Scotland faces deepening dental crisis
Leading Edinburgh practice calls for immediate action to reverse decline.
Scotland is confronting a deepening dental crisis with new analysis revealing the scale of workforce contraction and patient access barriers across the country, according to one of Scotland’s leading dental practitioners.
The current landscape is marked by a dual problem: a severe decline in NHS primary care provision, manifesting as practice closures and limited patient access, particularly in rural and non-city areas, and a critical erosion of NHS secondary care capability, notably acute within the Lothian region.
Dr David Offord, Practice Principal and Specialist Oral Surgeon at Edinburgh-based Vermilion, is calling for government intervention to turn around a beleaguered dental profession.
The warning comes ahead of the fifth Vermilion Biennial Symposium on Friday 3 October, when Scotland’s dental community will gather at the Royal College of Physicians of Edinburgh to address what organisers describe as the most critical challenges facing the profession in decades. Scottish Labour Party Leader, and former dentist, Anas Sarwar will deliver the keynote speech.
A shortfall in dentists
“We’re witnessing a measurable decline in the active NHS dental workforce, particularly in general dental services, exacerbated by reduced training pipeline inflow and a significant exodus of dentists to private practice or retirement,” said Dr Offord.
“The numbers tell a devastating story: 190 fewer active NHS dentists in just three years¹, 45,432 patients in Dumfries and Galloway alone losing access to NHS dental care², and children waiting over a year for basic tooth extractions.”
The crisis is particularly acute in areas outside the big cities, including Fife, Moray, Dumfries and Galloway and Central Scotland, where entire communities have been left without access to NHS dental services. In Fife, where eight dental practices are currently mothballed, not a single NHS dentist is currently accepting new patients, while across Scotland, 82% of practices are closed to new adult NHS patients.³
With specialist dental consultants in critical shortage, particularly in Oral Medicine and Restorative Dentistry, NHS Lothian has recorded exceptionally long waiting periods for specialist dental treatment. The longest recorded wait for an adult tooth extraction in Lothian reached 104 weeks (two years) while the wait for children’s tooth extractions can be over a year.⁴
The human cost
The statistics reflect a public health crisis with severe consequences for Scotland’s most vulnerable populations. The gap in dental participation rates between children from the most and least deprived areas has widened dramatically from 7% in 2010 to 20% in 2022, creating a two-tier system that abandons those who need care most.⁵
“We’re seeing patients resort to dangerous DIY dentistry, travelling hundreds of miles for treatment or going without care entirely,” Dr Offord said. “This isn’t just about oral health. Untreated dental problems can lead to serious systemic health issues, emergency hospital admissions and, in extreme cases, life-threatening infections.”
The training pipeline crisis
The workforce shortage is being compounded by a reduced training pipeline. The decision to close the Edinburgh Dental Hospital and School in 1994 and the withdrawal last year of the University of Edinburgh from the Edinburgh Dental Institute has left the capital without adequate secondary dental care infrastructure. Combined with COVID-19 disruptions that reduced dental school intake and a declining number of vocational training programme participants, Scotland faces a multi-decade deficit in qualified professionals in both primary and secondary care.
Call for political action
The Vermilion Biennial Symposium will challenge political leaders to deliver concrete solutions to the crisis. The event will specifically call for:
- A new, fully funded NHS contract is making primary care dentistry an attractive career option, thus improving patient care.
- A comprehensive national dental workforce plan with long-term funding commitments.
- The establishment of a new Edinburgh Dental Hospital and School to provide integrated training of dentists, specialists and dental care professionals.
“Scotland needs a comprehensive, fully-funded dental workforce plan that addresses recruitment, retention and training across all levels of care,” said Dr Offord. “This symposium provides a neutral forum where innovative ideas for both primary and secondary NHS dentistry can be discussed.
“It is a unique opportunity to lobby senior politicians, who may have the levers of power come May 2026, with positive solutions to the crisis in Scottish dentistry.”
References
1Trends in NHS Dental Workforce in Scotland (2019-2024)
2Dumfries and Galloway NHS Board – visit parliament.scot
3A UK-wide BBC survey in 2022 found that 82% (687 of 839) of dental practices in Scotland with NHS contracts were closed to new adult patients. That’s compared to 91% in England. The results also showed 79% of practices in Scotland and England were not accepting new child patients.
4Scottish Labour obtained the figures from health boards under freedom of information in November 2024.
5COVID-19 Recovery Committee 13th Meeting, 2022 (Session 6), Thursday 15 June 2023 Recovery of NHS dental services inquiry – Scottish Parliament.
Comments are closed here.