THE number of NHS dental treatments being carried out on adults in Scotland remains well below pre-pandemic levels, amid warnings that oral health inequalities are widening.
An annual report by Public Health Scotland (PHS) found that overall NHS dental activity, for adults and children combined, had returned to around 70 per cent of pre-Covid levels when February 2022 was compared with February 2019.
Dental practices are required to claim back the cost of dental work carried out on the NHS from the public purse, with the number of claims paid each month used by PHS as a proxy for NHS activity.
READ MORE: What's happened to NHS dentistry?
For adults, activity had returned to around 600,000 treatments per month compared with around one million per month pre-pandemic, when most people were receiving six-monthly routine check-ups.
A single patient can account for several treatments.
However, the report notes that the figures include thousands of claims for telephone triage – where patients are quizzed pre-appointment about their Covid status – and issuing prescriptions for painkillers and antibiotics, activities for which dentists were not remunerated before June 2020.
It also warns that, based on an analysis of activity from December 2021 to February 2022, the dental recovery has been uneven with “an increase in inequalities (relative to the already existing pre-pandemic inequalities)... those from the most deprived areas [were] less likely to have contact with a primary care NHS dentist than those from the least deprived areas”.
This does not take into account an increase in wealthier Scots taking out private dental plans or paying for non-urgent procedures privately in order to get quicker treatment or check-ups.
Scottish Labour covid recovery and health spokeswoman Jackie Baillie said: “This damning report lays bare the crisis engulfing NHS dentistry in Scotland.
"The SNP’s failure to support NHS dentistry has left us with a two-tier system, with those who can’t afford private care being left behind.
"Scotland’s shameful dental health inequalities are already widening, this will only get worse if NHS services are left to fail.”
On April 1, physical distancing requirements, which curtailed the number of patients who could be in a dental waiting room at once, were lifted, with dentists also no longer required to don full PPE to carry out aerosol-generating procedures - such as fillings or root canal - on patients not suspected to have Covid.
PHS said this is expected to allow practices to ramp up the number of patients being seen, but national guidance also cautions that it comes with an increased risk of outbreaks.
These changes have coincided with the introduction this month of a temporary funding model which will see dental practitioners in Scotland reimbursed 170 pence for every £1 of treatment they carry out on the NHS.
READ MORE: 'Train more dental therapists to help clear waiting lists', says expert
The payment system is intended to incentivise dentists to increase and continue providing NHS care at a time of record-breaking backlogs.
It replaces the Covid support grants which guaranteed dental practices 85% of their pre-pandemic NHS income in exchange for performing at least 20% of pre-pandemic NHS activity while much stricter infection control protocols limited patient turnover.
The PHS report shows that tooth extractions have seen the strongest recovery, with 30,000 adults and children having teeth pulled per month in December to February compared to around 38,500 pre-Covid.
Root canal treatments remained half pre-pandemic levels, while prescriptions for antibiotics and painkillers were three-times higher - including 156 children a month being given drugs for dental pain or infections compared to none pre-Covid.
Scottish Conservative Shadow Health Secretary Sandesh Gulhane, a GP, said the figures should be an "urgent wake up call".
He added: “Humza Yousaf simply has not got a grip on the scale of the crisis facing dentistry across Scotland and must now ensure people have access to regular check-ups."
A spokesman for the Scottish Government said it was "confident" the revised payment model and updated infection control guidance were "substantial steps in the right direction to improving access, and ensuring the sector is able to quickly return to more normal levels of activity”.
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