SCOTLAND has always had a dubious record on dental health. We have a notoriously bad diet and a love of all things sweet and fizzy. Thousands of children have to have rotten teeth extracted every year. And when dental treatment is necessary, the system is often letting patients down. Either they struggle to find an NHS dentist in their area or they are forced to wait for prolonged periods for the treatment they need. It is a health crisis let down by a service that is not fit for purpose.

The latest figures simply add to the grim picture. According to the British Dental Association in Scotland, children as young as two are waiting up to six months to have decaying teeth extracted. The fact that children so young need to have teeth removed at all is just one of the depressing consequences of poor eating habits and social deprivation, but the waiting times are a result of a shortage of theatre space and a reduction in hospital dentists.

The figures, while troubling, do need to be put in some context though. First of all, waiting times are much better in some parts of Scotland than others. We also appear to be heading in the right direction on dental health, albeit slowly. Ten years ago, 54 per cent of primary one children had no obvious tooth decay; now it is 69 per cent. That still leaves a large number of children suffering decay, but at least there seems to be improvement.

Some of that improvement is down to the Childsmile programme which was launched in 2001 and provides dental health education in schools and nurseries. But it is still concerning that thousands of young children are having to have teeth extracted every year and that, in some areas, the service is not in place to deliver treatment quickly.

The solution to the problem will have to include prevention and cure. The prevention side involves ensuring Childsmile is reaching as many children as possible, although much of the problem of teeth decay in children is part of the bigger problem of social deprivation.

Then there is the persistent cultural issue in Scotland with sweets and sugary treats being seen as rewards for good behaviour. Some parents are also aiming far too low with their children’s dental health – in other Western countries, tooth decay in young children would be a scandal, but in Scotland, parents have low expectations and may not even be shocked that their children need fillings. All of that needs to change.

We also have to face up to the fact that the only cure for patients facing delays is more investment in the service. In time, the hope must be that prevention programmes reduce the number needing treatment, but at the moment the demand is not matched in capacity. Indeed, capacity is falling, with the number of dental consultants in training dropping by 26 per cent in the last year alone, which leaves the Scottish Government with a choice: accept that thousands of children have to wait months for treatment or invest to provide a service that can treat them when they need it.