SDR ‘remains fundamentally flawed’
The Statement of Dental Remuneration remains fundamentally flawed, despite the introduction of Determination 1 last November, according to a leading clinician.
“The crisis underlying oral health globally is a result of dentistry’s inappropriate model for the delivery of dental care,” said Peter Mossey, Professor of Craniofacial Development and Associate Dean for Internationalisation at the University of Dundee.
Professor Mossey said he was “full of admiration” for the recent work of the Chief Dental Officer and his team and Determination 1 had “undoubtedly made an impact.” But, he said, it “continues to have fundamental flaws and will widen the inequalities gap.”
He criticised the lengthening of the recall interval from six month to a year: “Prolonging the recall interval has had a profoundly negative effect on the perception of the importance of oral health.”
Professor Mossey said it ignores “one of the fundamental values of recall as a screening tool for a range of diseases, and this includes oral cancer detection for which the evidence for dental recalls being lifesaving is overwhelming.
“As well as increasing risk of disease it also has negative effects on the dentist/patient relationship and is contrary to attempts to project the dental profession as a caring profession playing a role in holistic care.”
Writing in Scottish Dental magazine, Professor Mossey says that “a paradigm shift is required that begins to address primary prevention as described in the WHO Global Oral Health Action Plan.”
He argues that Scotland, by introducing an Oral Health Improvement Plan (OHIP) for marginalised groups and Childsmile for mothers and infants, is “uniquely well positioned to adopt the preventive paradigm. Both are government supported initiatives underpinned by proportionate universalism to address oral health inequalities.
“The integration of health and social care in Scotland, introduced in 2016, and more recently a behaviour change model (MAP) are other progressive initiatives for primary prevention.
“A new model for appropriate remuneration of the workforce in primary dental care that rewards the integrated and prevention-oriented agenda that the Scottish Government already aspires to would transform the health service, improve population health and well-being and ensure long-term sustainability.”
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