Recruitment of dentists into the NHS is "the worst its ever been" with younger practitioners opting to go straight into private practice or head overseas, one of Scotland's dental leaders has warned.

David McColl, chair of the Scottish Dental Practice Committee (SDPC) at the British Dental Association, said dentists embarking on their careers today were reluctant to take on the stress of a five-day week and were put off by the "treadmill" style of NHS dentistry, where comparatively low fees mean practices need a high turnover of patients to remain profitable.

A lack of mentoring available in practices with heavy NHS caseloads, where senior dentists are too busy to devote much time to training and support, was also a deterrent, he added.

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Mr McColl said: "Our biggest problem at the moment is recruitment.

"Trying to recruit dentists to work in the NHS is probably the worst it's ever been and I've been working as an NHS dentist for 37 years. We just can't recruit.

"We have enough dentists - but we don't have enough that want to work in the NHS.

"Younger people have a different idea about how they want to work. They want a better work-life balance.

"They don't want to come into an environment with a payment model where they're going to be on this treadmill all the time.

"All that does is lead to stress and burnout. None of them really want to work a five-day week - they want to work on a part-time basis."

Mr McColl, whose practice in the Govanhill area of Glasgow does mainly NHS work, said he sympathised with younger dentists who wanted to prioritise their own wellbeing.

He said: "In the past few years we've had three suicides in the west of Scotland among dentists - older dentists - because of stress.

"I had a real job trying to get the Scottish Government to realise that this is a problem and you need to do something about it. You can't just let it run.

"Now we have information about mindfulness-based stress reduction programmes in the vocational training year.

"It's not that these younger dentists will need it at that time, but they need to be able to recognise the signs of stress and how to manage it."

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Mr McColl was speaking to the Herald ahead of the Scottish Dental Show in Glasgow at the end of May, when the profession will have a chance to quiz senior Scottish Government officials on the state of NHS dentistry.

The Herald, in collaboration with Scottish Dental magazine - who stage the annual conference - is currently surveying readers about their experiences of accessing NHS dentistry since the pandemic and over the past six months.

In November 2023, a revised model for NHS dentistry was introduced in Scotland which aims to cut waiting list backlogs and make it easier for patients to get treatment without going private.

The shake-up included an end to routine six-month check ups in favour of a risk-based approach where those with poorer oral health would be seen on a more regular basis, while most patients were downgraded to annual appointments.

It also included increases in the NHS charges for dental procedures, such as fillings, after dentists complained that the previous fees were too low to cover their costs - spurring many practices to close their lists to new NHS patients and devote a larger share of appointments to private-only work.

The Herald: Waiting lists for NHS dental treatment spiralled after practices faced severe restrictions on activity during the pandemicWaiting lists for NHS dental treatment spiralled after practices faced severe restrictions on activity during the pandemic (Image: PA)

Mr McColl said the new payment system was an improvement but "can't be the final destination".

The BDA is calling on Scottish Government officials to consider more radical changes, such as adopting a general practice-style funding model where practices would receive a fixed sum per registered NHS patient.

It argues that this would make NHS dentistry more sustainable and stem the shift to private practice.

However, Mr McColl said younger dentists were also being influenced by social media, which had bolstered the appeal of cosmetic dentistry.

He said: "That's the 'sexy side' of dentistry if you like - aesthetics. You only need to look at social media to see stuff about implants and composite bonding [a smile-enhancing procedure].

"That's the world we live in now and you can understand younger people wanting to go into that - it's going to be a bit more rewarding than run-of-the-mill NHS."

Mr McColl added that Scotland's higher tax bands meant that dentists could save around £6000 a year by working in England instead, while others are heading overseas.

He said: "Australia is a very attractive place for people to go. They're better paid, better conditions, more time with patients.

"There's a lot of dentists I know or have heard about who are thinking about going to Australia."

The Herald: Public Health Minister Jenni MintoPublic Health Minister Jenni Minto (Image: ScotGovt)

Public Health Minister Jenni Minto said the changes introduced in November 2023 followed "extensive consultation with the dental sector and practising NHS dentists".

She said: “Our priority in bringing forward payment reform is to ensure that fee levels are reflective of the increased costs of modern dentistry, thereby providing longer term sustainability and encouraging the dental sector to increase its existing NHS provision.

“In the first month following these changes, almost 400,000 patients were seen by an NHS primary care dentist – an early indication that our reforms are working.

“In addition to this, we are also actively working with our counterparts across the UK on a range of workforce initiatives designed to further improve service sustainability through increases to the supply and diversity of the workforce.”