Search

Objective: Since 2013, Revive Dental Care has been operating a community outreach dental service for homeless and 'hard-to-reach' patients. This research aimed to (a) explore the dental care experienced by people accessing the service, (b) examine barriers and facilitators to using a dental service, (c) examine the impact of the service and (d) identify good practice in providing dental services for homeless people., Methods: Semi-structured interviews with 20 patients, nine members of the dental staff and four staff members from the community centres providing services for homeless people., Results: Findings suggest that homeless patients have overall poor daily dental care and experience significant dental problems due to a range of lifestyle factors. Most participants had not seen a dentist for many years and previous experiences of seeing a dentist were often unpleasant. Barriers to care included fear, embarrassment, lack of money, living chaotic lifestyles, not prioritising dental care and difficulties finding an NHS dentist that would take on homeless people. Service provision for homeless and/or hard-to-reach patients needs to be proactive with dental staff going to community settings and making personal contact., Conclusion: Crucially, providers must acknowledge that the patients are vulnerable. A successful service needs to be informal, adapt to patient needs and accommodates chaotic lives.

Introduction: Despite advances in evidence-based dental school educational programmes, the charge is sometimes made that dental students are 'no longer as good as they used to be'. Recent modifications have meant that dental education is now a 'life-long experience', of which dental school is the initial, albeit very important, component. Contemporary dental students will normally enter dental foundation (DF) training on completion of dental school. As such there may be value in including DF trainers in dental school teaching programmes. The aim of this paper is to report the experiences, feedback and opinions of these DF trainers following their first-hand experience of the community-based clinical teaching programme at Cardiff, and assess if their perspectives of contemporary dental student education changed following this., Materials and Methods: DF trainers were invited to attend the community-based clinical teaching programme at Cardiff on an observer basis. Twenty-four DF trainers attended, following which evaluation questionnaires were completed. Information sought included opinions and attitudes to the teaching programme, the physical environment in which the teaching programme took place, knowledge and attitudes towards community-based clinical teaching and modifications that DF trainers would make to the teaching programme to further improve the knowledge, skills and attributes of dental school graduates for DF training., Results: Responses were received from 20 DF trainers (response rate = 83%). All 20 respondents felt that the teaching provided within the community-based clinical teaching programme was appropriate, with one respondent noting that it was like 'a day in the life of a dental practice', 'where anything could present'. Sixteen respondents were satisfied with the scope and content of the community-based clinical teaching programme, with a small number recommending inclusion of teaching in relation to inlays/onlays (n = 2), simple orthodontics (n = 1) and splinting (n = 1). Eighteen respondents reported that they felt students were adequately prepared for entry into DF training. All 20 respondents reported that their visit to the community-based clinical teaching programme had improved their perception of contemporary dental school education with one respondent noting: 'I am certainly more confident about students graduating' and another noting: 'It has reassured me that there are final year dental students that appear very professional and competent'., Conclusions: This investigation has demonstrated there is much to be gained by inclusion of DF trainers in undergraduate dental student community-based clinical teaching programmes. In an era where tensions exist between dental school teaching and subsequent DF training and independent practice, inclusion of DF trainers can exert positive pressures on dental school programmes and on DF training to ensure that young and newly graduating dentists are best prepared to meet the needs of their patients.

Objective: To develop a personal digital assistant (PDA) application for oral health assessment fieldwork, including back-office and database systems (MobilDent)., Design: System design, construction and implementation of PDA, back-office and database systems., Methods: System requirements for MobilDent were collected, analysed and translated into system functions. User interfaces were implemented and system architecture was outlined. MobilDent was based on a platform with. NET (Microsoft) components, using an SQL Server 2005 (Microsoft) for data storage with Windows Mobile (Microsoft) operating system. The PDA devices were Dell Axim., Results: System functions and user interfaces were specified for MobilDent. User interfaces for PDA, back-office and database systems were based on. NET programming. The PDA user interface was based on Windows suitable to a PDA display, whereas the back-office interface was designed for a normal-sized computer screen. A synchronisation module (MS Active Sync, Microsoft) was used to enable download of field data from PDA to the database., Conclusions: MobilDent is a feasible application for oral health assessment fieldwork, and the oral health assessment database may prove a valuable source for care planning, educational and research purposes. Further development of the MobilDent system will include wireless connectivity with download-on-demand technology.

Objective: To achieve consensus within primary dental care on the contents of a clinical minimum data set to measure oral health status., Design: Using the Delphi process a simple random sample of 30 LDCs and 10 CDS services in England were asked to rank a list of existing clinical indicators in order of their perceived importance as a means of measuring oral health. A nominated panel representing the stakeholder organisations of primary dental care reviewed this ranking and identified a core group of clinical indicators to be included in a clinical minimum data set., Results: An 80 percent response rate to the Delphi process was achieved. Consensus was reached on a core group of 10 indicators, which can provide information on patient's perceptions of pain, function and appearance, and professional measurements of caries, teeth present, periodontal disease, oral sepsis, presence of mucosal pathology and tooth wear., Conclusions: A representative sample of primary care dentists in England and the key representative organisations of primary dental care achieved consensus on the contents of a clinical minimum data set to record oral health status in primary dental care. This is a first step in standardising the measurement of oral health status across primary care.

Our objective was to describe the management of oral cancer and pre-cancer as stated by primary care dentists and their views on screening. We conducted a survey of all general dental practitioners and community dentists in Northern Ireland (n = 635), to which 428 replied (response rate: 67%). 94% stated that examination of the oral soft tissues constituted part of their usual practice during the regular dental check-up. Suspicious lesions were generally referred early, 68.5% of dentists referring white lesions within one month of presentation. The corresponding figures for red lesions, lumps and persistent ulcers were 80.1%, 89.7% and 91.7%. The incidence of oral cancer was over-estimated (median '70' cases/year, versus the true figure of approximately 40/year) as, in all likelihood, was the percentage by which mortality could be reduced by screening (median: 50%). Accordingly the adoption of a screening programme was favoured over investment in health promotion. Indeed, only 14% said that their patients records routinely contained information about smoking or alcohol habits. Although there are some areas of practice which could improve and the potential of screening is probably over-valued, primary care dentists in Northern Ireland already opportunistically screen and refer patients promptly.