Dentists say instructions issued to Scottish health boards today are the first formal information on how practices should implement free dental care for 18 to 25-year-olds – and give dental practices just one working day to prepare before the policy takes effect on Tuesday.

The British Dental Association (BDA) Scotland says it is concerned over the lack of clear messaging from the government to manage patient expectations around when they’ll get an appointment, as capacity is still lowered due to covid-19.

A Freedom of Information request by the organisation shows that practices across Scotland are dealing with a backlog of almost 1.5m missed appointments throughout the pandemic, and that their members lack capacity to cater for the anticipated spike in demand as a result of the policy.

BDA Scotland added that the short notice will mean many practices will be unable to introduce the required changes, including staff training for the new arrangement and the development of practice management systems. 

Chair of the BDA’s Scottish Dental Practice Committee, David McColl says the issues are rooted in a lack of understanding of how the profession works:

“It beggars belief that practices have been given a single working day to prepare for seismic change in how dentistry is delivered in Scotland. 

“The rollout of free dentistry will inevitably increase patient expectations and heap more pressure on dental teams who are already struggling to address a colossal backlog.   

“Ministers risk creating demand for care that simply cannot be met, and must communicate clearly what is and isn’t available. Failure to do so will only leave hard-pressed colleagues bearing the brunt of patients’ frustrations. 

“The Scottish government hasn’t fully understood the operation of dental practice throughout this pandemic. 

"We need better communication and appropriate investment.

“This is not the way to implement a landmark policy.”  

The organisation says there has been no formal public or business consultation on the policy, and just one meeting with the BDA has taken place, back in June, to discuss the changes.

Health Secretary Humza Yousaf today wrote to NHS dentists, thanking them for their ‘outstanding efforts’, acknowledging that NHS dentistry ‘is not at present near pre pandemic ‘business as usual’’ and setting out additional funding for the sector.

A government spokesperson says the BDA was informed at the June meeting that the policy would be introduced in the government’s first 100 days as part of a programme to support young patients and the wider NHS:

“Dentists will need to make minimal administrative adjustments to implement this new policy, but the public under age 26 will no longer have to pay for dental care – the Scottish government will cover the costs to reduce the burden on the patient.”

The spokesperson added:

“The Scottish government has from the beginning of this pandemic put in place emergency support payments for NHS practices and dentists, which includes £33m of additional funding per year. National Procurement continues to provide around £1.5 million of PPE a week free of charge to those dental contractors providing NHS care – previously dentists were required to source and purchase their own PPE supplies.

“Not only that, but today we announced a further £7.5m for dentists to buy new equipment to help them reduce the impact of UK-wide covid restrictions, on top of the £5m we have already given them for ventilation improvements to their businesses.

“Systems suppliers have already incorporated the changes necessary for dental practices, working closely with Scottish government and its partners to do so.”

A business regulatory impact assessment of the proposals estimated up to 620,000 young adults will benefit from the changes.

It also suggested that dental practices will likely make savings under the new policy, as administration costs should decrease.

Read more: "Overwhelmed" dentists fear looming oral health crisis; Doctors’ pay: Another year of "must do better"

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