Shona Robison said it was “astounding” that nearly 58,000 patients have been deregistered from NHS dental practices in the past two years.

Almost half the people in Scotland deprived of NHS dental treatment this year live in Fife and Tayside.

“It shows the extent of the crisis,” she said.

“It also raises questions about the Executive’s response to this crisis. A small number of extra dentists are being recruited to the NHS, but it’s not going to cope with the numbers involved.”

Ms Robison said a longer-term solution to the problems facing NHS dentistry can only be achieved through constructive dialogue between the Scottish Executive Health Department and the British Dental Association.

It is now eight months since the announcement of the Scottish Executive Health Department’s Action Plan, which the Executive claimed would be the solution to Scotland’s dentistry problems.

“However, we still have no deal on the table and dentists are continuing to leave the NHS,” said Ms Robison.

“The Executive and the BDA must reach a deal, otherwise this is going to continue. There must be a compromise from both sides to resolve this crisis.

“Dentists are getting fed up waiting (for an agreement to be reached), and are leaving the NHS.

“We need both parties to get back round the table, get more dentists to work in the NHS and convince the ones who have left to come back.”

Scotland’s dentists rejected the £295 million package from the Executive. The Dental Action Plan (DAP) is intended to help lure dentists back from the private sector. Talks broke down after the British Dental Association (BDA) said the package would force its members to treat a set number of adults on the NHS before receiving the money.

A Tayside dental expert warned the NHS exodus would continue. Dave Howie, an NHS dentist in Angus, and chairman of the Tayside Local Dental Committee, said, “None of us imagined it was going to come to this when we graduated all those years ago.

“A lot of the time, dentists are leaving the NHS, because it’s so stressful.

“We are seeing up to 40 patients a day and there is increasing burnout among dentists, who are either retiring or leaving the NHS for a better quality of life.

“It is not surprising so many dentists are leaving the NHS. It’s just come to Tayside a wee bit later than it has done to a lot of other parts of Scotland.”

Dr Christopher Southwick, a dental expert at Dundee University, said there were two reasons so many people have deregistered from the NHS.

“One is the registration expires with the health board after 15 months and the health board takes them off the dentist’s list. It’s nothing to do with the dentist at all,” he said.

“The second thing is so many dentists are now transferring to private schemes, either purely private or a pay-as-you-go monthly capitation scheme.

“They then offer their patients the opportunity to join a scheme after advising them they'll no longer be able to offer NHS treatment.

“The fee structure within the NHS for dentists has become so poor. They were not being remunerated adequately for the services they were providing.

“They warned that if it didn’t change they going to be leaving the NHS. The BDA has been giving warnings for the entire life of the Scottish Parliament.”

Dr Southwick also works in a Fife access centre providing treatment for people who can’t access NHS dentistry.

“I think we’ll see more people withdrawing from the NHS,” he added.

“I’m on one of the local committees and people there are now talking quite openly — and this is something I would never have imagined 10 years ago in Dundee — I know that people are planning to leave the NHS.

“The reason patients are leaving is because dentists are leaving.

“Dentists want to be able to offer better quality treatments and more preventive care.

“Dentists feel they want to provide a better quality of care for their patients with a greater preventive care and they feel they haven’t been able to do it under the existing NHS contract.

“The Government is now beginning to put money in but it’s not targeted at the patient — it’s targeted at premises, and all sorts of other things — too little too late.”

David Stobbs, an NHS dentist and secretary of the Tayside Local Dental Committee, said it was “absolutely no surprise” to see so many patients had deregistered from NHS dentistry.

“The pressure on practices within the NHS is getting greater,” he said.

“NHS dental practices are having trouble recruiting new dentists. It’s a fact there are not as many graduates as there used to be. That’s been a problem for two or three practices in Tayside.

“There is also growing disillusionment with the fee scale structure.”

Mr Stobbs said money is being pumped into the NHS in Scotland but dentistry is receiving only a small fraction and very, very little is filtering through to local practices.

“The Government budgets are decided two or three years down the line and there is no way dentists are going to get more money than they are getting now,” he added. “The exodus will continue and I can only see a gradual decline in NHS dentistry.”

NHS Tayside said there are currently 89 dentists in Dundee who are registered to provide NHS treatment to patients and if someone is looking to register as an NHS patient they can contact them on 01382 424492 for a list of dentists who are registered.

Dr Andrew Russell, director of Primary Care said, “The NHS Tayside Primary Care Division has recently agreed plans to improve access to NHS dentistry across Tayside.

These plans include a £1 million proposal to equip premises in Perth, Dundee and Angus to deliver more NHS services locally.

“We also have plans to make further investment in providing more extensive facilities with salaried NHS dentists working at a site to be developed at Kings Cross in Dundee and in a new facility in Perth & Kinross.”

Dr Morag Curnow, Clinical Director for NHS Tayside’s Community Dental Services, said, “These longer-term plans to take on more salaried dentists will eventually mean new patients can register for full care and treatment instead of the current position where only emergency care and short episodes of treatment could be offered”.

A spokesperson for the British Dental Association said there is no doubt that Scotland has a dreadful record on dental health.

“A shortage of dentists, a lack of long-term investment in NHS dentistry and a lack of commitment on the part of the Scottish Executive have brought us to this point where dentists are working to capacity and patients are still struggling to access dental care.

“The BDA has repeatedly urged the Scottish Executive to work with the dental profession to create a decent future for Scotland’s dental health and to make figures such as these a thing of the past.”

Meanwhile, a Lithuanian dentist, who is being forced to quit the NHS due to lack of funding, said today that practising within the health service was like “travelling back in time”.

Aivaraus Januskevicus began working in Scarborough, North Yorkshire, three months ago.

But because of changes in the way the Government funds dental services, the practice Mr Januskevicus had been working in has been told the money is not there to fund him. He said, “it’s not just a mess, it’s a disaster.”