A record 76% of Scottish Primary 1 children had no obvious tooth decay according to a new report, but children’s oral health varied drastically with deprivation.
Similarly to levels of obvious decay, average decay experience also reached its lowest level on record, at 0.92 affected, missing or filled teeth per child.
However, the percentage of children with no obvious decay dropped to 62% in the most deprived areas, compared with 87.3% in the most affluent ones.
Geographical location was also linked to disparities: decay-free rates ranged from 72% in Fife to 90% in Shetland.
Released today (27 October), the report summarises the findings of Public Health Scotland’s (PHS) National Dental Inspection Programme for 2026. All Primary 1 and Primary 7 pupils in local-authority schools were offered a basic dental inspection, with a more detailed survey focusing on a representative sample of Primary one children, typically aged between four and six.
Why has Scottish children’s oral health improvement stalled?
Though there are signs of improvement, dentist and owner of City Dental Care in Edinburgh, Hamza Al Haddad noted that progress seems to have plateaued somewhat. The previous two reports put decay levels at 73.2% and 73.5% respectively.
Al Haddad suggested that much of the current decay is ‘treatment the pandemic delayed’. He said: ‘The pandemic interrupted prevention at the ages when it counts, and that the recovery is not finished.’
Considering what needs to change for improvements to pick up speed, Dr Al Haddad suggested the following measures:
- Supervised toothbrushing – school brushing currently runs in 58% of primary schools, against 65.9% before the pandemic
- Treat age six as a prevention window – PHS has said in successive reports that the pattern of decay supports greater use of fissure sealant, and fluoride varnish is recommended for every child from age two at least twice yearly
- Start in the first year – in September 2025, 42.1% of children aged zero to two were registered with an NHS dentist, compared to 47.4% in September 2019
- Pay for prevention – since the November 2023 payment reform, varnish, brushing instruction and diet advice are claimed together under one preventive item, so national data cannot show whether varnish was given. PHS welcomed paying dentists for prevention, but said it would welcome more detail on what the item delivers
- Look again at water fluoridation – no public water supply in Scotland is fluoridated. Start where BDA Scotland does: fund boards to carry out feasibility studies.
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