The identification of agreed criteria for referral following the dental inspection of children in the school setting.
AIM: To clarify the function of the school based dental inspection. OBJECTIVE: For representatives of the Community Dental Service, General Dental Service and Hospital Dental Service to identify an agreed set of criteria for the referral of children following school dental inspection. DESIGN: Qualitative research methodology used to establish a consensus for the inclusion of referral criteria following dental screening. SETTING: Ellesmere Port, Cheshire, England. MATERIALS: A Delphi technique was used to establish a consensus amongst the study participants on the inclusion of nine possible criteria for referral following dental screening. All participants scored each criterion in the range 1-9, with a score of 1 indicating that referral of individuals with the condition should definitely not take place, and a score of 9 indicating referral should definitely take place. Referral criteria were accepted only if they achieved a group median score of 7 or more, with an interquartile range of three scale points, with the lower value being no less than 7. RESULTS: Four of the nine possible criteria met the agreed group standard for inclusion: 'Sepsis', 'Caries in the secondary dentition', 'Overjet > 10 mm', and 'Registered & caries in the permanent dentition'. CONCLUSION: It is possible to agree clear criteria for the referral of children following the school dental inspection. (+info)
Where is UK general dental practice going?
Dentistry is a fundamental part of healthcare; without it a large proportion of the population would suffer severe detriment to their general health. However, in order to achieve our professional aims we have to pursue the business of dentistry. (+info)
Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care.
BACKGROUND: The need for closer coordination between primary care medical and dental services has been recognized. AIM: To assess the attitudes of general medical practitioners (GMPs), general dental practitioners (GDPs), and patients to an integrated medical-dental patient-held record (integrated medical-dental PHR); to examine patients' use of these records, and the utility of the records for doctors and dentists. METHOD: A three-phase study was carried out: (1) postal survey of GMPs and GDPs; (2) randomized trial of patients, using postal questionnaires before and one year after the issue of integrated medical-dental PHRs to cases; (3) assessment by doctors and dentists of anonymized integrated medical-dental PHRs from this trial. The study was carried out in medical and dental practices in affluent and deprived areas in Greater Glasgow Health Board. Two hundred and thirteen GMPs, 183 GDPs, and 369 patients registered with GMPs and GDPs were surveyed. Eighteen GDPs and GMPs assessed the integrated medical-dental PHRs. RESULTS: Eighty per cent of dentists had contacted a doctor and 16% of doctors had contacted a dentist in the previous three months; 87% of dentists and 68% of doctors thought an integrated medical-dental PHR would be of some use. Twenty-one per cent of dentists and 85% of doctors had practice computers. Most patients wanted to be able to see and read their own records. Twenty-four per cent of patients said there were mistakes and 30% noticed omissions in the integrated medical-dental PHR issued. Experience of having an integrated medical-dental PHR made patients more positive towards the idea of having a patient-held record and being able to check the accuracy of records. Integrated medical-dental PHRs contained important information for half the GDPs and one-third of the GMPs. CONCLUSION: Both professionals and patients have reasonably positive attitudes towards the use of patient-held records. Among patients, the experience of having the integrated medical-dental PHR led to greater enthusiasm towards the idea. Dentists in particular would benefit from the transfer of information from doctors, but better methods are needed to ensure that patients take the integrated medical-dental PHR with them. Given the current lack of ability to easily produce an integrated medical-dental PHR, further examination of the routine issue of a copy of their medical summary, by GMPs, to all patients would be worthwhile. (+info)
Orthodontic treatment with fixed appliances in the General Dental Service in Scotland.
The records of 128 subjects treated by orthodontic specialists with fixed appliances in the General Dental Service in Scotland were randomly selected from the Scottish Dental Practice Board for analysis. The results of the study revealed that: (1) Mean post-treatment Peer Assessment Rating was 7.8 +/- 4.6 PAR points. (2) Mean reduction in PAR score was 14.9 +/- 10.6 PAR points. (3) Mean percentage reduction in PAR was 59 per cent. (4) Twenty-eight per cent of the cases were 'greatly improved', 15 per cent of the cases were made 'worse or no different'. (5) Median duration of treatment was 15 months, with a range of 2-41 months. (6) Multiple regression analysis showed that 82 per cent of the variability of PAR change could be predicted by the pretreatment PAR scores and the number of arches treated. Post-treatment PAR scores and duration of treatment could not be predicted with adequate reliability. It was concluded that although about 75 per cent of the cases were treated to at least acceptable alignment and occlusion, the modest average percentage reduction in PAR score could be explained by the low average initial PAR score and the borderline need for treatment in many cases. (+info)
Survey of dental treatments for pediatric patients referred to the pediatric dental clinic of a dental school hospital.
This survey was conducted to clarify which dental treatments in children are regarded as difficult by general dentistry practitioners. The subjects were 615 children who first visited Tokyo Dental College Chiba Hospital from January 1995 to August 1999 with reference letters. There were 615 children in the study; 571 (92.8%) came from Chiba City where our hospital is located and the 11 regions surrounding Chiba City. The prime reasons for referral in the order of frequency were treatments of dental caries, malalignment/malocclusion, traumatized teeth, supernumerary teeth, retarded eruption/impacted teeth, abnormal direction of erupted teeth, congenitally missing teeth, prolonged retention of deciduous teeth, and abnormal frenulum. Patients with dental caries or traumatized teeth in the deciduous dentition period and those with malalignment/malocclusion, supernumerary teeth, or retarded eruption/impacted teeth in the mixed dentition period were often referred to medical organizations specializing in pediatric dentistry because of the difficulties in controlling the patients' behavior and in providing adequate treatment. The information about pediatric dental treatments considered difficult by general dentists revealed by this survey appears to be useful and needs to be incorporated in the programs for clinical training of undergraduate students and education of postgraduate students. (+info)
The privatisation of NHS dentistry? A national snapshot of general dental practitioners.
There is a prevalent perception that NHS dental treatment is increasingly difficult to access. In order to access the validity of this perception data on the percentage of private and NHS patients treated by general dental practitioners (GDPs) were analysed. These data were derived from a national survey. The findings showed that GDPs can be divided into three broad groups on the basis of the proportion of patients treated privately or through the National Health Service (NHS). Approximately 50% of GDPs nationally concentrate on NHS dentistry (85% or more of their patients are treated under the NHS); 25% treat more than 70% of their patients privately; the remaining minority of practitioners fall between these two positions treating moderate proportions of both private and NHS patients. Regional differences also exist in the payment systems chosen by GDPs. The median percentage of private patients per dentist varies widely by area being around 50% in the South East and South West, 30% in London, 20% in the West Midlands and Eastern counties and less than 10% elsewhere. In a multivariate regression GDP characteristics were also significant in explaining the median percentage of private patients per GDP The findings add to widely held concerns about access to NHS dentistry, though suggest that problems may be limited to certain areas of the United Kingdom. (+info)
The outcome of root canal treatment. A retrospective study within the armed forces (Royal Air Force).
OBJECTIVE: The objective of this study was to investigate the outcome of conventional root canal treatment in a general practice setting within the Royal Air Force dental service. Design Retrospective review. METHODS: Teeth that had been root-filled for 12 months or more by Royal Air Force dental practitioners in patients attending a large Royal Air Force dental centre were included in the study. Following clinical and radiographic review the root fillings were classified as 'definitely successful', 'probably successful' or 'failed' The effect on success of several variables on the outcome was investigated. RESULTS: Out of a total of 406 teeth, 59% were maxillary teeth and 41% were mandibular teeth. Sixty-nine per cent of the total sample had pre-existing periapical radiolucencies. Cold lateral condensation of gutta-percha was the most widely used filling technique (64% of all cases). Fifty per cent of the teeth had root fillings within 2 mm of the radiographic apex, 32% were greater than 2 mm from the radiographic apex and 18% were overfilled. Cold lateral condensation was the most successful (92% overall) filling technique. Maxillary anterior teeth had a better success rate (96%) than other tooth types. Teeth with pre-existing periapical radiolucencies had a higher success rate (87%) than those cases where there was no pre-existing periapical radiolucency (80%). Root fillings that were less than 2 mm from the radiographic apex of the tooth had a higher success rate (88% overall) than those that were greater than 2 mm from the radiographic apex (77% overall). Of the 406 cases, 57% (n=231) were classified as definitely successful, 28% (n=114) were classified as probably successful and 15% (n=62) were classified as failures. Thus, the overall success rate combining definitely successful and probably successful root fillings was 85% (n=344). CONCLUSIONS: Root fillings placed using cold lateral condensation of gutta-percha to within 2 mm of the radiographic apex of the tooth were associated with the best outcome. (+info)
A national survey of dental hygienists: working patterns and job satisfaction.
OBJECTIVE: To describe the working practices and level of job satisfaction of dental hygienists in the United Kingdom. DESIGN: Postal questionnaire survey of 3,955 dental hygienists registered with the General Dental Council. Replies were received from 2,533 (64%). RESULTS: At the time of the survey only a small proportion of respondents (11%) were not working as dental hygienists, the most common reason for a current career break being child rearing. The majority of dental hygienists (78%) were employed in general dental practices, and most worked in more than one practice (64%). Approximately half worked part-time (fewer than 30 hours per week), and part-time working was more common amongst those respondents with childcare responsibilities. In the region of 60% of respondents had taken one or more career breaks during their working life, and the average total duration of career breaks was 11 months, the most common reason for all career breaks was child rearing. Additional qualifications had been gained by 35% of the sample, a high proportion (75%) had attended training courses in the previous year. The respondents expressed a high degree of job satisfaction, those who were older and who had childcare responsibilities expressed higher levels of job satisfaction. CONCLUSIONS: Dental hygienists express a high level of job satisfaction. A proportion take breaks in their career, most commonly for pregnancy and child rearing. The majority return to part-time employment after their career break. Planning of future requirements for the training of professionals complementary to dentistry should be informed by a consideration of the working patterns of dental hygienists. (+info)