Unravelling Referral Paths Relating to the Dental Care of Children: A Study in Liverpool

2008 ◽  
Vol os15 (2) ◽  
pp. 45-52 ◽  
Author(s):  
Rebecca V Harris ◽  
Susan M Pender ◽  
Alison Merry ◽  
Anthony Leo
Keyword(s):  
Primary Care ◽  
Dental Care ◽  
Care Setting ◽  
Postal Questionnaire ◽  
Dental Service ◽  
General Anaesthetic ◽  
Referral Decisions ◽  
Referral Networks ◽  
Dental Practitioners ◽  
Patient Groups

Objective To describe primary care referral networks relating to children's dental care and the main influences on referral decisions taken by dentists working in a primary care setting. Design A postal questionnaire to all 130 general dental practitioners (GDPs) in contract with Primary Care Trusts (PCTs), and 24 Community Dental Service (CDS) dentists in Liverpool. Outcome measures Characteristics of patient groups and factors influencing the choice of referral pathway of children referred from primary dental care. Results There were good responses rates (110 [85%] GDPs and 22 [92%] CDS dentists). The two main reasons why GDPs referred children to hospitals were (a) for treatment under general anaesthetic (GA) or relative analgesia (RA) and (b) for restorative care of dentally anxious children. GDPs also referred anxious children requiring simple restorative care and/or RA to the CDS. Only eight GDPs (7%) cited a lack of experience as a reason for referral of dentally anxious children for simple restorative care, compared to 53 (48%) who cited a lack of RA facilities, and 25 (23%) who cited financial considerations. Conclusions GDPs refer children to both hospital services and the CDS, and identify a lack of RA facilities and economic pressures as key reasons for referral.

Factors Influencing the Career Aspirations and Preferred Modes of Working in Recent Dental Graduates in Wales

2008 ◽  
Vol os15 (4) ◽  
pp. 157-163 ◽  
Author(s):  
Luke Davies ◽  
David R Thomas ◽  
Sandra J Sandham ◽  
Elizabeth T Treasure ◽  
Ivor G Chestnutt
Keyword(s):  
Dental Care ◽  
Career Aspirations ◽  
Continuing Professional Development ◽  
Postal Questionnaire ◽  
Dental Service ◽  
Attractive Alternative ◽  
Clear Understanding ◽  
Dental Practitioners ◽  
The Future ◽  
Postgraduate Qualification

Introduction In England and Wales, National Health Service (NHS) primary dental care services are now commissioned on a local basis. In planning for the future, it is important that commissioning authorities have a clear understanding of the perspectives of recent dental graduates: vocational dental practitioners (VDPs). Objectives This study investigated the career aspirations and preferred modes of working of VDPs in Wales. Methodology Data were collected via a postal questionnaire, comprising 37 closed and open questions, mailed to all 59 VDPs in Wales. Results A total of 53 (90%) VDPs participated, of whom 47 saw their future in general dental practice: 5, 35, and 7 indicating a preference to work in the NHS, mixed (NHS and private), and private sector, respectively. None selected the Community Dental Service as their preferred vocation. More than half of all respondents intended to undertake a postgraduate qualification within the next five years and 22 wished to specialise. Of the 53 VDPs, 44 were concerned that lack of NHS contracts would limit where they could practise, and agreed that family and other social commitments were a significant influence on choice of practice location. Access to high-quality premises and continuing professional development were agreed as important by 41 VDPs. A majority (37) agreed that private dentistry was an attractive alternative to NHS dentistry. Of the respondents, 38 (22 females, 16 males) expected to work part-time at some point in the future and 14 said they would consider a career outside dentistry. Only nine VDPs agreed that they would be happy working in a single-handed practice and even fewer (six) indicated they would be happy working for a corporate body. Conclusions Numerous factors impact on the career aspirations of VDPs. These factors have been quantified in this study, and healthcare-commissioning bodies need to be aware of them when planning future dental care provision in Wales.

Inequalities in the Provision of NHS Primary Care Dental Services in Scotland in 2004

2007 ◽  
Vol os14 (3) ◽  
pp. 89-96 ◽  
Author(s):  
J Timothy Newton ◽  
Alison C Williams ◽  
Elizabeth J Bower
Keyword(s):  
Primary Care ◽  
Postal Questionnaire ◽  
Dental Service ◽  
Health Board ◽  
Dental Services ◽  
Care Community ◽  
Service Demand ◽  
Provision Of Services ◽  
Care Surgery ◽  
Health Boards

Objective To assess inequalities in the provision of National Health Service (NHS) primary care dental services between Health Boards and the four provider groups (General Dental Service [GDS] non-specialist, GDS salaried, specialist working in primary care, Community Dental Service [CDS]) in Scotland. Methods A postal questionnaire survey of all dentists (N=2852) registered with the General Dental Council at an address in Scotland was undertaken. The following were assessed: the proportion of primary care dentists not accepting new children/adults for NHS care or using a waiting list, the proportion of dentists working in wheelchair-accessible surgeries, furthest distance travelled by patients to primary care surgery in an average week, waiting time for routine NHS treatment, and the proportion of dentists offering weekend or evening appointments to NHS patients. Data were analysed by Health Board and the four provider groups. Results A total of 2134 (74.8%) completed questionnaires were returned. One thousand, five hundred and seventy-seven dentists (73.9%) of the respondents were providing NHS primary care dental services for at least part of each week. There was a wide variation in the provision of NHS primary care dental services between Health Boards. Borders, Dumfries and Galloway, and Grampian performed poorly on most indicators, whereas Lanarkshire, Greater Glasgow, and Argyll and Clyde generally performed well. The CDS scored well on most indicators of service provision. There were problems with the provision of specialist dental services in primary care, and GDS services provided by Health Boards. Conclusions Because the problem issues differed between Health Boards and the four provider groups, it is likely that both local and national solutions are required to improve the provision of services. Further research on service demand is required to confirm the apparent inequalities in provision suggested by the study.

The Establishment of an Intravenous Conscious Sedation Service for Adult Patients in a Primary Dental Care Setting

Dental Update ◽  
2020 ◽  
Vol 47 (1) ◽  
pp. 22-36
Author(s):  
Rebecca SL Binnie ◽  
Nigel D Robb ◽  
Sarah L Manton ◽  
Stephen J Bonsor
Keyword(s):  
Surgical Procedures ◽  
Dental Care ◽  
Clinical Relevance ◽  
Care Setting ◽  
Conscious Sedation ◽  
Dental Anxiety ◽  
Adult Patients ◽  
Behaviour Management ◽  
Dental Practitioners ◽  
Management Techniques

Dental anxiety is common within the population and can detrimentally affect the delivery of dental care for those patients affected. Non-pharmacological-based behaviour management techniques are available to the clinician but may not be sufficient or applicable for every patient. In such cases, intravenous conscious sedation with midazolam has been demonstrated to be safe, effective and well tolerated. The present article reviews the criteria and guidance which must be addressed by the dental team when establishing an intravenous conscious sedation service in a primary dental care setting. CPD/Clinical Relevance: General dental practitioners may wish to consider establishing a conscious sedation service in their practices to facilitate the care of nervous patients or those undergoing prolonged, unpleasant treatments such as surgical procedures. The present paper aims to highlight the considerations which require to be addressed in order to establish such a service for adult patients using intravenous midazolam.

Proposed Career Pathway for Clinical Academic General Dental Practitioners

2011 ◽  
Vol os18 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Vishal R Aggarwal ◽  
Nikolaus OA Palmer ◽  
Pamela Nelson ◽  
Russ Ladwa ◽  
Farida Fortune
Keyword(s):  
Primary Care ◽  
Dental Care ◽  
Alternative Pathway ◽  
Bologna Process ◽  
Medical Practitioners ◽  
Medical Careers ◽  
Foundation Programme ◽  
Dental Practitioners ◽  
Career Pathway ◽  
General Medical Practitioners

The Modernising Medical Careers framework provides the opportunity for both medical specialists and general medical practitioners to follow training pathways that lead to appointments as National Health Service (NHS) consultants and to senior academic posts. Similar opportunities are available for dentists who wish to specialise. However, they are not available to dentists working in primary dental care who wish to become NHS consultants or senior academics in general dentistry. An alternative pathway is required that does not force committed primary care dentists who wish to become NHS consultants or senior academics down a path of specialisation. In this paper, the authors explore the situation in some detail and propose a career pathway with appropriate competencies for primary care dentists who aspire to become NHS consultants or senior academics. They justify why such posts should be created. The competencies have been developed using key guidelines and documents from the European Bologna Process and the Association for Dental Education in Europe, the Curriculum for UK Dental Foundation Programme Training, and the General Dental Council monospecialty curricula. It is hoped that the proposed pathway will produce highly trained generalists who will: (a) encourage and undertake research in primary dental care, where over 90% of dentistry is delivered, (b) support and lead outreach centres so that teaching and clinical cases reflect primary dental care, where students will spend their working lives post-qualification, and (c) provide a means of increasing the numbers of clinical dental academics, which have been in decline over the last 10 years.

scholarly journals Referral decisions and its predictors related to orthopaedic care.  A retrospective study in a novel primary care setting

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0227863 ◽  
Author(s):  
Esther H. A. van den Bogaart ◽  
Marieke D. Spreeuwenberg ◽  
Mariëlle E. A. L. Kroese ◽  
Mark W. van den Boogaart ◽  
Tim A. E. J. Boymans ◽  
...  
Keyword(s):  
Primary Care ◽  
Retrospective Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Orthopaedic Care ◽  
Referral Decisions

A Care Pathway for Children Unable to Accept Dental Care within the General Dental Services Involving the Use of Inhalation Sedation and General Anaesthesia

2015 ◽  
Vol 4 (2) ◽  
pp. 29-34 ◽  
Author(s):  
Allyson R Shepherd ◽  
Halimah Ali
Keyword(s):  
General Anaesthesia ◽  
Dental Care ◽  
Dental Treatment ◽  
Care Pathway ◽  
Treatment Modalities ◽  
General Anaesthetic ◽  
Dental Services ◽  
Inhalation Sedation ◽  
Dental Practitioners ◽  
The Right

Dental treatment is the commonest reason for a child to be in hospital in the UK. This is a shocking statistic for a preventable disease. How can we reduce the high numbers of dental general anaesthetics? It is essential that dental treatment under general anaesthesia (GA) is fully justifiable, ensuring that the right patients receive the right treatment. Guidance for general dental practitioners on when to refer a child for a dental GA is discussed. Treatment planning for this dentally high-risk group of children requires a holistic approach. It is complex and requires an experienced and competent clinical team, including dental care professionals with additional postgraduate qualifications. Often, alternative treatments are successful and a GA can be avoided. An audit of 85 patients referred for GA with Oldham Community Dental Service demonstrated 35% of patients accepted treatment with local anaesthesia only, 25% required inhalation sedation and only 25% were actually referred on for GA. Treatment for this group of patients must include the availability and provision of appropriate alternative treatment modalities, with the right staff and facilities, including those for dental general anaesthetic sessions. Ongoing follow-up within the general dental services is essential for this group of patients.

scholarly journals Planning Oral Health and Clinical Discharge in Primary Care: The Comprehensive Dental Care Protocol Outcome

2015 ◽  
Vol 16 (3) ◽  
pp. 172-177 ◽  
Author(s):  
Yuri Wanderley Cavalcanti ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Ailma de Souza Barbosa ◽  
Wilton Wilney Nascimento Padilha
Keyword(s):  
Primary Care ◽  
Health Promotion ◽  
Oral Health ◽  
Dental Care ◽  
Dental Service ◽  
Service Planning ◽  
Wilcoxon Test ◽  
Oral Health Promotion ◽  
Care Protocol ◽  
Public Dental Service

ABSTRACT Introduction The dental care must be driven by preventive and curative measures that can contribute to the population's oral health promotion. Objective To evaluate the impact of the actions proposed by a comprehensive dental care protocol (CDCP) on the oral health condition of primary care users. Materials and methods The sample consisted of 32 volunteers, assisted throughout the six phases proposed by the CDCP: diagnosis of dental needs; resolution of urgencies; restorative interventions; application of promotional measures; evaluation of the achieved health level; and periodic controls. Data were collected through clinical exams, which measured the simplified oral hygiene index (OHI-S), gingival bleeding index (GBI) and the decayed, missing and filled teeth (DMFT) Index, before and after the CDCP was implemented. Statistical analysis consisted of the Wilcoxon test, at 5% significance level (α = 0.05). Results The OHI-S and GBI indices showed a significant reduction (p < 0.05) from the initial (1.4 ± 0.6 and 46.3 ± 19.9) to final condition (0.9 ± 0.3 and 21.5 ± 7.5). The decayed, missing and filled teeth and the missing teeth component were not significantly altered (p > 0.05), showing final values equal to 12.7 ± 9.6 and 5.6 ± 7.8, respectively. Decayed elements were fully converted into filled elements, and the final values of the decayed and filled elements were, respectively, 0.0 ± 0.0 and 7.3 ± 5.7 (p < 0.05). Conclusions The enactment of the CDCP had a beneficial effect on the oral health of the population assisted by the dental services offered in primary care and this protocol seems to fit the public dental service demands. Clinical significance The CDCP can be useful to public dental service planning since it showed an efficient clinical outcome to the patients. We consider that this protocol should be employed in primary care oral health services in order to achieve overall upgrade, access enlargement and public oral health promotion. How to cite this article Cavalcanti YW, de Fátima Dantas de Almeida L, de Souza Barbosa A, Padilha WWN. Planning Oral Health and Clinical Discharge in Primary Care: The Comprehensive Dental Care Protocol Outcome. J Contemp Dent Pract 2015;16(3):172-177.

Perceptions and Attitudes to a Fundamental Reform of General Dental Services in Wales

2007 ◽  
Vol os14 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Ivor G Chestnutt ◽  
David R Thomas ◽  
Rajiv Patel ◽  
Elizabeth T Treasure
Keyword(s):  
Dental Care ◽  
Postal Questionnaire ◽  
Dental Services ◽  
England And Wales ◽  
New Ways Of Working ◽  
Care Services ◽  
Open Questions ◽  
Perceptions And Attitudes ◽  
Dental Practitioners ◽  
Negative Perceptions

Background The greatest reform of state-funded dental care in England and Wales, since the inception of the National Health Service (NHS) in 1948, occurred on 1st April 2006. It encompassed the dissolution of a universal national contract and the introduction of locally commissioned primary dental care services in England and Wales. Suggested advantages included the elimination of the fee-for-item-of-service ‘treadmill’, an increased emphasis on prevention, and improved access—at a time when many practitioners were opting to provide care outside the NHS system. Objectives This study investigated the perceptions and attitudes to the new contract, in the three months immediately prior to its implementation. Methodology Data were collected via a postal questionnaire, comprising a combination of 56 closed and open questions. The questionnaire was mailed to all general dental practitioners in Wales. Results 691 (64.5%) questionnaires were returned. Just 140 (23%) dentists agreed or strongly agreed that they would have more time to spend with patients under the new contract. The majority of respondents, 361 (59.3%), disagreed that they would be able to spend more time on prevention. Three hundred and sixty-six (60.2%) disagreed that they were strongly attracted by the new method of remuneration and only 62 (10.2%) perceived a reduced level of administration. Of the 608 dentists who provided NHS dental services, 418 (68.6%) indicated they would continue to do so, 130 (21.4) were undecided, and 55 (9%) stated that they would not take up the new contract. Allowing for the number of days worked per week and the percentage time spent on NHS patients, these equate to 72.3%, 21% and 5.9% of NHS capacity respectively. Conclusions This study has established baseline perceptions of reform in state-funded dental care in Wales. As the new contract evolves, it will be interesting to determine whether the largely negative perceptions of new ways of working expressed in this study are realised.

The advantages and disadvantages of providing minor oral surgery in primary care

2013 ◽  
Vol 4 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Jayendra Patel
Keyword(s):  
Primary Care ◽  
Dental Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Oral Surgery ◽  
Healthcare Sector ◽  
Fiscal Constraints ◽  
Advantages And Disadvantages ◽  
Minor Oral Surgery ◽  
Spending Cuts

The National Health Service (NHS) has recently been faced with increasing government targets at the same time as increasing spending cuts. Within the current fiscal constraints, the NHS is expected to deliver quality services while at the same time ensuring value for money.1 Since 1995 there have been developments to move the delivery of specialist dental care into the primary healthcare sector. This followed a report by the Chief Dental Officer (CDO) for England, who reviewed the arrangements for specialist training in dentistry.2 To keep in line with Europe, the CDO also recommended an increase in the provision of specialist dental care provided in the primary care setting.

An Investigation into Merseyside General Dental Practitioners’ Interest in Primary Care Research, Their Views on Research and Their Training Needs

2005 ◽  
Vol os12 (4) ◽  
pp. 145-149 ◽  
Author(s):  
Nikolaus OA Palmer ◽  
Brian Grieveson
Keyword(s):  
Primary Care ◽  
Dental Care ◽  
Research Training ◽  
Evidence Base ◽  
Training Needs ◽  
Research Network ◽  
Primary Care Research ◽  
Training Support ◽  
Care Research ◽  
Dental Practitioners

Objectives The aims of this investigation were to evaluate the interests of primary care dental practitioners within the Mersey Postgraduate Deanery in research and their views on research, their experience and research training needs. Method A questionnaire was sent to all practitioners in the Mersey Deanery asking for views on dental research, whether they had been involved in any research projects or had any research training, and whether they would be interested in research training and being part of a primary dental care research network. Results A total of 192 practitioners from the 1120 in the Mersey Deanery expressed an interest in being involved in primary care research. Most believed that primary care research was very important in providing a stronger evidence-base in dentistry and improved quality of dental care. Over 50% of respondents were interested in collaborative research, provided that their income and time could be protected and it was part of the normal working day. Almost 25% had some research experience and a number had undergone research training, ranging from informal training to part of a degree. Conclusions A number of GDPs in the Mersey Deanery are interested in primary care research. With appropriate training, support and recognition within the new Personal Dental Services (PDS) contracts, there is a golden opportunity for more primary care dentists to participate in research. This, in time, will add to the evidence base in dentistry and should improve patient care.

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