Scotland faces deepening dental crisis across primary and secondary care

Leading Edinburgh practice calls for immediate action to reverse decline

Edinburgh, Scotland - 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, 3rd October, where 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

Dr. Offord warns that Scotland's dental workforce is at breaking point. "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.

"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 explained. "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

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 making primary care dentistry an attractive career option, thus improving patient care
• A comprehensive national dental workforce plan with long term funding commitments
• 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."

The Vermilion Biennial Symposium takes place on Friday, 3rd October 2024 at the Royal College of Physicians of Edinburgh. Registration is open to all dental professionals committed to finding solutions to Scotland's dental crisis.

About  Vermilion: Vermilion is a leading referral-only dental practice based in Edinburgh and Kelso committed to advancing oral healthcare through clinical excellence, professional education, and policy advocacy.