Aspects of general dental practice in the national health service

Abstract

This paper is concerned with the pattern of care delivered by general dental practitioners in England and Wales under the aegis of the National Health Service. The main feature of the results is the high degree of variability in the extent and content of the workload of individual practitioners. The most important factors include geographical location, sex, age and partnership arrangements. The emphasis given to conservation is highest in regions with the highest per capita proportions of practitioners and vice versa. Female dentists carry out only about three-fifths of the numbers of courses of treatment, fill only about three-fifths of the numbers of permanent teeth and extract only about two-fifths of the numbers of permanent teeth as do their male colleagues of the same age. For male practitioners the average number of courses of treatment reaches a peak in the 35–39 years age-group and subsequently decreases with increasing age. There is a general tendency for the age of the dentist to be positively correlated with the age of his or her patients. Even when this effect is taken into account, there is a marked difference in the content of the workload with the age of the dentist, younger male practitioners giving greater emphasis to conservation than older male practitioners. In all age groups, the emphasis given to conservation tends to decrease as the size of the workload increases. The pattern of care is also associated with partnership arrangements. On average, dentists working in partnerships carry out about ten per cent more courses of treatment than colleagues of the same age and sex working single-handed, and the ratio of permanent teeth filled to permanent teeth extracted tends to be lower in partnerships.