Social background of minority ethnic applicants to medicine and dentistry

AIM

To explore ethnic variations in social background of successful applicants to undergraduate United Kingdom medical and dental schools.

METHOD

Retrospective analyses of University and College Admissions Services data on all students to commence study in pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Analyses were undertaken for two categories of social class, namely higher (professional and intermediate) and lower (skilled non-manual, skilled manual, partly skilled, and unskilled) social class.

RESULTS

Over 15 thousand students were accepted to study medicine and dentistry during the three-year study period, of which 80% were from high social class backgrounds. More medical (80.9%) students were from high social class backgrounds than dental (73.3%) students (OR = 1.54, 95% CI = 1.39, 1.70). Social class differences were observed, with a greater proportion of higher social class students amongst the white students than amongst the minority ethnic students (OR = 1.42, 95% CI = 1.30, 1.55). This was more marked in dentistry (OR = 1.48, 95% CI = 1.22, 1.79) than in medicine (OR = 1.35, 95% CI = 1.22, 1.49). More students from higher social class backgrounds were observed in medicine than in dentistry amongst the black (OR = 1.55, 95% CI = 0.59, 4.00), Indian (OR = 2.04, 95% CI = 1.58, 2.62) and white (OR = 1.44, 95% CI = 1.26, 1.64) groups.

CONCLUSIONS

Significant inter-ethnic differences are observed in the social background of students entering medicine and dentistry. Dentistry accepted a greater proportion of students from lower social class backgrounds and from black and minority ethnic groups.

Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children

OBJECTIVES

To investigate the relationships between socio-demographic factors, infant feeding habits, oral hygiene and the prevalence and patterns of caries in Brazilian 3-4-year-olds.

METHODS

Systematic random sampling was used to select children enrolled in municipal nurseries in Araraquara, Brazil, in 1998. Clinical examinations were carried out by one examiner using dmft and dmfs indices and WHO criteria. Questionnaires for information related to the socio-demographic background, oral hygiene and dietary history of the children were completed by their mothers.

RESULTS

Caries was seen in 46% of the children; 17% of them had the more extensive pattern involving molars and incisors. Social class, mother's education, and age at which breast-feeding terminated showed statistically significant associations with caries. Feeding bottles with added sugars were still being given to 80% of the children. When the significant variables were taken into account only age at which breast-feeding terminated showed a significant relationship to the pattern of disease. Children who were never breast-fed or were breast-fed beyond the age of 24 months had a higher prevalence of the more extensive pattern of caries.

CONCLUSIONS

The association between the length of time a mother breast-feeds and extensive caries should be a consideration in any local infant feeding policies or health promotion strategies. The duration for appropriate breast- or bottle-feeding should be emphasised.

Changes in oral health over ten years amongst UK children aged 4-5 years living in a deprived multiethnic area

OBJECTIVE

To examine the changes over a decade in caries experience amongst children aged 4-5 years living in a deprived multiethnic community in the United Kingdom.

DESIGN

Cross-sectional surveys.

SETTING

Schools and nurseries in the Old Trafford area, Manchester, England, 1989, 1990, 1991 and 1998.

MAIN OUTCOME MEASURES

Mean dmft, oral cleanliness and proportion of children with rampant caries.

RESULTS

The unadjusted Odds Ratio for caries free children examined in 1998 compared with children examined prior to 1998, was only significant amongst the white group. White children examined in 1998 were over three times more likely to be caries free than white children examined previously. South Asian children whose mothers were non English speaking examined in 1998 were almost twice as likely to have good/fair oral cleanliness than those examined prior to 1998. Moreover, South Asian children whose mothers were non-English speaking in 1998 were over three times more likely not to have rampant caries than their counterparts in the earlier years.

CONCLUSION

There were significant improvements in caries and oral health amongst white children over the decade, and although less marked these were mirrored amongst South Asian children.

Transcultural oral health care and the Chinese--an invisible community

The Chinese, a 'silent minority', are the most scattered, but neglected, community in the UK. Most dentists will have at least a few Chinese people in their community. This paper describes the health beliefs, dental knowledge, attitudes and behaviours of the Chinese. Implications for general dental practitioners are discussed.

The development of a tactile graphic version of IOTN for visually impaired patients

The Index of Orthodontic Treatment Need (IOTN) is a visual-based index and has been widely used. This paper describes the development and evaluation of tactile graphics representing the aesthetic component (AC) of IOTN for the use of visually impaired patients (VI). Four tactile graphics were produced corresponding to IOTN photographs 1 (graphic 1, no treatment - mild need), 5 (graphic 2, moderate need), 8 (graphic 3, severe need; increased overjet) and 10 (graphic 4, severe need). Nine (30-50 years) expert consumers from the Royal National Institute for the Blind (RNIB) and 13 VI schoolchildren (11-16 years) evaluated the graphics. The evaluation was in terms of design features, complexity of information and ease of use. Each individual was asked to arrange the graphics in order of severity of malocclusion. The procedure was repeated after 30 min to test individual reliability (http://www.clinorthodres.com/cor-c-084/). The consumer group was able to identify the main features in each graphic and found them easy to use. Six had arranged the graphics correctly at the first attempt and five on their second. The children were able to distinguish the different oral features, except the overjet presentation in graphic 2. Nine children arranged the graphics correctly at the first attempt, but only six at the second. The confusion centred for both groups on presenting an increased overjet with graphic 2. A modification was undertaken to enhance the anterior-posterior nature of the image. Fifteen VI schoolchildren reassessed the modified graphics, 14 arranged them correctly at the first attempt and 13 at the second. The study concluded that IOTN tactile graphics were well accepted and showed a good reliability.

The development of a tactile graphic version of IOTN for visually impaired patients

The Index of Orthodontic Treatment Need (IOTN) is a visual-based index and has been widely used. This paper describes the development and evaluation of tactile graphics representing the aesthetic component (AC) of IOTN for the use of visually impaired patients (VI). Four tactile graphics were produced corresponding to IOTN photographs 1 (graphic 1, no treatment - mild need), 5 (graphic 2, moderate need), 8 (graphic 3, severe need; increased overjet) and 10 (graphic 4, severe need). Nine (30-50 years) expert consumers from the Royal National Institute for the Blind (RNIB) and 13 VI schoolchildren (11-16 years) evaluated the graphics. The evaluation was in terms of design features, complexity of information and ease of use. Each individual was asked to arrange the graphics in order of severity of malocclusion. The procedure was repeated after 30 min to test individual reliability (www.clinorthodres.com/cor-c-084/). The consumer group was able to identify the main features in each graphic and found them easy to use. Six had arranged the graphics correctly at the first attempt and five on their second. The children were able to distinguish the different oral features, except the overjet presentation in graphic 2. Nine children arranged the graphics correctly at the first attempt, but only six at the second. The confusion centred for both groups on presenting an increased overjet with graphic 2. A modification was undertaken to enhance the anterior-posterior nature of the image. Fifteen VI schoolchildren reassessed the modified graphics, 14 arranged them correctly at the first attempt and 13 at the second. The study concluded that IOTN tactile graphics were well accepted and showed a good reliability.

An in vitro study of the effect of fluoridated milk on oral bacterial biofilms

Microcosmic dental plaques were grown in artificial saliva and supplemented with either milk or fluoridated milk. The presence of fluoride in the milk increased the pH of the biofilms and reduced the proportions of streptococci, demonstrating that in this model, fluoridation of milk produces biofilms with reduced cariogenic potential.

Oral health related quality of life--views of the public in the United Kingdom

OBJECTIVE

This study was designed to determine the United Kingdom public's perception of how oral health affects quality of life (QoL) and to determine socio-demographic variations in these perceptions.

RESEARCH DESIGN

The vehicle for this study was the ONS Omnibus Survey in the UK. A random probability sample of 2,668 eligible addresses was selected from the British Postcode Address File. Setting The data were collected by qualitative, face-to-face interviews with respondents, nation-wide, in their homes, about how their oral health status affected their QoL.

PARTICIPANTS

1,778 adults aged 16 years or older across the UK took part in the study.

RESULTS

75% (1,340) believed their oral health either enhanced or reduced their QoL. Most frequently, this was perceived as being the result of its effect on eating. comfort and appearance. Other ways in which QoL was affected are also presented. Sociodemographic variations were apparent. For example, people from higher socio-economic backgrounds believed that their oral health enhanced their QoL to a greater degree (OR=1.46, CI=1.20, 1.78) than the lower socio-economic groups. Women claimed that their oral health had a greater negative effect on QoL than did men (OR=1.36, CI=1.11, 1.64). Younger people (16-64 years old) reported that their oral health status reduced and enhanced QoL more than older adults (65 years and over) (OR=1.59, CI=1.23, 2.04).

CONCLUSIONS

The study shows that the UK public perceives oral health as affecting their QoL in a variety of physical, social and psychological ways and that significant socio-demographic variations exist in these perceptions.

Prevalence of caries and developmental defects of enamel in 9-10 year old children living in areas in Brazil with differing water fluoride histories

AIMS

To assess the prevalences of caries, of developmental defects of enamel and their interrelationship in Brazilian 9-10-year-olds from areas of contrasting fluoridation histories.

METHODS

Systematic random sampling procedures were used to select children from an area where water had been fluoridated in 1963 and from a second area where water had been fluoridated since 1998. Clinical examinations for caries were carried out using the DMFT index and WHO diagnostic criteria. Developmental defects of enamel on upper incisors were diagnosed using the DDE index.

RESULTS

A difference of 40% in DMFT was observed, with a lower prevalence of disease in the area fluoridated since 1963. Diffuse opacities affected 14.3% of the children from the area fluoridated since 1963 compared with only 2.4% in the area fluoridated in 1998. Children living in the area fluoridated in 1963 who had diffuse defects had twice the chance of being free from caries compared with those living in the same area who had no defects or who had only demarcated or hypoplastic defects.

CONCLUSIONS

This study confirms previous ones in showing the benefits of water fluoridation. Diffuse opacities of upper incisors affected relatively few subjects in either of the two areas.

Factors influencing older people's self reported use of dental services in the UK

OBJECTIVES

This study was designed to determine the use of dental services and factors associated with their use among the United Kingdoms' older population.

DESIGN

A national study involving 1,116 older people (aged 60 or older).

SETTING

Home Interviews were undertaken exploring the time and reason for last dental visit. In addition, socio-demographic characteristics and proxy oral health measures (self-reported number of teeth and edentulous status) of the respondents were collected.

RESULTS

Forty seven percent (528) claimed they visited the dentist within the past year, 10% (116) claimed that the reason for their last visit was because of a dental emergency, 43% (484) were classified as "regular attenders"--having attended the dentist within the past year for a non dental emergency. Bivariate analysis identified that regular dental attendance was associated with age (P < 0.01), social class (P < 0.01), income level (P < 0.01), educational attainment (P < 0.01), self-reported number of teeth possessed (P < 0.01) and edentulous status (P < 0.01). In regression analysis, self reported edentulous status and number of teeth possessed emerged as the most important factors in determining service utilisation. Possessing a full denture was associated with a 6-fold decrease, having accounted for other factors, in the likelihood of attending the dentist within the past year for a non dental-emergency (OR = 0.15, CI 0.10, 0.21).

CONCLUSION

Less than half of the sample population were "regular dental attenders", their attendance was associated with a number of socio-demographic and oral health factors. In particular, edentulous state was a major factor associated with their use of services.

Provision of dental general anaesthesia for extractions in child patients at two centres

AIM

To two contrasting centres, to describe the provision of dental general anaesthesia (DGA) for simple non-surgical extractions in terms of the type of treatment provided, including the number of primary and permanent teeth extracted, and the characteristics of child patients attending in terms of their age group and gender.

DESIGN

Retrospective analysis of hospital records.

METHOD

Data were drawn from records of services over a 12-month period in 1996/97 at: a) a London dental hospital (Centre 1), and b) in the community dental services in Rochdale, Lancashire (Centre 2). Information was collated and analysed using the SPSS statistical software package.

RESULTS

The majority of patients at both centres were aged less than 9 years. Almost one third (31%) of those seen at Centre 1 were below 5 years of age, but fewer of this age group were treated at Centre 2. Children aged 9 years or less had an average of 5.4 (SD = 3.0) primary teeth extracted at Centre 1 and 3.0 (SD = 2.0) at Centre 2. For permanent teeth, an average of 3.2 (SD = 1.2) and 2.7 (SD = 1.4) were extracted at Centres 1 and 2 respectively.

CONCLUSIONS

Both services were used primarily for the extraction of primary teeth although the services differed in the ages of patients who used them and in the numbers of teeth extracted. Numbers of patients attending the service at Centre 1 had declined over time but numbers of teeth extracted per child had increased.

A study of the impact of oral health on the quality of life of older people in the UK--findings from a national survey

OBJECTIVES

The aim of this study was to was to determine whether older adults perceive oral health as affecting their life quality and to identify variations in impacts in relation to socio-demographic factors, dental service utilisation and method of payment.

DESIGN

This study formed part of the Office for National Statistics Omnibus Survey, which utilised a random probability sample of addresses from the British Postcode Address File (PAF).

SETTING

3,000 homes were selected from one hundred post sectors across Britain. Respondents were interviewed in their homes about how oral health affects their quality of life. Subjects 454 older people (aged 65 and over) took part in the survey.

MAIN OUTCOME MEASURES

The study group perceived oral health as impacting on their quality of life in general (negative and/or positive impact) (70%, 318), enhancing (53%, 241) and detracting (44%, 199) from their life quality. The most frequently perceived way in which oral health affects life quality was its effect on eating and comfort. Older people from higher socio-economic groups reported that oral health had a greater impact on their quality of life in general (positive and/or negative impacts), (OR = 1.77, 95% CI = 1.22,2.78) and specifically, enhancing their quality of life (OR = 1.52, 95% CI = 1.01,2.30). Those who reported attending the dentist within the last year perceived that their oral health enhanced their life quality (OR = 1.55, 95% CI = 1.01,2.38).

CONCLUSIONS

Socio-economic background and dental attendance pattern are associated with how older people perceived oral health as affecting quality of life. These findings may have implications for promoting regular dental attendance and auditing dental services for older people.

Compounding inequalities in the oral health of older women living outside Dublin

BACKGROUND

The Irish population is ageing with an increase in the absolute number of older people. However, there is a deficiency of information on the oral health status of older people in the Republic of Ireland. Traditionally, the primary measure of oral health status in older populations has been the prevalence of edentulousness. The aim of this retrospective study was to obtain information on the edentulous status of older people and to investigate the compounding effects of age, gender and area-of-residency on the prevalence of edentulism, using as a sample those over 65 year-olds who registered at dental hospitals in the Republic of Ireland during 1995.

DESIGN

All patient records from both dental hospitals in the Republic were identified on electronic databases, and information was collected over a period of six months. Of the 566 patients who registered at the dental hospitals in 1995, it was possible to access 524 (93 per cent) records.

RESULTS

The edentulous rate in the sample was 42 per cent, but significant variations were apparent with age, gender and geographical residency. In addition, there was evidence of compounding inequalities in the prevalence of edentulism when the combined effects of age, gender and area of residency were studied. Considerable inequalities were observed; at age 65 women resident outside Dublin were 1.65 times more likely (or 65 per cent more likely) to be edentulous than men resident in Dublin of the same age. At age 75, women were 1.46 times more likely to be edentulous than men.

How long do routine dental restorations last? A systematic review

OBJECTIVE

To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth, and to identify and examine factors influencing its variability.

METHOD

Accepted guidelines were followed. An advisory group oversaw the project. Simple Class I and Class II amalgam, composite resin, glass ionomer and cast gold restorations were covered. Comprehensive searching of electronic databases, hand-searching, and location of 'grey' literature, generated 124 research reports. Those considered relevant were assessed for validity and quality according to agreed criteria. The analysis was descriptive.

RESULTS

Eight of 58 relevant research reports were categorised, according to agreed criteria, as being of satisfactory validity and quality. They suggested that 50% of all restorations last 10 to 20 years, although both higher and lower median survival times were reported. The findings were supported by the totality of studies reviewed. However, variability was substantial. Restoration type, materials, the patient, the operator, the practice environment and type of care system appeared to influence longevity.

CONCLUSIONS

Many studies were imperfect in design. Those considered to be the most appropriate for analysis were too limited to undertake a formal statistical exploration. Therefore there remains a need for definitive randomised controlled trials of restoration longevity, of sound design and adequate power, employing standardised assessments and appropriate methods of analysis.

Who uses independent dental services? Findings from a national survey

This study was designed to determine private dental services use in the UK and to determine if those who use an independent dental service attend more regularly, in addition to identifying factors associated with the use of private dental care. A random probability sample of 2668 addresses was selected from the British Postcode Address File (PAF) and 1865 adults aged 16 years or older took part in this study (70%). Respondents were interviewed in their homes about their use of dental services and socio-demographic information was collected. The data were analysed using the statistical package CHAID. A total of 23% (424) reported to be seen on a private basis the last time they visited the dentist. Of those, 54% (230) reported to have attended the dentist within the last six months compared to 46% (629) of those who used NHS services (P < 0.05). Level of income was identified as the most significant factor in determining the use of private services, this being greater for those earning above 30,000 Pounds (P < 0.05). For those on low (< 10,000 Pounds) or middle (10,000 Pounds-< 30,000 Pounds) incomes, area of residence was the next most important factor in determining private service use. Residents of London and the South East in both low- and middle-income groups were more likely to use private services (P < 0.05). Residents of the North of England and the Midlands/East Anglia were less likely to use private services (P < 0.05). In conclusion, income and area of residence appear to be the most important determining factors in the use of private dental services.

Variations in admissions to hospital for head injury and assault to the head. Part 1: Age and gender

The study retrospectively investigated variations in the use of secondary healthcare for head injury, particularly assault. A total of 25,300 emergency head-related admission were examined over a two-year period, of which 3756 were for assault. More males were admitted during summer and holiday periods, while there were fewer female patients with head injuries and the incidence varied less. The largest number of admissions was among men aged 15-44 and most assaults occurred at weekends. Females were more likely than males to die from all head injuries (OR=1.31) and violent head injuries (OR=2.38). Women (15+) stayed longer in hospital than males. Injuries among males are primarily associated with social occasions. Females experience head injuries all the year round suggesting that these injuries are the result of domestic violence. There are important demographic differences in numbers of patients and duration of hospital care required to treat these avoidable injuries.

Variations in admission to hospital for head injury and assault to the head. Part 2: Ethnic group

This study retrospectively investigated variations in the use of secondary healthcare for head injury, particularly assault. A total of 25,300 emergency head-related admissions were examined over a two-year period, of which 3756 were assaults. There were seasonal differences according to ethnic group: far more injuries, particularly assault, occurred amongst the black and minority ethnic groups during the summer months and holidays. Black males had two to three times the rate of admission for assault than any other group. Among whites, females stayed longer in hospital after a head injury. White women stayed significantly longer than South Asian women following a head injury and South Asian men stayed significantly longer than white men after an assault. There are substantial seasonal variations and differences in the length of hospital stay after a head injury, particularly assault, depending on ethnic group. These differences require clarification and more detailed studies of head injuries ought to record the patient's ethnic background.

The importance of oral health to older people's quality of life

OBJECTIVES

This study was designed to determine whether older people perceive oral health as being important to Quality of Life (QoL) and if so, to identify the most important ways in which their lives are affected. In addition, to identify if subgroups of older people perceive its importance differently.

DESIGN

Nationwide qualitative face to face interviews with older people were carried out utilising the Office for National Statistics Omnibus survey in Great Britain.

SUBJECTS AND METHODS

454 adults aged 65 or older took part in this study, part of a random probability sample of adults in the UK.

SETTING

Respondents were interviewed in their homes.

RESULTS

72% (313) perceived their oral health status as important to their QoL through a variety of physical, social and psychological ways. Most frequently its impact on function: eating (29%, 126) and symptoms: comfort (14%, 59) were considered most important. Gender and social class variations were apparent (P < 0.05).

CONCLUSION

Older people perceive oral health as being important to life quality in a variety of different ways. There are significant social class and gender variations which must be taken into consideration when assessing oral health needs of older people.

Helicobacter pylori in dental plaque of Pakistanis

Helicobacter pylori is now generally accepted to play a key role in acid related and neoplastic pathology of gastroduodenal diseases. Recent reports have concluded that dental plaque is not an important reservoir for Helicobacter pylori, however, these studies did not consider the ethnic background of their subjects nor the amounts of dental plaque present. The aim of this study was to explore the association of Helicobacter pylori dental plaque colonisation in 125 males and 53 females (group I) attending a dental clinic in Pakistan. A simultaneous sample of 30 healthy volunteers with good orodental hygiene consisting of 17 males and 13 females was included as a control group (group II). Six dental plaque specimens were obtained from each subject with a sickle scaler; two were inoculated into CLO test gel and the remaining four were used to prepare cytology slides stained with Giemsa's stain. CLO test was positive in all specimens from group I, while cytology for Helicobacter pylori was positive in 173 cases in this group. One hundred and forty two cases had heavy plaque deposits and all of them were positive on cytology. In group II CLO test was positive in 20 and dental plaque cytology was positive in 7 cases. In conclusion, it is important that future studies into the prevalence of Helicobacter pylori in the oral cavity should take into account the levels of oral cleanliness and the ethnic background of the subjects.

The value and use of 'quality of life' measures in the primary dental care setting

General dental practitioners are used to taking a dental history and carrying out an examination. The history and examination invariably form the basis of the patient-dentist dialogue with regard to the treatment to be provided and the financial costs involved. The dialogue between patient and dentist is complex, and the importance of 'quality of life' for the patient is now emerging as a central focus of this dialogue. This paper explores the concept of 'quality of life'. In terms of oral health, and considers the potential of 'oral health-related quality of life' measures for general dental practice. Examples of their use in general dental practice are considered, in relation to marketing dental services, improving compliance in treatment plans, assessing the quality of care and improving communications between the patient and the dental team. Quality of life indicators are being used in the healthcare sector for commissioning, planning and evaluating services. In addition, primary care researchers are using these indicators as part of their evidence-based treatment approaches. As general dental practitioners become more involved in planning services and research, it is important they understand the impact of 'quality of life' indicators have on their treatment and practice management.

Risk factors for oral epithelial dysplasia--the role of smoking and alcohol

The present study provides an assessment of the importance of tobacco and alcohol consumption upon the development of oral epithelial dysplasia (OED) in a large group of European patients. Data were collected in a case-control study based upon 630 patients with OED and 643 control subjects selected from UK dental hospital patients with oral disease not caused by tobacco or alcohol. Logistic regression was used to determine the association of several independent factors on the risk of OED. No relationship emerged between patient's gender, age or ethnicity and risk of OED. The regression model demonstrated a combined effect of tobacco smoking and alcohol drinking upon the risk of OED. Non-filter cigarette smoking was a significant predictor of OED, as was alcohol consumption, and the two habits compounded one another in the overall risk of disease. When both factors combined were included in the model through interaction terms, their individual impact was only moderately reduced, illustrating the importance of both factors in their own right. However, more detailed analysis of tobacco smoking habits revealed that the increased risk of OED from smoking was largely attributable to heavy smoking (20 cigarettes per day, OR = 4.38, 95% C.I. = 2.6, 7.2) especially non-filter cigarettes (OR = 1.95, 95% C.I. = 0.9, 4.0) relative to non-smoking. Both heavy smoking and non-filtered tobacco were higher risks for OED than alcohol consumption alone. Tobacco cessation was associated with a significant decline in risk of OED, the reduction being rapid and marked. For alcohol consumption the association with OED was considerably stronger for drinkers of fortified wines and spirits (OR = 3.75, 95% C.I. = 1.40, 10.05 and OR = 1.36, 95% C.I. = 0.76, 2.45, respectively). It is concluded that, while tobacco and alcohol synergistically influence the development of OED, exclusive tobacco consumption is more likely than exclusive alcohol consumption to give rise to OED. The risk of OED may thus be significantly reduced by behavioural changes such as moderation of tobacco and alcohol use.

A survey of dental practitioners on their use of electronic mail

OBJECTIVES

To assess the feasibility of using electronic-mail as a tool for surveying dental practitioners; to determine both response rates and response times for this method; and provide baseline information on e-mail usage.

METHOD

Self-administered questionnaire distributed by e-mail to 309 practitioners on Monday morning, 1 June 1998.

RESULTS

53.4% response rate within 1 month; 10.2% of replies were sent within 2 hours; and nearly half the replies were sent within 48 hours. Qualified dentists were more likely to respond early than undergraduates. The most popular point of access for e-mail was home (69.1%). The majority of responders (56.8%) use e-mail every day with 1 in 7 (14.2%) using it at least four times a day. 72.4% stated that they found e-mail useful for communicating with professional bodies, while 41.3% used it to communicate with colleagues about patients and patient referrals. 34.0% found e-mail useful for ordering goods, and supplies and 14.6% were using electronic mail to make patient appointments at least some of the time.

CONCLUSIONS

Responses can be obtained at much greater speed than conventional postal techniques will allow, but response rates were only 53.4%. E-mail is predominately used at home and for inter-professional communications, only a small proportion of responders use it for direct communication with patients.