Call to simplify NHS treatment list

A recent survey shows scottish dentists are in favour of simplifying the NHS treatment list

14 December, 2022 / editorial

Most dentists in Scotland believe that a simplified list of treatments available on the NHS – the so-called Determination I – should be developed, according to a survey carried out earlier this year.

The survey, initiated by the Scottish Government, received 557 responses from a range of dental professionals across Scotland, with the most – almost half – coming from Associate Dentists.

The survey asked respondents an initial question about whether they would prefer to retain the existing Determination I, develop a simplified version or extend the existing version, with 83 per cent stating they would prefer to develop a simplified version.

This was followed by a series of questions about each of the six sections contained in the list of treatment items. Orthodontics was not included in the list of treatments as it will be considered in a separate phase of reform.

The treatments mostly commonly mentioned for inclusion in the list were periodontal care, preventive care/screening and extractions for urgent dental care. In terms of perio, suggestions were made for a perio assessment, with various elements such as BPE, plaque and bleeding indices, pocket charting, along with education and preventive advice.

Management of perio related conditions, such as abscesses and periodontium was also noted. For preventive care/screening, respondents suggested that oral health advice, instruction and education was required. This should be available for adults, parents/carers, and in domiciliary care settings.

The use of diet diaries, smoking and alcohol cessation advice, prescription of fluoride products, fluoride varnish and silver diamine fluoride liquid were some of the suggestions made.

The treatments most cited for exclusion were endodontics, veneers, dentures and crowns. For endodontics, the most cited for exclusion was molar endodontics.

In terms of veneers, the reasons given were that they are not required to maintain oral health, they are often purely aesthetic, and they are not financially viable. Some respondents did note if they were available, it should only be in exceptional circumstances or for replacements for people who already have veneers.

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Scottish Dental magazine