Find out how dental quality is monitored

The standard and quality of NHS dental treatment in Scotland is monitored by the Scottish Dental Reference Service (SDRS).

The SDRS is a small, independent team of experienced NHS dentists who make sure NHS dental treatment is carried out to a satisfactory standard.

Monitoring dental quality

Every dentist in NHS general practice or the Public Dental Service can expect three to four patients to be monitored by the SDRS every year. As part of this quality monitoring process, the SDRS will:

• check that dentists are carrying out appropriate treatment
• examine patients’ mouths either before or after treatment.

After this quality monitoring, the SDRS will send a report to the dentist. Patients can also request a copy of this report.

Steps in the monitoring process

1. Before every dental appointment, patients sign a form for the treatment they receive. By signing this form, the patient agrees to have an examination by a Dental Reference Officer (DRO) if necessary.
2. No routine treatment can be provided before a DRO examination. But treatment may be carried out to relieve pain or prevent unwanted deterioration in the condition of the patient’s teeth. If you need clarification on this, you can contact the SDRS.
3. The DRO examination is comfortable and non-invasive and will assess whether the treatment proposed by the dentist is the most appropriate.

Timeline of the quality monitoring process

1. The case is randomly selected by SDRS from Midas by the Dentists Health Board Area and added onto the SDRS database.
2. A Clinic is set up and the patients are added onto this.
3. Letters are then sent to the patient asking them to attend the clinic on a specific date.
4. The patient calls to make an appointment time suitable for them.
5. Once the patient has confirmed they are attending, an email is sent to the dentist advising them of this and gives the dentist the opportunity to attend the clinic or send further information supporting their claim, such as X-Rays.
6. After the patient has attended the appointment, the DRO writes a draft report which is sent by email to the Dentist along with a 150 stencil requesting the Dentists comments on the report.
7. The dentist should always respond to the report by email unless it is a code 1 with no administrative codes.
8. The comments are received by the DRO who will then decide with the further information if the DRO report should be amended.
9. If there is no change, the report is then passed to Dental Advisor.
10. The Dental Adviser looks at the report and information received and makes the final decision whether to close the case or if further information or clarification is needed.

More information for dentists

If a DRO examination is part of the prior approval process, and the patient doesn’t attend the appointment, the treatment plan will not be approved.

If you want to discuss a report, your first contact should be the DRO who carried out the examination.

More information for dental patients

Patients can claim reasonable travel expenses for examinations by the SDRS. They can request a form to claim at the time of the appointment. The form should be posted to the NHS at the address shown on the form.

Admin codes on DRO Reports

• (i)(r) possible regulatory concern
• (i)(m) possible mis claim
• (i)(c) possible clerical concern
• (P) possible prior approval violation or avoidance.

Dental Codes on DRO Reports

D1 pre-treatment codes

• A and B – satisfactory
• C unsatisfactory
• D completely unsatisfactory

D2 post-treatment codes

• 1 and 2 – satisfactory
• 3 unsatisfactory
• 4 completely unsatisfactory

For more information on DRO examination codes click here.

Contact the SDRS

If you have any other queries, email nss.psddental@nhs.scot or call the SDRS on 0345 712 5449 (calls charged at local rate).

See the SDRS leaflet for futher information.