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Health / NHS experiencing continued pressure on dental service

NHS Shetland says it “remains fully committed to providing a sustainable and equitable dental service” despite continuing to work at almost 50 per cent less capacity than before the Covid pandemic.

However, for the foreseeable future NHS Shetland public dental service is still only able to provide an emergency or non-routine service for the majority of patients.

The health board said it is “extremely grateful for the continued understanding of the community in these unprecedented times for dental service provision”.

Dentistry director Antony Visocchi said: “The lack of access to general dentistry for patients registered with NHS Shetland was a recognised problem prior to Covid.

“This issue has developed due to many factors, not least the long-standing recruitment and retention issues across many rural and remote areas. Covid has highlighted this issue and has exacerbated the problem.

“Additionally, the entire dental profession is now faced with a workforce shortage. Currently, there is a recognised shortage of dentists providing NHS care in Scotland.

“To provide some further context to our circumstances, NHS Shetland public dental service is currently working at almost 50 per cent less capacity than the pre-Covid figures.

“With over 70 per cent of the Shetland population registered with us, this ‘real-time’ reduction has only exacerbated an already prevalent problem.”

Additionally, identified priority groups remain a focus for the service to ensure the most vulnerable in the community can access treatment to support their needs.

At the moment one independent operator in Lerwick takes in NHS patients under a general dentist service scheme, while the health board offers its own services for certain groups such as children and people in care from premises like Montfield in Lerwick and some health centres.

A new oral health strategy was approved last year which aims to re-focus NHS dental provision to provide a more sustainable health-board delivered service.

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Phase one of this strategy aims to return the NHS Shetland public dental service to pre-Covid levels.

NHS Shetland said the Scottish Government has recognised the strategy as an “exemplar” for dental service provision in island health board regions.

One ultimate aim is for a large dental facility within a new Gilbert Bain Hospital, while there are also objectives to improve training facilities.

The public dental service is aiming to recruit two more dentists and it is hoped that the health board will be in a position to appoint them next month, with a view to starting in late 2024.

Dental nurses Miriam Moar and Ingrid Couper were also recently accepted on the NHS Education for Scotland (NES) orthodontic therapy training programme 2024/25.

Dental nurses Miriam Moar (left) and Ingrid Couper (right). Photo: NHS Shetland

An innovative ‘on-island’ model to allow this training has been agreed with NES and will take place over two years rather than one to ensure that both nurses get the required clinical supervision hours.

Moar and Couper went through a “rigorous” application and interview process before being formally offered a place on the course in April.

NHS Shetland said this has only been made possible due to the initiative, support and commitment of orthodontic clinicians Prof. Grant McIntyre, Dr Elinor Chalmers and Dr Catherine Tothill.

Visocchi said: “As a result, the orthodontic service will have more stability but also build strong foundations for the future.

“We are delighted to be able to offer this opportunity to our existing staff to upskill and develop their careers within the dental profession. Congratulations to both Miriam and Ingrid for their achievement.”

Despite some progress, the dental director added that it is vital “more than ever” for people to look after their own dental health at home.

“Twice daily tooth brushing with fluoride toothpaste and restricting sugary foods and drinks to mealtimes are the cornerstones of good oral health,” Visocchi said.

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