Patient history as a predictor of future treatment need? Considerations from a dataset containing over nine million courses of treatment.

Aim It is the aim of this paper to consider whether overall patient treatment history per se and what length of patient history, matters in predicting future treatment need.Methods This study used a data set (SN7024, available from UKDataService), consisting of treatment records for General Dental Services' (GDS) patients, this being obtained from all items of service payment records for patients treated in the GDS of England and Wales between 1990 and 2006. For the purpose of this study, the GDS dataset for patients attending in 2003 was restricted to adult patients (aged 18 or over on 31 December 1990; that is, year of birth earlier than 1973) who attended in both two-year periods 1991/2 and 2004/5. Each course of treatment was classified as 'active' (eg restoration, extraction, prosthesis) or 'not active' (eg prevention, diagnosis). Treatment costs for 2001-2005 (outcome), 2000 (one-year history), 1999-2000 (two-year history) and so on until 1991-2000 (ten-year history) were determined, and history and outcome correlated.Results A total of 455,844 patients met the inclusion criteria, namely adults with a full history. They received 9,341,583 courses of treatment, of which 49% were classified as 'active' and 51% as 'not active'. The analysis indicated that both total costs and active treatment costs are positively correlated with their historical values, with the correlation coefficients increasing from 0.24 and 0.25 with one year of history to 0.42 and 0.44 with ten years of history. Overall, therefore, future treatment cost is correlated with past treatment costs.Conclusions Treatment history may provide an important correlate of future dental treatment needs and the more history the better, at least up to five years. However, active treatment is the important component and should be distinguished from preventive and diagnostic treatments.

Technique Tips--The Cost of One Post-Operative Sensitivity following Placement of a Posterior Composite Restoration.

Use a low shrinkage stress composite but, if not, use incremental placement and a layer of flowable at the gingival box; Ensure good bonding to dentine and enamel and avoid (over) etching the dentine; Ensure good adaptation at the gingival floor of a Class II box; Make sure that the restoration has received sufficient light; Provide good isolation; Use reliable and tested materials throughout.

The evidence base for 'own label' resin-based dental restoratives.

UNLABELLED: There is anecdotal evidence that sales of 'own-label' (OL) or 'private label' dental products is increasing, as dentists become more cost conscious in times of economic downturn. However, the purchase of such (less expensive) products could be a false economy if their performance falls below accepted standards. So, while the examination of a resin-based product under research conditions alone may not guarantee success, it could be considered that a material which has been subjected to testing under research conditions will demonstrate its effectiveness under laboratory conditions or reveal its shortcomings; either of these being better than the material not being examined in any way. It was therefore considered appropriate to determine the materials on which research was carried out, with particular reference to OL brands. OBJECTIVE: To determine whether there is a research base behind OL resin-based restorative dental materials.

Mouthwatering but erosive? A preliminary assessment of the acidity of a basic sauce used in many Indian dishes.

UNLABELLED: The aim of this study was to assess whether some types of Indian cuisine may contain erosive components. Indian dishes were prepared by a previously published method and their pH measured using a pH probe. The results indicated: (i) that some components of Indian cooking, such as tomatoes and red chilli powder, had the potential to erode enamel; (ii) that the pH of some foods was reduced with increasing temperature; and (iii) that all the basic masalas made and tested had a pH of less than 4.5. Within the limitations of the study, it may be concluded that the basic sauce/masala used in north Indian dishes may have erosive potential. CLINICAL RELEVANCE: This information could be considered useful when advising patients who eat Indian curries about causes of acid erosion of their teeth.