Chamber and committees

The Childsmile Programme is designed to help improve the oral health of children in Scotland and is delivered through a range of measures. The Childsmile Core Programme is available throughout Scotland and is introduced to families by their Health Visitor. Every child in Scotland is provided with a dental pack containing a toothbrush and toothpaste on at least six occasions by the age of five and can receive twice-yearly applications of fluoride varnish from the age of 2.

Childsmile School and Nursery ensures that all 3 and 4 year old children attending nursery are offered free, daily, supervised toothbrushing. Those children in the 20 per cent most deprived areas of Scotland are also able to receive an additional twice-yearly fluoride varnish applications by Childsmile dental teams in nurseries and schools until at least primary 4.

More information on the Childsmile programme can be found at: https://www.child-smile.org.uk/index.aspx .

The Scottish Government is committed to ensuring that all communities within Scotland, including NHS patients in Inverclyde, can access a NHS dentist.

We have provided over £150 million of financial support to date to maintain the capacity and capability of NHS dentistry and agreed further funding into the new year to address the cost of living crisis.

From April 2022 we have re-introduced a system of fee per item payments that incentivises NHS dental teams to see patients. Public Health Scotland statistics (link attached) show that these measures have increased patient examination appointments and are comparable to pre-pandemic levels, allowing more patients to be seen and dental practices to begin to register more patients as they work through the pandemic backlog.

dental-treatment-statistics/nhs-dental-treatment-statistics-month-ending-31-august-2022/">Public Health Scotland - Monthly Statistics - Dental Activity

NHS registration is significantly higher in Scotland than the rest of the UK, with more than 95% of the population registered with a NHS dentist.

Over the extended-period we have seen significant improvements in child oral health in Scotland. The first year of the National Dental Inspection Programme in 2002/03 showed that 45% of primary 1 children had no obvious decay experience. Despite the unique challenges of the pandemic this figure has increased to 73% in 2021-22.

This is a demonstration of the success of prevention-based oral health programmes such as the Childsmile Programme - a flagship programme at the leading edge of prevention-based oral health care provision - where nursery and schoolchildren receive regular tooth brushing instruction and fluoride varnish application.

We recognise that oral health inequalities in children continue to present a considerable challenge, and have been exacerbated by the pandemic restrictions on NHS dentistry during the pandemic.

Which is why as part of the recovery of NHS dental services we have increased funding to child dental services by introducing for the first time an enhanced examination fee from 1 February 2022. The latest monthly activity statistics from Public Health Scotland show that 330,000 child examinations have been provided this year with almost 60,000 in the month of August alone.

I refer the member to the answer to question S6W-11835 on 8 November 2022. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers.

As part of a suite of measures introduced on 1 February 2022, dentists now receive an enhanced examination fee for seeing patients, including a new additional child examination fee. These changes also included the extension of Childsmile fees for children and young people up to 17 years of age (before up to 5 years of age), and fluoride varnish application between 2 and 12 years of age (before between 2 and 5 years of age). Childsmile fees are weighted so that NHS dental teams receive three times the payment for children from SIMD areas 1 and 2.

The Childsmile Programme has an emphasis on prevention, rather than treatment, and has resulted in significant improvements in children's oral health through being delivered via nursery schools, primary schools, and dental practices, and includes free, daily, supervised toothbrushing, the application of fluoride varnish, and dietary and oral hygiene advice.

The Scottish Government is responsible for putting a framework in place that is conducive to the encouragement of NHS dental services. Part of that framework includes providing funding, through the emergency support payments, multiplier payments, and bridging payments, to help NHS dental practices to provide NHS dental services.

We understand that there are particular challenges in attracting dentists to work in more remote areas which is why we have recently updated the Recruitment and Retention Allowance. This Golden Hello payment means that dentists providing NHS dental services in qualifying areas, including Gretna, can receive up to £25,000 over a two year period. We are also working closely with NHS Education for Scotland (NES) to develop a mentorship scheme for EU dentists which will allow them to work in Scotland to support areas facing recruitment challenges whilst they work towards their VT equivalence.

NHS Boards make arrangements with dental contractors to provide NHS dental services in their areas as local provision is the responsibility of the Board. However, officials meet regularly with the Board and are working closely with them on suitable contingency arrangements should these be required.

The Scottish Government does not hold this information centrally, however each NHS Board will hold information on dental capacity for their respective areas.

We have recently updated the Recruitment and Retention Allowance payments to independent dental contractors providing NHS General Dental Services.

The Scottish Government is committed to improving access to NHS dental services, which is why we have included several areas in the Scottish Dental Access Initiative grant (SDAI). This financial grant enables dentists to open a new or expand an existing dental practice in areas where there is a particular and protracted problem with patient access to NHS dental services.

The areas currently included in the grant are:

• Dalmellington and Patna within NHS Ayrshire and Arran;
• Kelso and Berwickshire (exc. Eyemouth) within NHS Borders;
• NHS Dumfries and Galloway;
• Auchtermuchty within NHS Fife;
• Banff, Fraserburgh, Huntly and Moray within NHS Grampian;
• Isle of Bute, Islay and Jura, Lochgilphead, Mull and Iona, and Tarbert within NHS Highland;
• NHS Orkney;
• NHS Shetland;
• NHS Western Isles.

Officials are in regular contact with NHS Boards about areas which may benefit from having the SDAI and the areas can be updated as and when required.

The Scottish Government does not fund the costs of private dental treatment. The budget for NHS General Dental Services is entirely for NHS dentistry.

Private dental care was subject to the same infection prevention controls that reduced access to dental services during the pandemic period.