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At least 19 recordsLinked to original sources
PubMed1993

Quality assurance in medicine: a dental audit system.

Two principal components of a quality assurance system for dental plans are described, using a case report to illustrate the methodology. Criteria of acceptable quality of patient care for general practice were developed first. Then plan, practice and patient profiles, derived from claims or encounter data, were used to identify the nature and extent of aberrant patterns which were uncovered. Based on analysis of the profiles, site visits were made to a targeted sample of practices and selected patient dental records were evaluated for various levels of the process of care. Categories were rated as either acceptable or unacceptable. Principal dentists were debriefed on the findings and a report including corrective action plans prepared for the responsible agency. Follow-up to monitor compliance is planned. Although aberrant profiles do not necessarily mean that care is unacceptable, the findings from the record review confirmed the concerns raised by the data analysis.

Capitation Fee↗
PubMed1997

A simple technique for data management in general dental practice audit.

General practice audit is essential in the process of developing an evidence-based approach to dental care. The CHAID (CHi-Squared Automatic Interaction Detector) statistical software package is both practical and user-friendly for many simple applications. The types of questions asked in general practice audit projects will frequently be suitable for analysis using this technique. This may include the identification of patients who are likely to fail appointments and place an additional financial burden on the practice. This paper illustrates the potential value of CHAID to general dental practitioners (GDPs) by using examples of commonly cited dental audit topics. This paper aims to illustrate how a simple statistical package (SPSS CHAID) may be of use for both audit and practice management activities.

Appointments and Schedules↗
PubMed1998

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.

Age Factors↗
PubMed1998

An audit of oral and dental health regimens practised in the management of oropharyngeal cancer.

The purpose of the present study was to find out what preventive care was offered to patients after radiotherapy, particularly if they were dentate. As the mean age of the population increases and the number of people who retain at least some of their teeth into old age also rises, it is likely that more and more people with a diagnosis of oral cancer will be dentate. The incidence of oropharyngeal cancer has also started to increase recently and is affecting more young and dentate people. It is of paramount importance to provide comprehensive management for these patients, not only to remove the disease and reconstruct the defect, but also to provide the patient with the opportunity of experiencing a good quality of life by having a comfortable mouth after treatment. A questionnaire was sent to all senior fellows of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and the results analyzed. The results of this survey show that improvements could be made if some simple preventive measures were instigated in the early stages of treatment.

Age Factors↗
PubMed2001

An audit of general dental practitioners' referral practice following the distribution of third molar guidelines.

Oral and maxillofacial surgery waiting lists are amongst the longest of any surgical specialty. The majority of patients on these waiting lists have been referred for removal of their third molars (wisdom teeth). With increasing pressure to reduce the size of both out-patient and surgical waiting lists, it is important to ensure that only those patients with a recognised clinical need are referred and accepted for treatment. In April 1998, local general dental practitioners were issued guidelines for the management of patients with impacted third molars. This paper describes an audit that assessed the impact of this intervention. The results suggest that referral guidelines are an effective means of changing general dental practitioners' referral practice and that, used along with other strategies, could be effective in reducing oral and maxillofacial surgery out-patient and surgical waiting lists.

Communication↗
PubMed2000

The reduction of broken appointments in general dental practice: an audit and intervention approach.

PURPOSE OF STUDY: Accumulation of time lost because of broken appointments in general dental practice can lead to an inefficiently-run practice and may also lead to reduced financial income. This study assessed the reasons for patients failing to attend and analysed the effect of two simple interventions in reducing the numbers of broken appointments. BASIC PROCEDURES: This study audited the causes of broken appointments in a Glasgow dental practice over a four-month period and, in a second four-month period, analysed the effect of using two new methods of patient information in reducing the number of broken appointments in two target groups of the practice population. MAIN FINDINGS: The majority of patients failing to attend for dental treatment were unemployed. Simple changes to recall letters and appointment cards significantly reduced the rates of failed appointments in patients attending the practice. PRINCIPAL CONCLUSIONS: Simple modification to existing practice systems (recall letters and appointment cards) led to a statistically significant reduction in the number of broken appointments.

Appointments and Schedules↗
PubMed1997

An audit of antibiotic prescribing in general dental practice.

Clinical audit is widely recognised as the systematic and critical analysis of the quality of clinical care, including treatment regimes, the associated use of resources, and the resulting outcome and quality of life for the patient. The prescribing of antibiotics in general dental practice is an area 'wide open' for audit analysis since the profession must clearly accept its responsibility to use antibiotics sensibly; however, the definition of 'sensibly' is likely to vary from practitioner to practitioner. This audit reviews the need for antibiotic prescribing in general dental practice over two consecutive four-month periods. A consensus was achieved on the rationale for antibiotic prescribing and the number of prescriptions fell by 50% as a result.

Anti-Bacterial Agents↗
PubMed2006

An audit of single drug (propofol) dental general anaesthesia in children.

AIM: The aim of this study was to evaluate and describe the (dis)advantages of intravenous single drug anaesthesia (IVA) using the target- controlled infusion of propofol in order to validate a protocol. The treatments were performed in two secondary dental care clinics in Amsterdam. METHODS: Retrospective study of the anaesthetic reports and medical history of 950 patients treated were screened for any irregularities and medical problems. RESULTS: Most children treated were in the age group 2-5 years, time needed to wake up decreased significantly with age. Fourteen children dropped out of the planned IVA treatment because of medical reasons, 12 of whom were treated under general anaesthesia (GA). A further 26 were treated under GA because of convenience reasons. Total number of medical problems prior to treatment was 45 and mild complications were 42. CONCLUSIONS: There was a low morbidity in patients treated. The method seems to be successful in young children and creates an increase of treatment capacity in the field of special dental care. Preoperative screening is necessary, on paper and after consultation of a specialist. However blood test screening for allergies seem to be questionable. The treatment method is not possible without the presence of the anaesthesiologist and his team.

Anesthesia, Dental↗
PubMed2006

An inhalation sedation patient profile at a specialist paediatric dentistry unit: a retrospective survey.

AIM: To report on the characteristics, treatment, attendance, scheduling and duration of treatment sessions of child patients attending a specialist paediatric dental hospital service for inhalation sedation. METHODS: A retrospective study was carried out of all 88 patient case notes of inhalation sedation recipients between September 2004 and March 2005. The recorded data included: child's age, gender and level of social deprivation together with the details of the treatment that was undertaken, the time between the first and current/last sedation appointment and the total number of appointments attended, cancelled and missed. RESULTS: Twenty of the subjects were excluded giving a sample of 68; 51% male, mean age at start of treatment 9.8 years (range 4 to 15) and mean age at end of treatment 10.6 years (range 4 to 16). Of these children 35 (51%) were socially deprived. In respect to treatment, 29% had extractions, 22% endodontics, 81% restorations and 25% fissure sealants. In respect to the number of quadrants that had teeth requiring treatment; 26.5% had one, 25% two, 22% three and 26.5% four. The mean number of treatment sessions required was 4.4 with a mean duration between first and last appointments of 9.5 months (range 0.25 051). There were 27% of appointments cancelled, while 12% of patients failed to keep their appointments. CONCLUSIONS: Although over half of the children treated under inhalation sedation came from socially deprived areas, attendance was reasonable and the majority required less than 5 appointments for treatment completion. The treatment provided was variable not only in respect to the procedures but also to the number of quadrants treated.

Adolescent↗
PubMed1998

UK National Third Molar project: the initial report.

The National Third Molar (NTM) project was set up to assess current clinical practice in the UK concerning the management of third molar teeth. Patients were recruited from both hospital and general dental practice. During the one month study period 9248 patients with 26,577 third molars were recruited. In this report we present the findings in the 8298 patients with 25,001 third molars who were referred to hospital for assessment. Over half of all patients referred for assessment had either no extractions or a single third molar extracted. Less than a quarter of all patients referred underwent removal of all four third molars. Twenty per cent of all third molars assessed were not extracted. Of all lower third molars listed for extraction, 9574 (78%) were associated with symptoms or disease. Pericoronitis was the commonest indication for extraction and was cited in 39.5% of all extractions. Almost 70% of third molar extractions were done under general anaesthesia while less than a quarter were performed under local anaesthesia alone.

Adult↗