Inequalities in access to NHS primary care dental services in Scotland during the COVID-19 pandemic

Introduction: This study aims to quantify the impact of the COVID-19 pandemic on access and inequalities in primary care dental services among children and adults in Scotland. Methods: Access was measured as any NHS Scotland primary care dental contacts derived from administrative data from January 2019 to May 2022, linked to the area-based Scottish Index of Multiple Deprivation (SIMD) for children and adults, and related to population denominator estimates from National Record Scotland. Inequalities for pre-pandemic (January 2019 – January 2020) and recent (December 2021 – February 2022 and March 2022 – May 2022) periods for both children and adults were calculated and compared using the slope index of inequality (SII) and relative index of inequality (RII). Results: Following the first lockdown (March 2020) there was a dramatic fall to near zero dental contacts, followed by a slow recovery to 64.8% of pre-pandemic levels by May 2022. There was initial widening of relative inequalities in dental contacts in early 2022, which, more recently, had begun to return to pre-pandemic levels. Conclusion: COVID-19 has had a major impact on access to NHS primary dental care, and while inequalities in access are apparent as services recover from lockdown, these inequalities are not a new phenomenon.