Good news: You'll get NHS dentist for toothache agony. Bad news: You're 6,836th on waiting list

WHEN Caroline Dollemore-Hunt urgently needed a dentist to treat a painful problem with her teeth, she thought the NHS would provide one.

But after being told she is 6,836th on the waiting list merely to be registered with an NHS dentist, she has become resigned to her teeth crumbling and falling out before she can get help.

Unable to afford expensive private treatment, Mrs Dollemore-Hunt and her husband, John, who also needs dental attention, are left helpless like tens of thousands of patients living in rural areas of Scotland where NHS dentists are in short supply. In total, almost 35,000 people have been put on NHS Highland's waiting list after contacting them for help finding a dentist.

It is a situation mirrored in other rural areas of Scotland, including Grampian, where less than 30 per cent of adults are registered with an NHS dentist. In the Borders, 38 per cent of adults have an NHS dentist and in Orkney it falls to 34 per cent.

Dentists have blamed a growing burden, created by having to comply with health and safety legislation and general regulations, and a lack of allowances from the Scottish Government, meaning they are forced to take on more private patients to pay their bills. A shortage of dentists – especially those willing to work in rural areas – has also added to a growing crisis in dentistry hitting those in remote areas the hardest.

Mrs Dollemore-Hunt's position on the waiting list came to light after the couple – who have recently moved to Lybster, Caithness, to take on a croft – contacted their MSP Jamie Stone.

Mr Stone, Lib Dem MSP for Caithness, Sutherland and Easter Ross, wrote to NHS Highland asking when a dentist would be available. In a letter back, the board's chairman, Garry Coutts, revealed that Mrs Dollemore-Hunt had been placed on the waiting list for an NHS place and was currently 6,836th in the list for the Caithness area. Mr Coutts explained that, last year, 1,400 patients were taken off the waiting list and offered places with salaried dentists – those who only work for the NHS.

But Mr Dollemore-Hunt said this meant they could wait more than five years before an NHS place was available for them. He said: "It could be even longer, as vulnerable patients such as children and those with learning disabilities are given priority."

Mrs Dollemore-Hunt, who needs treatment after a filling fell out of a tooth on which she had root canal treatment several years ago, described the situation as "an absolute disgrace".

"I am so cross I can hardly speak about it," the 47-year-old said. "I have heard so many stories from so many people about problems getting an NHS dentist. But I always thought if I really needed one, then I would be able to get one."

Mr Dollemore-Hunt, who also needs treatment for two other aching fillings, said: "I believe that if we wait as long as the health board are suggesting it will take to access NHS dentistry, then our teeth will be lost forever.

"Private treatment is not an option because we just can't afford it. All the money we have got has to go into running the croft and feeding the animals. We are now just living with the pain; we take aspirin and other painkillers from the chemist. That is all we can do."

NHS Highland has a list of more than 8,600 people wanting to be registered with an NHS dentist in the Caithness and Sutherland region – almost a quarter of the 39,000-strong population. But waiting lists are even longer in other parts of the Highlands. In the south-east area, 14,827 people are awaiting NHS registration – from a total population of 89,000. In the mid-Highland area, providing services to 93,400 people, the NHS dental waiting list is 11,827.

NHS Grampian also said it had a waiting list of 28,776 people waiting to be registered with a salaried dentist. Many of these, the board said, may already have NHS or private provision but wanted to access the salaried service.

An spokeswoman for NHS Highland said it recognised that access to NHS dentistry was an issue and was creating new facilities to try to meet demand.

Dr Andrew Lamb, British Dental Association director for Scotland, said he knew of patients travelling from Inverness to Glasgow to access NHS dental care. He said the problem came down to a shortage of dentists, the costs of running a practice now and the difficulties attracting dentists to work in rural areas.

Dr Nigel Carter, chief executive of the British Dental Health Foundation, said as well as having implications for people's dental health, not seeing a dentist could impact on other areas of people's wellbeing: "There is increasing evidence now of the link between dental health and systemic health. There are implications for things like heart disease, stroke, low birth-weights and diabetes."

Shona Robison, public health minister, said: "A number of financial recruitment and retention measures are in place to attract dentists to work in the NHS and remain in Scotland."

THE TOOTH HURTS

Percentage of adults registered with NHS dentist

Greater Glasgow & Clyde 58%
Ayrshire & Arran5 6%
Lanarkshire 55%
Tayside 54%
Forth Valley 52%
Lothian 51%
Western Isles 44%
Shetland 43%
Dumfries & Galloway 41%
Fife4 0%
Borders 38%
Orkney 34%
Highland 29%
Grampian 29%
Scotland 49%

THE ALTERNATIVE

A selection of prices private dentists charge for treatment:

Check up £20 to £40
Hygienist appointment £20 to £45
Filling £20 to £60
Root canal £100 to £300
Crown £200 to £400

BLAME THE GOVERNMENT, NOT THE HARD-WORKING DENTISTS

DENTISTS are running businesses and as such have to pay for their premises, their staff and other costs.

We are paid fees for treating NHS patients and can also qualify for extra allowances from the Scottish Government by meeting certain criteria.

The problem has been how the Scottish Government defines NHS commitment.

To qualify for these extra payments to maintain our practices, worth tens of thousands of pounds, high-street dentists have to have at least 500 NHS registered patients.

Of these, 100 must be fee-paying NHS patients – those not exempt from charges altogether.

Dentists must also gross at least £50,000 a year from their NHS patients.

Currently, of the 38 high-street dental practices in the Highlands, 27, including myself, are deemed not to be committed to the NHS, meaning we do not qualify for this extra money.

Across Scotland, 273 practices are said not to be NHS-committed, while there are 600 that are committed.

A lot of dentists are very angry when they are sent the letter telling them they are not committed. Many practices are treating thousands of NHS patients but may not meet all or any of the criteria to receive the allowances.

As dentists, we have to fund our practices from our own incomes. If the Scottish Government won't give us the funding, we have to get it from patients.

It is unfortunate, but that is business.

Dentists also face extra costs from new guidelines for decontamination procedures, which are due to come into force in 2009. This means we will have capital costs of £25,000 to £40,000 to bring equipment up to the new required standards, plus ongoing maintenance costs.

The NHS is spending huge sums of money increasing the number of salaried practices, with dentists employed directly by health boards.

They are only seeing around 20 per cent of the NHS patients. I believe the money spent on creating salaried dental surgeries could have been better spent on high-street dentistry.

• Robert Donald is a dentist in Nairn and secretary of Highland local dental committee.