Oral health improvement ‘has stalled’
Improvements in oral health achieved through Scotland’s pioneering ChildSmile oral health programme have “stalled”, according to an expert giving evidence to the Scottish Parliament’s COVID-19 Recovery Committee.
Professor David Conway, Director of Dental Research at Glasgow University, told the committee: “When we look at the oral health outcomes, the worrying statistic is that the improvement we have seen for 15 years has stalled. We collected the data differently, but the improvement has not continued on that trajectory that we were observing before the pandemic.”
Professor Conway, who was representing Public Health Scotland at the committee’s inquiry into the recovery of NHS dental services, added that registration levels for 0 to 2-year-olds have dropped to 25 per cent since the pandemic.
The committee expressed its “concern” at this statistic and that the ChildSmile programme is not universally accessible across all nurseries in Scotland, with some expressing “hesitancy” to implement it in the COVID recovery period.
“The committee was [also] surprised to learn that NHS boards have no role in ensuring children can access preventative healthcare programmes, such ChildSmile,” it said in a letter to Jenni Minto, the Minister for Public Health.
“The Committee was also concerned to learn from the responses to its survey that the recovery of dental services is lagging behind in areas that experience higher levels of deprivation and that there is currently no equivalent of the child inspection programme to assess the oral health of the adult population.”
In an update published in June to its overview of NHS dentistry in Scotland1, the Scottish Parliament Information Centre (SPICe) added looking a children’s oral health inequality before and after the pandemic, which shows a rising inequality gap.
Tom Ferris, the Chief Dental Officer, told the committee that the Scottish Government is trying to build “key indicators” into a reformed payment system, so that relevant data on oral health can be collected on an anonymised basis and used to inform the clinician of the oral health of their case list.
Once implemented, these reforms would enable the data to be aggregated up to the practice level, board level and national level to build a better picture of the oral health of the adult population.
The committee said it was drawing this evidence on the current state of preventative oral healthcare programmes to the minister’s attention “as something which should be prioritised in the COVID recovery period.
It added: “The committee also invites the Scottish Government to consider whether NHS boards should be given a greater role in service delivery, including whether they should have an underlying duty to provide services. The committee considers that this and any other options that may assist in increasing access to – and the impact of – preventative oral healthcare policies should be actively explored by the Scottish Government.”