Dental

My perspective is from someone who qualified in 1978 – half way through the 60 years. At that time, nearly four out of ten adults in Scotland had no teeth at all.

When the NHS dental service started, the unexpected and overwhelming demand for care caused enormous pressures, and within a few years charges were introduced for dentures and then for treatment.

Some groups remained exempt from charges and still do – particularly children. They are our top priority.

Dentistry at the time of the advent of the NHS was very much the “blood and vulcanite” era. Vulcanite was what they made dentures from. It seems incredible now, but it was routinely expected that people would come in to the surgery to have all their teeth taken out.

Then we moved into the “drill and fill” era when people were encouraged to keep their teeth. Now we have moved into the preventative age – making sure teeth do not go bad in the first place.

There is no disputing that historically Scotland’s record on dental health has been appalling. But equally, there is no disputing the fact that we are beginning to make real progress.

Dental decay is usually due to poor diet – sweets between meals – and lack of fluoride. And it remains a residual problem, particularly in our deprived communities. We have been fortunate over the last few decades to have had the benefit of fluoride toothpaste and this has made an enormous difference to the population’s dental health.

Schools and nurseries have been magnificent in how they are encouraging children to eat more fruit, they are so much better than they used to be.

We now have more than 90,000 children in our tooth brushing programme – brushing their teeth under supervision every day. It is certainly the largest project of its kind in Britain, if not Europe.

The whole Childsmile programme starts with the health visitor giving toothbrushes and paste to younger children. It continues through nursery and is maintained in primary schools.

We are also making special efforts for those who need it most in areas of social deprivation by providing a fluoride varnish service through the preventive-based school dental service.

There are a lot of things happening – the new dental school in Aberdeen to train more dentists, more students are now going through our dental schools and more are staying in Scotland when they graduate.

We have a strong community dentistry service. This offers treatment to patients with special needs, homeless people and others with complicated medical conditions.

We are also taking on more salaried dentists and other measures to ensure NHS dental provision in areas of shortage.

For patients, there have been many advances – high speed drills, more comfortable chairs and much better treatment all round. That has changed markedly since 1948.

We can look to the future with some optimism. I think the next 60 years will be easier than the last 60 years!

Margie Taylor
Chief Dental Officer