexit.

Oral Cancer and HPV

Oral cancers kill three times more Scots than car accidents. The country has one of the highest rates for the condition in Europe. Residents in Scotland’s most deprived communities are more than twice as likely to develop and die from oral cancer as those in more affluent areas. The BDA is therefore seeking action on smoking cessation.

Also, assurances that a rapid catch up programme will be in place to ensure school children are protected from the Human Papillomavirus via vaccination. HPV is an important risk factor for oral cancer, and while steps were in place to extend the programme to boys in the last academic year, the programme continues to face massive disruption as a result of school closures.

The Association is making direct contact with every candidate seeking election to Holyrood to ask them to commit to addressing oral health inequality.

Robert Donald, chair 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.’

This article first appeared in Dentistry Scotland magazine. You can read the latest issue here.