Covid Scotland: Tooth extractions up 26 per cent

No figures were available for April to June 2019, but monthly data for the seven months leading up to the pandemic suggest they would be broadly similar.

Extractions are now substantially exceeding levels seen pre-pandemic

In a sign of the impact of the pandemic on tooth decay, extractions are one of the few NHS dental procedures now exceeding pre-Covid levels. The only other is X-rays, which are up by 22%.

Total NHS dental claims - at 989,799 from April to June - still remain 28% below 2019 levels.

However, the report by Public Health Scotland does show a sharp increase activity from April, when dentists were allowed to de-escalate Covid infection control measures which had limited the number of patients they were able to see over the past two years.

READ MORE: Millions unspent on care as dentists cut back on 'unaffordable' NHS treatment

This also coincided with the introduction of a temporary "multiplier" payment model which reimbursed dentists at a rate of £1.70 per £1 of NHS work claimed.

The multiplier - later cut to a rate of £1.30 from July onwards - replaced the system which had operated during the pandemic, whereby dentists carrying out at least 20% of their pre-Covid NHS activity were reimbursed with the equivalent of 85% of their pre-Covid NHS income.

The PHS report shows that the total number of NHS claims paid rose by 53%, from 646,248 in January to March, to 989,799 in April to June this year.

Dentists submit a claim once a patient's treatment is complete. This can cover a single appointment, such as a check-up, or multiple appointments for patients requiring several dental procedures.

Total number of NHS dental claims, by month of payment. Activity rose sharply from April, but remains around 28 per cent below pre-Covid levels

Claims for X-rays up rose by 79% compared to January-March, with claims for scale and polish more than doubling - up 116%.

Meanwhile, claims for fillings were up 77%, and root canals treatments by 73%.

Basic examinations increased 90%, to 714,315 between April and the end of June, though this still fell short of the pre-pandemic levels when over 800,000 patients were being seen each quarter.

The figures come after criticism from dental leaders that the 1.7 multiplier was "easily exploitable" and had encouraged dentists to prioritise one-off examinations or simple procedures that they could claim for right away, rather than complex patients requiring multiple fillings or root canals which would take months to complete - by which time the multiplier rate would be reduced.

READ MORE: Warning exploitable' fee model encouraged dentists to 'cash in' and widened health inequalities

The current 1.3 rate is considered too low to cover the rising costs of materials, staffing and other overheads, and there is a push to overhaul the fee-per-item model which has been blamed for driving dentists to cut back on NHS work.

David McColl, chair of the British Dental Association’s Scottish Dental Practice Committee said: “NHS dentistry in Scotland remains a shadow of its former self, tackling an historic backlog while huge numbers struggle to access care.

“The only thing that will bring this service back from the brink is real reform and fair funding.”

READ MORE: Dentists and Government polarised over how to fund NHS care

Public Health Minister Maree Todd said dentistry was "on the road to recovery".

She added: “This couldn’t have happened without the hard work of dentists across the country, who have been supported by £85 million of government funding to keep them afloat during the pandemic, as well as an increase in fees to encourage more examination appointments.

“There remains more to do and we are in regular contact with dentists to understand the pressures that remain to ensure that they continue delivering accessible NHS dental care for those who need it most.”