Nice deal for patients?

For many years now patients have been familiar with the dental mantra ‘visit your dentist every six months’. Many practices still send patients six-monthly recalls, a service many have come to rely on. In some cases, where practices have decided to discontinue this service because they are too busy to offer appointments on such a regular basis, patients have asked why they have not been recalled.

In October 2004, the NHS National Institute for Health and Clinical Excellence (NICE) set guidelines for dentists on the frequency with which they should review their patients’ dental health, which challenged the ‘one size fits all’ approach to maintaining oral care.

With the changes in NHS dentistry introduced in April 2006 starting to affect patients, some receptionists have found the need to spend time with patients explaining how the new system works. They have needed to go through the changes in registration and charges, and needed to reinforce messages given by the dentist about their recommendations for the interval each patient should leave between check-ups.

When talking to receptionists, the British Dental Receptionists Association (BDRA) frequently finds they are not as fully informed as they would like to be about any changes happening in dentistry.

In particular we find that receptionists are not aware of the NICE guidelines and are therefore not in a position to set patients’ minds at rest if they feel they are not receiving the same standard of care when offered extended intervals between appointments.

For this reason the BDRA has produced a dental health review fact sheet setting out the following information:

• The NICE dental recall guidelines are a tool for dentists to define the optimum recall interval for individual patients

• The recommendations apply to patients of all ages (with and without natural teeth) receiving NHS primary dental care in England and Wales

• The guidance takes into account the potential of the patient and the dental team to maintain the patient’s quality of life, as well as their wellbeing associated with oral health and dental diseases.

The guidance reinforces the fact that an oral review takes into account much more about the condition of any teeth present in the patient’s mouth at the time of examination.

In fact the review also checks for indicators of general health conditions, preventive habits and periodontal health.

The whole of the dental team, working together, should establish the following information in order for the dentist to make recommendations for the frequency of each patient’s dental health reviews:

• Medical history

• Social history – intake of alcohol and tobacco and

family dental trends

• Dietary habits

• Exposure to fluoride

• Dental history

• Periodontal history

• Oral mucosa – presence of any lesions

• Plague control – levels of oral hygiene

• Saliva flow rate

• Erosion and tooth wear.

Once all of these factors have been considered, the dental team will then start to tailor care routines in order to optimise patients’ oral health.

Patients will then be advised on how often they should attend their routine oral assessments, which could be anything from every 3 to 24 months.

There is therefore a world of difference between the dental check-ups of the past and the oral health reviews that today’s dental patients receive.

It is vitally important that reception staff are kept informed of these differences, so they too can play a

meaningful part in helping patients to achieve and

maintain the best possible standards of oral care.

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