Abstract

BackgroundDentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners’ views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS.MethodsA cross-sectional postal survey of primary care dentists working across different models of care within London was conducted, with a target to achieve views of at least 5 % of London’s dentists. The questionnaire instrument was informed by qualitative research and the dental literature and piloted prior to distribution; data were analysed using SPSS v19 and STATA v12.0.ResultsSix per cent of London’s primary care dentists (n = 243) responded to the survey; 53 % were male. Just over one third (37 %; n = 90) were aware of the DwSI service being provided. Most practitioners reported that having access to a DwSI in Endodontics would support the care of their patients (89 %; n = 215), would carry out more endodontic treatment in the NHS primary dental care if adequately reimbursed (93 %; n = 220), and had more time (76 %; n = 180). Female respondents appeared to be less confident in doing endodontic treatment (p = 0.001). More recently qualified respondents reported greater need for training/support for performing more endodontic treatment in the NHS primary dental care (p = 0.001), were more dissatisfied with access to endodontic service in the NHS primary dental care (p = 0.007) and more interested to train as a DwSI in endodontics (p = 0.001) compared with respondents having a greater number of years of clinical experience since qualification.ConclusionThe findings lend support to the concept of developing dentists with enhanced skills as well as ensuring additional funding, time and support to facilitate more routine endodontics through the NHS primary care to meet patient needs. More recently qualified dentists working in London were more concerned regarding endodontic service access, expressed need for training/support for undertaking more endodontic treatment in the NHS primary dental care and a desire to train as a DwSI in endodontics.

Highlights

  • Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity

  • The majority of dental service is provided in primary care, mostly in National Health Service (NHS) primary dental care, which operates on a co-payment system, wherein the NHS dentists are remunerated under three bands of ‘units of dental activity (UDAs)’ [6, 7]

  • The questionnaire consisted of a combination of 31 closed and open ended questions exploring primary dental care practitioners’ views regarding the Dentists with Special Interest (DwSI) services in endodontics, their awareness and use of the pilot service, changes required to endodontics services and their personal interests in enhancing the skills

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Summary

Introduction

Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners’ views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS. Primary dental care practitioners are the main providers of dentistry acting as ‘gatekeepers’ to specialist care within England [1,2,3,4]; it is imperative to explore their views on models of care This paper reports their views on a combined educational and service initiative in London, established by the former London Deanery and the National Health Service (NHS), in conjunction with commissioners. Since the introduction of this banded payment system in 2006, the level of endodontic care provided in the primary care sector has reduced [5, 10,11,12], with increased referrals to hospital services [13]

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