Scotland’s public dental service bill rises to £84.2m as demand for emergency care climbs

Spending on Scotland’s Public Dental Service — the safety-net service for people who cannot access routine NHS dental care — rose to £84.2 million in 2024/25, up from £76.5 million in 2022/23, official figures obtained by Scottish Labour show.

The 10 percent increase over two years has prompted concern that shortages of available NHS dentists are pushing more patients to emergency and specialist services. Total spending was £81.4 million in 2023/24 before rising again to £84.2 million in 2024/25, with most health boards reporting higher costs over the period.

Between 2022/23 and 2024/25 the largest relative increases were recorded in Dumfries and Galloway, where spending climbed about 35 percent from £1.5 million to £2.0 million; NHS Fife, which saw a 28 percent rise from £5.7 million to £7.3 million; and NHS Greater Glasgow and Clyde, which reported a 26 percent increase from £7.6 million to £9.6 million. Only NHS Lothian and NHS Tayside recorded falls in Public Dental Service spending, down 7 percent and 3 percent respectively.

The Public Dental Service provides care for people who cannot obtain treatment from independent dental practices. That includes patients with complex health needs, physical or mental disabilities, residents of long-stay care settings and those referred for specialist treatment, as well as acting as a safety net for people unable to find ordinary NHS dental care.

Scottish Labour’s dental spokesman Paul Sweeney said the figures provided “a worrying snapshot into the postcode lottery when it comes to dental care” and warned that more Scots were being forced to rely on the safety-net service. He said a Scottish Labour government would prioritise access to dentistry so people “can be treated wherever they are, and whatever their needs.”

Public health data cited alongside the spending figures indicate a large backlog of unmet dental need. About 1.8 million adults and 177,318 children in Scotland have not had a dental check-up within the past two years. More than 80,000 children and over a quarter of adults have not seen a dentist in the past five years, and over half a million adults have not had a check-up or any dental treatment in the past decade.

Stakeholders and officials trace part of the problem to the COVID-19 pandemic, when NHS dental services were paused and some practices sustained financial losses. That period coincided with a net reduction in the number of NHS dentists in Scotland, from 3,407 in 2019 to 3,240 in 2024, according to the figures released. The reduction in available NHS dentists has contributed to reports of growing “dental deserts” in which no practices are able to accept new patients within three months.

NHS boards have responded variably, with some expanding capacity in primary care and specialist services and others directing more patients to the Public Dental Service. Health board budgets and local workforce constraints have been cited as factors in the differing regional patterns of demand and spending.

Health campaigners and political figures have called for action to improve access to routine and urgent dental care, including measures to retain and recruit NHS dentists, invest in practice capacity, and reform the way NHS dental services are commissioned to ensure more equitable access across Scotland.

Ministers and health board officials have been asked to outline plans to address long waiting lists and regional disparities, but detailed national proposals linking funding to improvements in primary dental access have not been published alongside the spending data. The rising cost of the Public Dental Service underscores pressure on Scotland’s dental system as officials, practitioners and politicians debate how to restore routine access while maintaining specialist and emergency provision.