Do Antibiotics Decrease the Risk of Inflammatory Complications After Third Molar Removal in Community Practices?

PURPOSE: The role of antibiotic use in third molar (M3) surgery is controversial. The purpose of this study was to measure the association between antibiotic use and postoperative inflammatory complications after M3 surgery in the community office-based ambulatory private practice setting. MATERIALS AND METHODS: The authors designed and implemented a prospective cohort study and enrolled a sample composed of patients who had at least one M3 removed in a private practice setting by oral and maxillofacial surgeons participating in a practice-based research collaborative from June 2011 through May 2012. The predictor variable was antibiotic use of any type, categorized as yes or no. The primary outcome variable was the presence or absence of an inflammatory complication, specifically surgical site infection (SSI) or alveolar osteitis (AO), after M3 removal. Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between antibiotic use and inflammatory complications after M3 removal, with statistical significance set at a P value less than or equal to .05. RESULTS: The study sample was composed of 2,954 patients. Three fourths (75.2%) of the sample received antibiotics in some form. The overall inflammatory complication (AO or SSI) frequencies in the antibiotic and nonantibiotic groups were 5.0 and 7.5%, respectively (P = .012). After adjusting for differences between the two groups, statistical significance between the groups persisted. CONCLUSIONS: The results of this study suggest that antibiotic therapy, regardless of type, dose, frequency, or pattern of delivery, is associated with a decreased risk of inflammatory complications after M3 removal.

Health literacy environmental scans of community-based dental clinics in Maryland.

OBJECTIVES: We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education. METHODS: In 2011-2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques. RESULTS: Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques. CONCLUSIONS: Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate.

The influence of reflection on portfolio learning in undergraduate dental education.

INTRODUCTION: Disparity exists between the growing consensus about the positive effects of reflection on performance and the scarcity of empirical evidence demonstrating this effect. Portfolios are considered a useful instrument to assess and supervise competence-based education and to stimulate reflection. The present study describes the introduction of a portfolio in a social dentistry and oral health promotion course and investigates student reflection as a predictor for the acquisition of the other competences in the course. METHODS: Fourth year undergraduate dental students (n = 110) in the course 'Society and Health' between 2008 and 2011 collected evidence in their portfolios, demonstrating the acquisition of five competences: the ability to (1) assess the oral health profile of a target group; (2) integrate theoretical models in health promotion; (3) search for and apply scientific evidence; (4) work trans-, multi- and/or trans-disciplinarily; (5) reflect on personal development. Linear regression analysis was used to investigate the predictive value of reflection on the other course related competences. RESULTS: Reflection scores proved to significantly predict other course-related competences, when analysing all students between 2008 and 2011 and for each year separately, explaining between 10.7% and 25.5% of the variance in the other competences. CONCLUSION: Undergraduate dental students' competences related to social dentistry and oral health promotion were significantly predicted by the reflection scores obtained in a portfolio-based context. In line with the growing consensus about the benefits of reflection for dental students and professionals, results suggest the value to further develop the integration of reflection in dental education and practice.

Camera-related behaviours of female dental nurses and nursery school children during fluoride varnish application interactions in nursery school settings.

OBJECTIVE: To investigate camera awareness of female dental nurses and nursery school children as the frequency of camera-related behaviours observed during fluoride varnish applications in a community based health programme. METHODS: Fifty-one nurse-child interactions (three nurse pairs and 51 children) were video recorded when Childsmile nurses were applying fluoride varnish onto the teeth of children in nursery school settings. Using a pre-developed coding scheme, nurse and child verbal and nonverbal behaviours were coded for camera-related behaviours. RESULTS: On 15 of 51 interactions (29.4%), a total of 31 camera-related behaviours were observed for dental nurses (14 instances over nine interactions) and children (17 instances over six interactions). Camera-related behaviours occurred infrequently, occupied 0.3% of the total interaction time and displayed at all stages of the dental procedure, though tended to peak at initial stages. CONCLUSIONS: Certain camera-related behaviours of female dental nurses and nursery school children were observed in their interactions when introducing a dental health preventive intervention. Since the frequency of camera-related behaviours are so few they are of little consequence when video-recording adults and children undertaking dental procedures.

Opportunities and challenges to promoting oral health in primary schools.

UNLABELLED: Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children's health and oral health. However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. METHODS: A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. RESULTS: General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes wereimplemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. CONCLUSION: This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools. The paper also makes recommendations for further research.

Dental general anaesthesia--will the service disappear? A pilot study.

OBJECTIVES: To identify likely future trends in recruitment of consultant anaesthetists to the ambulatory dental general anaesthetic (DGA) services. PARTICIPANTS: The sample consisted of all anaesthetic specialist registrars (SpRs) in their final year of training, within Mersey and South-Western Deaneries in the U.K. RESEARCH DESIGN: A questionnaire divided into a quantitative section to establish level of training in ambulatory DGA, and a qualitative section designed to elicit opinions and attitudes towards ambulatory DGA services. RESULTS: The response rate was 75% (27/36). Within both regions 81% (22/27) had received practical training in ambulatory DGA procedures. SpRs in the South-Western Deanery held the greatest misgivings about the ambulatory DGA technique. Once appointed to Consultant position only 11% (3/27) of respondents expressed a definite interest in providing ambulatory DGA services. CONCLUSIONS: Within the Northwest and Southwest of England, most specialist registrars in anaesthetics receive training in ambulatory DGA, although their future commitment to the delivery of these services is questionable.

Comparación del desempeño técnico-asistencial en programas escolares con diferentes modalidades de implementación / Comparison of technical-assisstance performance in school programs with different implementation modalities

Se comparó el desempeño técnico-asistencial de 2 programas de atención odontológica con iguales protocolos de atención y diferente modalidad de implementación. Ambos programas se caracterizaron por un perfil preventivo-promocional; uso de protocolos validados según riesgo biológico, atención odontológica adaptada a sedes no convencionales, recursos asignados por método de necesidades; ejecución por recurso humano pre-profesional supervisado y modulación por altas. La modalidad de implementación difirió en la densidad/concentración de las actividades realizadas: en el Programa Extensivo (PE) las acciones se implementaron con frecuencia semanal; en el Programa Intensivo (PI) las acciones se concentraron en una semana en el año. Cobertura anual: PE = 120 escolares de 6 a 9 años de edad; PI = 180 escolares y preescolares de 3 a 12 años de edad. Se midió la cantidad de prestaciones, sesiones y tiempo -en minutos- hasta alcanzar el Alta Básica Operativa (ABO). Para comparar grupos (PI y PE) se utilizaron los tests: U de Mann Whitney, t de Student para mues-tras independientes, chi cuadrado y comparación de proporciones. La razón de prestaciones/sesión fue significativamente mayor (p=0,000) en el programa intensivo. El número de prestaciones hasta el alta (ABO) y la razón tiempo/sesión no mostraron diferencias entre programas (p=0,8 p=0,087), mientras que se evidenció una mayor razón tiempo/prestación y tiempo en alcanzar el alta (ABO) en la modalidad extensiva (p=0,000). La modalidad intensiva mostró mayor eficiencia en el desempeño técnico asistencial que la extensiva (AU)

Aim: To compare technical-care performance of 2 dental care programs with the same care protocols and different implementation modalities. Both programs shared the following features: preventive-promotional profile; use of validated clinical protocols according to biological risk, dental care adapted to non-conventional settings, allocation of resources by needs method; supervised pre-professional human resource and modulation by discharges. The implementation mode differed in the density/concentration of the activities: in the extensive program (EP) the actions were implemented on a weekly basis along the year; in the intensive program (IP) the actions were concentrated in one week in the year. Annual coverage of the programs: 180 schoolchildren and preschoolers (3 -12 years old); EP = 120 schoolchildren (6 - 9 years old). We measured the following variables: the number of dental services performed, the number of sessions and the time, in minutes, to reach the basic operating discharge (BOD). We used the following tests to compare groups (IP and EP): Mann Whitney U; Student's t for independent samples, chi square and comparison of proportions test. The action per session ratio was significantly higher (p=0.000) in the intensive program. The number of actions performed until discharge (BOD) and the time per session ratio did not show differences between programs (p=0.8 p=0.087). In the extensive mode, compared to intensive mode, it took longer to reach discharge (BOD) (p=0.000) The program implemented with intensive modality (PI) showed greater efficiency regarding technical-care performance when compared to the extensive mode (AU)

Utilización de servicios de salud por la población de cuatro consultorios del médico de la familia / Use of health services by the population of four family doctor's offices

Introducción: La utilización de los servicios de salud es un proceso social, dinámico y complejo. Objetivo: Describir la utilización de los servicios de salud por la población de cuatro consultorios del médico y la enfermera de la familia. Métodos: Estudio descriptivo de corte transversal entre los meses de enero de 2019 a enero de 2020. Se aplicó una encuesta a 775 personas de 18 años y más. Los datos se procesaron con el paquete estadístico SPSS versión 20.0 para Windows. Se utilizaron estadísticas descriptivas, expresando los resultados en tablas de distribución de frecuencias. Resultados: El rango de edades de mayor representatividad fue el de 70-74. El sexo femenino representó el 10,2 por ciento (46) y el masculino el 12,7 por ciento (41). En relación con la iniciativa para solicitar actividades de promoción y prevención, las más solicitadas fueron toma de tensión arterial, chequeo médico y peso corporal. La solicitud habitual de receta médica (706; 87,3 por ciento) se realiza al médico del consultorio. El lugar a donde se dirige el paciente, fundamentalmente, en caso de necesitar atención médica no urgente es al consultorio médico de la familia (650; 83,9 por ciento). Los lugares a donde se dirige, esencialmente, en caso de necesitar atención médica urgente son al cuerpo de guardia del hospital (520; 67,5 por ciento) y al cuerpo de guardia del policlínico (208; 27,0 por ciento). Conclusiones: La población de los cuatro consultorios estudiados utiliza los servicios en los diferentes niveles según el problema de salud que necesita resolver. Sería importante poder identificar en otras investigaciones por qué las actividades menos solicitadas son el tacto rectal, el antígeno prostático y el examen físico de mama, en aras de trazar estrategias que permitan incrementar el empoderamiento para la salud individual(AU)

Introduction: The use of health services is a social, dynamic and complex process. Objective: Describe the use of health services by the population of four family doctor and nurse's offices. Methods: Descriptive cross-sectional study carried out from January 2019 to January 2020. A survey was applied to 775 people of 18 years and older. The data was processed using the SPSS statistical package version 20.0 for Windows. Descriptive statistics were used, expressing the results in frequency distribution tables. Results: The age range of greatest representativeness was 70-74. The female sex represented 10.2percent (46) and the male sex was 12.7percent (41). In relation to the initiative to request promotion and prevention activities, the most requested were blood pressure testing, medical check-up and body weight. The usual request of prescriptions (706; 87.3percent) is made to the doctor in the office. The place where the patient goes, fundamentally, in case of needing non-urgent medical attention is to the family doctor's office (650; 83.9percent). The places where the patient goes, essentially, in case of needing urgent medical attention are the emergeny service in the hospital (520; 67.5percent) and the emergency service of the polyclinic (208; 27.0percent). Conclusions: The population of the four family doctor's office studied uses the services at different levels according to the health problem they need to solve. It would be important to be able to identify in other research why the least requested activities are digital rectal examination, prostate antigen and breast physical examination, in order to draw strategies that allow increasing empowerment for individual health(AU)

Evaluation of a community dental service for homeless and 'hard to reach' people.

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.

The origins and design of the Dental Pipeline program.

Funded by The Robert Wood Johnson Foundation and the California Endowment and with student financial aid from the W.K. Kellogg Foundation, the primary goal of the Pipeline, Profession, and Practice: Community-Based Dental Education program is to reduce disparities in access to dental care. In a national competition, fifteen dental schools were selected to participate. By the final year (2007) of the five-year project, the schools are expected to achieve three objectives: 1) increase the time (sixty days/year) that senior students and residents spend in patient-centered community clinics and practices treating underserved populations; 2) provide didactic and clinical courses for students and residents that prepare them for their community experiences; and 3) recruit more underrepresented minority and low-income students. The national program office that directs the project is located at Columbia University, and a national advisory committee oversees the program for the sponsoring organizations. The challenge is to demonstrate that the Pipeline objectives are achievable and that the program is sustainable without external support.

Pipeline, profession, and practice program: evaluating change in dental education.

This article describes the conceptual and analytical framework that will be used to assess the effectiveness of the Pipeline, Profession, and Practice: Community-Based Dental Education Program. The evaluation will use a mixed method qualitative and quantitative data collection, analysis, and triangulation. Baseline measures are reported using data from the 2003 ADEA survey of dental school seniors. Baseline measures show the dental schools are confronting a major recruitment challenge that will require short and long pipeline efforts to attract and retain underrepresented and low-income (URM/LI) persons. Gaps were found between the perceptions of URM and non-URM students in the adequacy of the curricula. The majority of all seniors described the current extramural clinical rotations as positive experiences, but URMs were more likely to report the experience improved their ability to care for diverse groups.

Intervención comunitaria en salud bucal en la población de San Pablo de Pillao, Perú, 2018 / Community oral health intervention in the population of San Pablo de Pillao, Peru, 2018

RESUMEN Introducción. Las intervenciones comunitarias permiten promover la salud y prevenir enfermedades en el poblador. Objetivo. Describir los diagnósticos y tratamientos realizados por estudiantes de odontología en el Campamento Universitario Multidisciplinario de Investigación y Servicio. Métodos. Se diseñó un estudio epidemiológico, con el enfoque cuantitativo en el distrito de San Pablo de Pillao, provincia Huánuco, Perú. Participaron docentes y estudiantes de la Facultad de Medicina, Humana, Odontología, Nutrición y Psicología. De un total de 250 asistentes a las sesiones, 95 adultos fueron atendidos en la consulta odontológica. Se realizaron sesiones educativas referidas a "anemia y desnutrición", "enfermedades diarreicas", "infecciones respiratorias", "alcoholismo y violencia", "crecimiento y desarrollo", "lactancia materna" y "salud bucal", así como una campaña de diagnóstico y tratamiento de efecciones bucodentales. Se utilizó el programa Excel para el análisis de datos. Resultados. Se atendieron 95 pobladores adultos. El 6,3 por ciento correspondió a edéntulos totales y el 40 por ciento a edéntulos parciales. De los dentados, el 97,3 por ciento presentó caries dental con un promedio de índice CPOD (suma de los dientes cariados + dientes perdidos + dientes obturados, en la dentición pemanente) de 2,08 ± 1,56. Con respecto al estado periodontal, el 38,9 por ciento presentó inflamación gingival severa. En los adultos se realizó 35 restauraciones, 28 exodoncia y 8 ajustes de prótesis. En adultos y niños se realizaron fluorizaciones y cinco actividades educativas de promoción de la salud. Conclusiones. La presencia de caries y enfermedad gingival fue altamente prevalente; las principales actividades terapéuticas realizadas en el campamento fueron las restauraciones y exodoncia(AU)

ABSTRACT Introduction: Community interventions make it possible to promote health and prevent disease in the population. Objective: Describe the diagnoses and treatments made by dental students at the Multidisciplinary Research and Service University Camp. Methods: A qualitative epidemiological study was designed for the district of San Pablo de Pillao, Huánuco province, Peru. The participants were teachers and students from the School of Human Medicine, Dentistry, Nutrition and Psychology. Of the total 250 subjects attending the sessions, 95 adults were cared for at the dental service. The educational sessions conducted dealt with the topics of "anemia and malnutrition", "diarrheal diseases", "respiratory infections", "alcoholism and violence", "growth and development", "breastfeeding" and "oral health", as well as a campaign about diagnosis and treatment of oral disorders. Data analysis was performed on Microsoft Excel. Results: Of the total 95 adult residents cared for, 6.3 percent were totally edentulous and 40 percent were partially edentulous. Of the dentate subjects, 97.3 percent had dental caries with a mean DLRP index (sum total of decayed + lost + restored permanent teeth) of 2.08 ± 1.56. As to periodontal status, 38.9 percent had severe gingival inflammation. A total 35 restorations, 28 exodontias and 8 prosthesis adjustments were performed on adult patients. Adults and children alike received fluoridation and attended five educational health promotion sessions. Conclusions: Dental caries and gingival disease were highly prevalent. The main therapeutic actions performed in the camp were restorations and exodontia(AU)

Risk perception of oral cancer in smokers attending primary care: a randomised controlled trial.

To encourage the public to attend and accept oral cancer screening, further understanding is required of the ability of structured information to alter patient knowledge and risk perceptions. Previous work has shown the benefit of written information for those at high risk of oral cancer, especially for tobacco smokers. This study investigated three hypotheses: first that a patient information leaflet (PIL) would enhance risk perceptions, and second that the effect of the leaflet on knowledge would be confirmed as in previous studies and third that these improvements would be associated with smoking behaviour. Patients (N = 995) attending 20 general dental practices in Northern Ireland were invited to participate, 28 refused (response rate = 97%). Patients were randomised into two groups. The experimental group received a PIL and then completed a self-report questionnaire, whereas the control group followed same procedure without the PIL. Measures included a 36 item oral cancer knowledge scale and two items to assess risk perception. Usable data were available from 944 patients; mean (SD) age = 42 (15), 65% female. Risk perceptions of oral cancer were minimally effected by the PIL (p = 0.023). This effect was demonstrable in smokers. Smokers were sixteen (95% CI: 8-30) times more likely to believe that they were at greater risk of oral cancer than non-smokers. A clear benefit of the PIL on patients' oral cancer knowledge was found, particularly for smokers and those with a history of smoking. These findings demonstrate that public awareness of smokers can be raised with written information although health beliefs such as risk perceptions require more intensive intervention.

Implementing a community-based oral health care program: lessons learned.

OBJECTIVES: The objective of this paper is to report key findings of a process evaluation that may be useful to other institutions seeking to implement a community-based oral health care program primarily targeting children in dentally underserved communities. By partnering with community-based organizations, public schools, and community health care providers, the Columbia University School of Oral and Dental Surgery (SDOS) established the Community DentCare Network (DentCare) in the Harlem and Washington Heights/Inwood neighborhoods of northern Manhattan. These low-income neighborhoods are characterized by poor oral health and have been designated by the federal government as health professions shortage areas. METHODS: The method used in the process evaluation was open-ended qualitative interviewing by a sociologist with extensive experience in this methodology aided by a participant-observer within the DentCare program. RESULTS: The heterogeneity of the two communities required different strategies and resources to gain trust and acceptance. Fundamental changes were required of SDOS over a 10-year period, beginning with prioritizing community service into a primary mission. Collaborating with medical clinics facilitated the implementation of the network when the partners shared the same philosophical goals. Faculty and staff with different skills were needed during the start-up and the sustained development phases of the program.

Community-based sealant programs in the United States: results of a survey.

The appropriate use of pit and fissure sealants could reduce substantially the majority of occlusal caries among US school-aged children. The 1986-87 national oral health survey conducted by the NIDR showed that less than 8 percent of the children 5-17 years of age had sealants on their teeth. The purpose of this national study was to document the current status of community-based sealant programs and to identify general program characteristics. Data were gathered through a mail survey to all state dental directors and site visits to four selected comprehensive community-based programs. Twenty-nine states were currently conducting sealant programs. The vast majority of these programs had formal quality assurance systems and companion health education components. Eight states indicated that sealant programs had been terminated within the last two years. Medicaid reimbursement for sealants was available in 42 states, with a mean reimbursement rate of $10.71 per sealant. Reimbursement rates ranged from $3.00-$20.00 per sealant. State practice acts almost uniformly permitted the placement of sealants by dental hygienists (n = 48), but less frequently by dental assistants (n = 15). Approximately 43 percent of state practice acts did not require a dentist to be present physically when auxiliaries place sealants in public/community sealant programs. All respondents indicated that there was a need for additional programs in their state. No structural factors--for example, level of Medicaid reimbursement for sealants or state practice act requirements for auxiliary supervision--were found to be associated with the presence of community-based sealant programs. Nationally, only a small percentage of children appeared to be receiving sealants in community programs.

University of Alberta dental students' outreach clinical experience: an evaluation of the program.

In a 25-year-old satellite dental program, advanced dentistry and dental hygiene students provide highly supervised dental treatment for patients in government-funded clinics in 3 under-serviced communities in northern Alberta. Analysis of the performance data of the 2003 University of Alberta dentistry students in their fourth and final year was used to evaluate this program. The data showed that the undergraduate students did numerous diverse general dental procedures during the 2-week rotation, most of which were basic treatments. Students could participate in the program up to 3 times. In subsequent rotations, students tended to do fewer preventive measures, and more restorative treatment and dental extractions. Available grading data for all students indicated that treatment objectives were fulfilled in the vast majority of cases. Such community-based field experience may significantly add to the competence of students entering private practice.

Oral health promotion for high-risk children: case studies from British Columbia.

Socio-economics, family stress and parenting style each plays as important a role in the development of early childhood caries as dietary and microbiological factors. Therefore, to be successful, oral health promotion initiatives should be designed and implemented with due consideration of issues such as collaboration with community partners, the role of dental health in overall child health and the involvement of the community in program planning. This article briefly describes 3 programs that have been undertaken in British Columbia either as public health initiatives or as demonstration research projects to improve oral health in young children from diverse communities with a high prevalence of early childhood caries.

A clinical minimum data set for primary dental care.

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.

Prevention and detection of oral cancer: the views of primary care dentists in Northern Ireland.

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.