Inequalities in the provision of NHS primary care dental services in Scotland in 2004.
OBJECTIVE
To assess inequalities in the provision of National Health Service (NHS) primary care dental services between Health Boards and the four provider groups (General Dental Service [GDS] non-specialist, GDS salaried, specialist working in primary care, Community Dental Service [CDS]) in Scotland.


METHODS
A postal questionnaire survey of all dentists (N=2852) registered with the General Dental Council at an address in Scotland was undertaken. The following were assessed: the proportion of primary care dentists not accepting new children/adults for NHS care or using a waiting list, the proportion of dentists working in wheelchair-accessible surgeries, furthest distance travelled by patients to primary care surgery in an average week, waiting time for routine NHS treatment, and the proportion of dentists offering weekend or evening appointments to NHS patients. Data were analysed by Health Board and the four provider groups.


RESULTS
A total of 2134 (74.8%) completed questionnaires were returned. One thousand, five hundred and seventy-seven dentists (73.9%) of the respondents were providing NHS primary care dental services for at least part of each week. There was a wide variation in the provision of NHS primary care dental services between Health Boards. Borders, Dumfries and Galloway, and Grampian performed poorly on most indicators, whereas Lanarkshire, Greater Glasgow, and Argyll and Clyde generally performed well. The CDS scored well on most indicators of service provision. There were problems with the provision of specialist dental services in primary care, and GDS services provided by Health Boards.


CONCLUSIONS
Because the problem issues differed between Health Boards and the four provider groups, it is likely that both local and national solutions are required to improve the provision of services. Further research on service demand is required to confirm the apparent inequalities in provision suggested by the study.
Newton
J Timothy
JT
Department of Oral Health Services Research and Dental Public Health, King's College London Dental Institute, London, UK.
Williams
Alison C
AC
Bower
Elizabeth J
EJ
D000328:Adult; D039602:After-Hours Care; D002648:Child; D019140:Dental Care for Children / Q000706:statistics & numerical data; D003815:Dentists / Q000600:supply & distribution; D005792:General Practice, Dental / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012606:Scotland; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D013039:Specialties, Dental / Q000706:statistics & numerical data; D013218:State Dentistry / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014850:Waiting Lists