Dental public health operates with a population and systems perspective across the three pillars of public health (healthcare public health, health protection, health improvement), seeking to improve health and prevent disease. Examples of dental public health activities undertaken in Scotland are outlined below:
Healthcare public health
Access to NHS primary dental care in Scotland dramatically reduced due to COVID-19 public health measures. A recent study found that inequality was exacerbated during the pandemic, as it has existed before COVID-19, with a higher proportion of adults and children from the less deprived areas having more contact with a dentist than those in the most deprived.
In April 2023, the Scottish Parliament’s COVID-19 Recovery Committee launched an inquiry into the recovery of NHS dental services. This inquiry will scrutinise what action the Scottish Government is taking to return the provision of NHS dental services to pre-pandemic levels of activity, as set out in the NHS Recovery Plan 2021-2026.
In a recent blog, the Scottish Parliament Information Centre has provided an overview of dentistry in Scotland and also highlighted some of the long-standing challenges for NHS dentistry.
NHS dentistry in Scotland is at a pivotal moment as the British Dental Association enters a process of formal engagement with the Scottish Government, covering fee allocation for the revised Determination I of the Statement of Dental Remuneration. In an answer to a parliamentary question, the Scottish Government has said that payment reform will be implemented by 1 November 2023. To help collecting baseline data before Determination I comes into play on 1 November 2023, a dashboard for indicators of dental access across territorial Boards in Scotland is currently under development.
Health protection
On 23 September 2021, the UK Chief Medical Officers published a joint statement in support of water fluoridation as an effective public health intervention in reducing tooth decay and reducing oral health inequalities. The Consultants in Dental Public Health group and the Directors of Dentistry in Scotland welcome this significant development in their joint statement in November 2021.
Water fluoridation is a devolved issue in the UK. Primary legislation remains in place through the Water (Fluoridation) Act 1985, for Health Boards with the support of local communities to ask Scottish Water to introduce water fluoridation. Policy responsibility for this legislation rests with the Health Protection team in the Scottish Government.
A recent random on-street representative survey in Scotland showed that majority of people were in favour of adding fluoride to water to reduce tooth decay. The two largest NHS Health Boards in Scotland, NHS Greater Glasgow and Clyde and NHS Lothian, have also included additional questions on water fluoridation in their recent public health surveys. The question on water fluoridation can be found on page 27 of the Lothian Public Health Survey 2023. The findings of these surveys will soon be available.
Health improvement
Childsmile is NHS Scotland’s national oral health improvement programme for children. NHS Scotland’s Climate Emergency and Sustainability Strategy 2022-2026 identifies climate change as a looming public health emergency. As an NHS service, Childsmile is supporting NHS Scotland to deliver against its strategic climate emergency and sustainability aims.
NHS National Services Scotland (NSS) and Childsmile have joined forces to launch Recycle and Smile. This new initiative is simple and easy for everyone involved. Childsmile professionals will take the programme’s used toothpaste tubes and toothbrushes to the local Public Dental Service collection site.
NSS recycling partner will collect the used items, break the plastic down into small chips and sterilise it. Once processed, it is ready to be recycled into useful items such as vehicle parts, garden planters and playground equipment.
Recycling all this plastic will contribute to a cleaner, greener and more sustainable Scotland – and that’s certainly something to smile about!
