1
|
Scott H, Cope AL, Wood F, Joseph-Williams N, Karki A, Roberts EM, Lovell-Smith C, Chestnutt IG. A qualitative exploration of decisions about dental recall intervals - Part 1: attitudes of NHS general dental practitioners to NICE guideline CG19 on the interval between oral health reviews. Br Dent J 2022; 232:327-331. [PMID: 35277631 PMCID: PMC8916955 DOI: 10.1038/s41415-022-3998-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022]
Abstract
Introduction The National Institute for Health and Care Excellence (NICE) Guideline CG19 recommends that the intervals between oral health reviews should be tailored to patients' disease risk. However, evidence suggests that most patients still attend at six-monthly intervals.Aim To explore facilitators and barriers to the implementation of CG19 in general dental practice.Methods Semi-structured telephone interviews were conducted with 25 NHS general dental practitioners (GDPs) in Wales, UK. Transcripts were thematically analysed.Results Dentists described integrating information on clinical risk, patients' social and dental history, and professional judgement when making decisions about recall interval. Although most GDPs reported routinely using risk-based recall intervals, a number of barriers exist to recall intervals at the extremes of the NICE recommendations. Many practitioners were unwilling to extend recall intervals to 24 months, even for the lowest-risk patients. Conversely, dentists described how it could be challenging to secure the agreement of high-risk patients to three-month recalls. In addition, time and workload pressures, the need to meet contractual obligations, pressure from contracting organisations and the fear of litigation also influenced the implementation of risk-based recalls.Conclusions Although awareness of the NICE Guideline CG19 was high, there is a need to explore how risk-based recalls may be best supported through contractual mechanisms.
Collapse
Affiliation(s)
- Hannah Scott
- Research Associate, Applied Clinical Research and Public Health, Cardiff University, University Dental Hospital, Heath Park, Cardiff, CF14 4XY, UK
| | - Anwen L Cope
- Honorary Lecturer in Dental Public Health, Applied Clinical Research and Public Health, Cardiff University, University Dental Hospital, Heath Park, Cardiff, CF14 4XY, UK.
| | - Fiona Wood
- Professor of Medical Sociology, Division of Population Medicine, School of Medicine, Cardiff University and PRIME Centre Wales, Heath Park, Cardiff, CF14 4YS, UK
| | - Natalie Joseph-Williams
- Senior Lecturer, Division of Population Medicine, School of Medicine, Cardiff University and PRIME Centre Wales, Heath Park, Cardiff, CF14 4YS, UK
| | - Anup Karki
- Consultant in Dental Public Health, Public Health Wales, Capital Quarter, Cardiff, CF10 4BZ, UK
| | - Emyr M Roberts
- Principal Dentist, The Courtyard Dental Care, Cardiff, UK; Dental Practice Advisor, Cardiff and Vale University Health Board, Woodland House, Cardiff, CF14 4TT, UK
| | | | - Ivor G Chestnutt
- Professor and Honorary Consultant, Dental Public Health, College of Biomedical and Life Sciences, Cardiff University and PRIME Centre Wales, UK; Clinical Director, University Dental Hospital, Cardiff and Vale University Health Board, UK; Director of Postgraduate Studies, School of Dentistry, Cardiff University, University Dental Hospital, Heath Park, Cardiff, CF14 4XY, UK
| |
Collapse
|
2
|
Role of Poor Oral Hygiene in Causation of Oral Cancer-a Review of Literature. Indian J Surg Oncol 2018; 10:184-195. [PMID: 30948897 DOI: 10.1007/s13193-018-0836-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/20/2018] [Indexed: 12/24/2022] Open
Abstract
Oral squamous cell carcinomas (OSCC) are among the commonest cancers in South East Asia and more so in the Indian subcontinent. The role of tobacco and alcohol in the causation of these cancers is well-documented. Poor oral hygiene (POH) is often seen to co-exist in patients with OSCC. However, the role of poor oral hygiene in the etio-pathogenesis of these cancers is controversial. We decided to evaluate the available literature for evaluating the association of POH with OSCC. A thorough literature search of English-language articles in MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Web of Science databases was conducted, and 93 relevant articles were short-listed. We found that POH was strongly associated with oral cancers. It aids the carcinogenic potential of other known carcinogens like tobacco and alcohol. Even on adjusting for known confounding factors like tobacco, alcohol use, education, and socio-economic strata, presence of POH exhibits higher odds of developing oral cancer.
Collapse
|
3
|
Pearce M, Catleugh M. Are general dental practitioners providing best practice in prevention in everyday general practice? Prim Dent J 2014; 2:38-43. [PMID: 24340497 DOI: 10.1308/205016813807440092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIMS To discover whether general dental practitioners are providing best practice in prevention, as defined by the 'Delivering Better Oral Health' toolkit, in everyday general practice. METHOD A questionnaire was created with five scenarios describing the key findings of the examination of five hypothetical patients. Dentists attending a postgraduate meeting were asked to list all the preventive treatment and advice they would give each patient. The content of their answers was compared with the toolkit by two researchers. RESULTS Twenty four dentists completed the questionnaire. In general terms, they did not mention much of the specific advice or recommend the treatment listed in the toolkit except that a significant proportion would apply fluoride varnish to children's teeth and all would give smoking cessation advice where appropriate. Suitable recall intervals, defined by the National Institute for Clinical Excellence, were suggested for three of the scenarios but the advice was inconsistent for the other two scenarios. CONCLUSION This small investigation suggests that dentists' implementation of prevention, as advised by the toolkit, is not thorough or consistent. Comprehensive adoption of prevention in dentistry will require intensive multifaceted education and organisational change such as might be provided by the new contracts being piloted at present.
Collapse
|