Is the dental check-up really necessary?

dental check-up
Should dentists refocus efforts on seeing high-risk children rather than recalling patients for their dental check-up?

We should spend more time seeing high-risk children then recalling low-risk patients, Michael Watson says.

Doctors are beginning to ask if health checks for the over-40s are really necessary and whether they cut the risk of disease.

A new study, by Imperial College London, of 50,000 who turned up for these ‘midlife MoTs’ showed that GPs have to see 4,762 people to prevent only one heart attack or stroke.

In addition those who had the health checks put on only a pound or two less than those who did not have one and they had only tiny reductions in blood pressure and cholesterol levels; they were also no more likely to quit smoking.

Research lead, Professor Azeem Majeed, said: ‘For any individual person the effects are so small that they wouldn’t notice them.’

Six-monthly dental check-up

Does any of this have relevance for dentists, after all we have been getting patients to attend for regular check-ups, and they are incorporated within clinical pathways as oral health assessments.

Around a quarter of UDAs, at a cost of over £500 million, are for band one; so is this money well spent?

The research on dental examinations was done 40 years ago by the late Professor Aubrey Sheiham, who in 1977 published a paper in the Lancet reviewing the evidence for the six-monthly dental check-up.

He concluded that the more dentists looked the more they found; and the more they found the more they did, risking over treatment.

He also concluded that the ritual may well do more harm than good and, although he did not use these words, dentists were looking for business.

Unsurprisingly he was roundly vilified within the profession, but he was largely vindicated by the 2004 NICE report on the frequency of check-ups.

Waste of time?

Responding to the latest research, Dr Clare Gerada, a former chair of the Royal College of GPs, said: ‘GPs have always known these checks were a waste of time that should be spent treating people who are actually sick.’

Should the same argument apply in dentistry?

If we didn’t spend so much time recalling patients with low risk of disease to tell them that their oral health is ok, we might have more time to see high-risk children who may never attend until they are seven and then have traumatic extractions under general anaesthetic.

Comments (2)

The problem is, it’s the “at risk”group who don’t attend, or whose parents can’t be bothered to bring them to the dentist, versus the regular attenders who have good health anyway.
In ireland we havé regular free checks for a portion of the population and until 2010 reduced cost treatment. Now , 6 years on, we are seeing a marked increase in emergency dental care for this group who had access to reduced cost dental care, but abstained from their visits once it was taken away due to government cut backs. This I see happening if check ups are reduced. The dentist should however, be free to recommend frequency of visits similar to hygiene visits, based on risk factors following examination. Basically a clinician should be able to do his job without a bureaucracy of targets and paperwork!

The six monthly check up on the NHS exists for only budget reasons to spread out payments to NHS dentists throughout the year.
However, the public belief it is for clinical reasons and insist on their 6 month check up.

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