THE figures are shocking but certainly not a surprise. New Public Health Scotland statistics show that only 45 per cent of those from the most deprived areas have seen a dentist since the start of the pandemic, in contrast to 56 per cent of people in the wealthiest places.

The figures for children were even worse with 73 per cent of young people in affluent communities seeing a dentist, compared to just 55 per cent in deprived areas. Of course, there's an equality gap between rich and poor, same as it ever was.

If you wanted to argue for an element of surprise, it might be that as many as 45 per cent of people in deprived areas had seen a dentist.

With the repeated headlines about a crisis in dental care, it feels like a moral conundrum to be seeking a simple check up when people who really need to access a dentist might not be able to.

I hadn't been able to get through to my own dentist so I was looking into moving to a new surgery. In researching whether to change practice I've been asking around about the experiences of other patients at dental clinics elsewhere and the response is mixed in the extreme.

Several people talked about booking appointments to see their usual dentist, receiving treatment and then being told at the reception desk they were expected to pay private rates. There's nothing you can do by that point, the work has been done and you have to pay up, whether it's going to be financially damaging or not.

Others were unable to get NHS check ups at all, or that the waiting list for an appointment was months long, but were told they could pay £55 and have a check up privately with almost no delay.

One woman I spoke to became involved in a slightly mad sounding situation where she paid to see a private dentist for tooth whitening she didn't really want in order to have a check up because she was worried about not having seen a dentist in such an extended while.

It seems to have been heavily discounted treatment from one of these voucher websites and the quickest and easiest way for her to access dental care. Despite asking quite a few questions, I couldn't really make it make sense but, judging by the gleam on what were the pearliest of whites, she was telling no lies.

My dentist, who I'm not criticising, they are excellent and I've been with the practice for 30 years, sends out a newsletter once a month detailing the delight of patients who have had successful dental work to, say, enhance their "bridal smile".

You absolutely understand the need to advertise private services at such a desperate time for the industry but if anything illustrates the current inequality gap, it's people who can pay for braces to have a nice smile in a set of photographs while others can't access the most basic of services.

And for people who are doing the frustrating ring round for an appointment, it's difficult to fathom the reasons that an essential health service is suddenly such a patchwork of provision. Dentists were forced to close for all but emergencies from March to November, 2020, creating both a backlog of appointments and a crash in earnings.

Scottish Government NHS treatment caps and quotas for performing NHS work have led to a guddle of a system with, it's been reported, large numbers of dentists saying they would leave the NHS for private practice or abandon the profession altogether.

Dentists have said that there is likely to never be a return to the system of six monthly check ups and that annual checks will now be the norm but that a pattern may not settle for some time due to existing backlogs.

It can't be the case that patients are expected to wait until an emergency situation before they can be seen by a dentist. It barely needs said that prevention is better than cure, and that catching and treating problems early on will ultimately help cut waiting lists.

We have a demoralised workforce and frustrated patient cohort, all against a backdrop of existing problems in NHS dentistry further exacerbated by the pandemic.

It has been nearly seven months since concerns were raised about people feeling forced to go private and around 18 months since the first mention of a two tier system being created by the set up developed in response to Covid-19.

Scottish Labour's complaint is that this is a risk of privatisation by the backdoor. It isn't a risk - it a reality. And it hasn't been by the backdoor at all. We very clearly already have a two tier system of dentistry in Scotland for those who can afford to look after their oral health and those who can't, and it has been created in plain sight.

It's a scandal and yet one that has passed relatively quietly, in all likelihood because it is those who are already most disadvantaged who are being disadvantaged further.

The Scottish Government really needs to step up and urgently reform funding to ensure patients can access affordable treatment and NHS dentistry doesn't haemorrhage talent.

The current situation fails everyone involved and is nothing but a brute kick in the teeth.