Working together to improve Orkney’s Health and Wellbeing - Dentistry

This feature on our Dentistry Service is the first of what will become a regular series of patient information updates to put the spotlight on clinical services at NHS Orkney. As an organisation, we want to share with you and be open and transparent about how we are addressing the challenges we face in supporting you. Dental provision in Orkney is under pressure and we need your help.

We start this feature by asking for your help to make the best use of every clinical appointment slot we have. We need to ask you, our patients, to attend appointments and always let us know if you are unable to attend. In September alone there were 82 missed appointments in the Public Dental Service, 32 of which were for children. This equates to almost 48 hours of clinical time lost in one month. This is not unusual, a similar number of patient appointments are missed every month.  

Missed appointments are not an issue unique to the dental department and we understand that sometimes things crop up to prevent us from attending. However, these figures are very frustrating and concerning for our staff in the Public Dental Service, especially as we also have lots of people waiting for dental treatments on our Dental Emergency Helpline waiting list. We therefore ask everyone to attend your appointment when you can, but if you can’t, please let us know so we can give that appointment to someone else.

Dentistry is challenged across Scotland and Orkney is no exception. We know that many of you in our community cannot get registered with a dentist (NHS or Private) to access routine dental care. We are committed to working with the community based independent dentists and the Scottish Government to improve access for patients. The Public Dental Service, operated by NHS Orkney in The Balfour and at Garson Dental in Stromness is the 'safety net' for patients who are not registered with a dentist in the community, as well as providing the emergency service for patients. Following triage, patients will be placed on the Dental Helpline waiting list prioritised by clinical urgency. 

We are acutely aware of those of you who feel you have been waiting on our Dental Helpline list for a long time, waiting for treatment for a broken tooth, problem with your denture or other concern that we cannot see immediately. We share and understand your frustration about not being able to get an appointment as quickly as you’d like. We ask for your understanding that we must triage and prioritise dental treatment needs based on the level of clinical urgency for the appointment space we have. We do have some patients who have been waiting for a dental appointment for over 18 months. We know that hearing of missed appointments will add to your frustration. 

Dental Services in Orkney have recently been described in the national media as a ‘dental desert’, but the Public Dental Service is providing some routine care, particularly for our special care patients, for those requiring oral surgery, and for children. Our committed dental team including dentists, dental therapists, dental nurses, oral health nurses, andChildsmile Team work hard to address clinical dental needs and provide preventive dental care both in clinic and in the community. The Childsmile Programme and the National Dental Inspection Programme provides reassuring access to dental services for families and children in Orkney. 

As the Public Dental Service Team, our role is to work with and support you to manage your oral health and meet your dental treatment needs when we can.

 What we are doing at NHS Orkney to help

• We are working hard to ensure we have sufficient clinical teams and staff to deliver timely care and appointments. We are seeking locum support to address some current gaps, and we have visiting teams on site over the next few months from Aberdeen to deliver restorative dentistry and maxillo-facial care.
• We offer the on-call out of hours emergency dentistry service so that we are as responsive to urgent dental cases as we can be.
• Where we have cancellations, we will offer appointments out to other patients to ensure as many appointments are used as possible, and we can make the best use of our precious clinical time.
• As a department, we appreciate that when we have to cancel your appointment, it is equally frustrating. We do our best to avoid this but sometimes we have to, to ensure you receive the most appropriate clinical care. We will rearrange your appointment as soon as we can.

What we need your help with

• Please attend appointments given, but if you can’t attend your appointment, please let us know, as soon as possible, so we can offer this to another patient. You can call us on 888258 (Balfour) or 850658 (Garson). Remember that 82 appointments were missed at the Public Dental Service in September alone – which amounted to approximately a week and a half of wasted clinical time (this cost £2,681).
• Remember that emergencies are uncontrolled pain, severe swelling, significant trauma, unusual lumps and bumps, and bleeding. Concerns such as chipped teeth, a lost filling or problems with dentures - while we recognise will be worrying or feel urgent for you – are not clinical emergencies.
• Please answer our clinical triage questions as honestly as you can and if you are asked to send in a photo to support your care with us, please do so to help your treatment plan.
• Please take responsibility for your own health, including your oral health – brush your teeth twice a day and ensure a healthy and balanced diet (keeping sugar to a minimum). It’s what you do every day that matters for your oral health. We’ll be here when you need us – but we need you to look after yourself too, to help prevent and minimise the chances of you needing urgent care and treatment.
• Please continue to treat our staff with the respect and dignity they deserve. NHS Orkney has a zero-tolerance policy of any abuse directed at our staff who are doing the best possible job, often in difficult circumstances. We have the right to refuse treatment when patients abuse our team, something we are saddened to say happens all too regularly.

Our staff care enormously about ensuring patients receive safe and timely care. They are working hard every day and going to extraordinary lengths to maximise the number of appointments we are offering and to ensure patients can access their dental care. To the majority of our patients who continue to show our teams the utmost respect, we are incredibly grateful. We recognise that our service continues to be under pressure but with your help we can make the most of the valuable dental services we have.