Thousands of elderly care home residents are in danger of suffering toothache and poor oral health in what is described by experts as a national scandal.
There are at least 40,000 care home places in Scotland, and senior dentists are concerned after studies showed shocking levels of deterioration in some residents.
One recent survey of Glasgow care home residents suggested that more than 50 per cent needed dental treatment, with 6 per cent needing urgent care. Studies have also found that only around one fifth of care home patients are registered with a dentist.
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Writing in the journal Scottish Dentistry, Dr Robert Donald blamed "a distinct lack of action from the Scottish Government", which he said was aware of the issues. Dr Donald, chairman of the Scottish Dental Practice Committee, is to meet Minister for Public Health Michael Matheson on Wednesday to reiterate his concerns.
He says the problem has become more pressing because better dental care has meant that more and more people - around 88 per cent of adults - still have their own teeth in their later years. However, he claims dental health may be neglected in residential care, and that this may also be the case for many people receiving care at home.
Dr Donald wrote: "Sadly, oral care is not a priority in these busy places. You will not be dentally assessed on admission and your daily care plan will not include intra-oral care. You can certainly forget your regular dental examinations."
The problem can be exacerbated by syrupy medicines or inadequate cleaning of partial dentures, he added. Although some care home staff have oral health training, high staff turnover and heavy workloads can undermine this, he said.
Poor dental health can contribute to other health problems, Dr Donald added, such as eating problems, dehydration or vitamin deficiencies. Dr Donald also said: "There should be a statutory duty for all residents in care homes to be registered with a dentist."
Drew Gibson, of Bearsden Dental Care, which was recently voted the best practice in Scotland, has extensive experience of working in care homes.
He supported Dr Donald's claims. "When you go into a care home environment, dental health is not always seen as a priority. If my own patients go into a care home it is very worrying to watch how quickly a patient's oral health can deteriorate."
Amy Dalrymple, head of policy for Alzheimer Scotland, added: "Good oral and dental care is a fundamental element of high-quality care, support and treatment for people with dementia, whatever their environment."
Brian Sloan, Chief Executive of Age Scotland, said: "Problems with teeth are not an inevitable part of getting older and should not be dismissed as such. Older people should be able to make the same choices about dental care and receive the same standard of treatment in a care home as they would out of one. Oral health needs should be included in residents' care plans and homes should help ensure that residents are registered with a dentist."
But Ranald Mair, chief executive of Scottish Care, the group representing the sector, said that while there was an issue around dental care, "it was an improving not deteriorating picture".
A Scottish Government spokeswoman said: "Delivering quality and compassionate care for older people that protects their dignity and independence is something that we must do well for every older person on every occasion, in every care home."