The impact of COVID-19 on NHS dental services and oral health in Scotland: annual report

About this release

This release by Public Health Scotland reports on the impact of COVID-19 using data from primary and secondary care dental services and oral health improvement programmes in Scotland.

Main points

• Access to NHS primary dental care in Scotland has reduced due to COVID-19. Socioeconomic inequalities in access to these dental services, while apparent prior to the pandemic, have increased in the most recent months.
• Dental contacts and treatments in the General Dental Service (GDS) declined due to the COVID-19 public health measures and have not yet fully recovered to pre-pandemic levels.

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Number of GDS treatments, by payment month; January 2019 to February 2022

• Public Dental Service (PDS) activity reduced during the first national lockdown and although not yet fully recovered, some parts of this service have returned to pre-pandemic levels.Public Dental Service (PDS) activity reduced during the first national lockdown and although not yet fully recovered, some parts of this service have returned to pre-pandemic levels.
• There has been a reduction in Hospital Dental Service (HDS) activity with recent levels still lower than before the pandemic.
• Oral health improvement programmes were impacted by the COVID-19 public health measures (particularly in schools and care homes), with reduced activity evident in Childsmile and Caring for Smiles. In-person aspects of these programmes have only recently recommenced.

Background

Most of the population in Scotland access routine dental care through the primary care setting of the NHS General Dental Service (GDS). The Public Dental Service (PDS) provides access to primary NHS dental care for patients who cannot obtain treatment from a general dental practice. This includes vulnerable patients such as those living in care homes, people with learning disabilities and patients with complex needs.

Due to the anticipated risks of transmission associated with dental care, during the first lockdown period in Scotland, all NHS dental practices were not able to see patients on their premises. Across Scotland over seventy Urgent Dental Care Centres (UDCCs) were established for the provision of emergency dental treatment. The remobilisation of primary care NHS dental services was undertaken in several time periods, as follows: from 20 May 2020: Capacity in UDCCs was increased, and provision expanded to include patients with acute and essential oral health care needs; from 22 June 2020: All dental practices reopened for face-to-face consultation with patients requiring urgent dental care treatments that could be provided using non-aerosol generating procedures (AGPs); from 13 July 2020: Dentists were able to see patients for the full range of routine non-AGP dental care; from 17 August 2020, aerosol associated treatments were permitted for urgent dental care only; from 1 November 2020: Practices were able to provide the full range of NHS treatments to all patients in need of both urgent and non-urgent care. Dentists were also able to provide domiciliary care; and from 1 April 2022: Dentists were allowed to de-escalate their infection prevention and control measures in line with national guidance to alleviate system pressures and allow an increase in patient throughput.