Reasons for referral of very elderly patients to the community dental service in rural England and the implications for developing oral health care services.

Abstract

To analyse the medical conditions and dental treatment requirements. Retrospective analysis. Rural South West Surrey, England. 100 patients aged 75 or over who were referred for dental treatment to the Community Dental Services (CDS) because of various medical disabilities. Age, sex, medical history including drug intake, dental treatment provided, time taken for treatment. Two-thirds of the patients required domiciliary care; two-thirds had problems of mental confusion. In addition, 89% were dependent on carers. Treatment requirements indicate that the majority of dental care, although time consuming, were simple in nature and within the technical scope of a competent general dental practitioner (GDP). This study implies that the reasons for referral are other than lack of dental skills and may be due to perceived difficulties in managing patients. Further research is recommended to establish whether aspects of patient management are problematic so that resources, including appropriate training programmes, can be developed to enable a quality service to be provided. In the evolving health care system in the United Kingdom (UK) these issues will need to be considered when developing contracts at a local level.