Introduction
Comment
With the advent of clinical governance, audit, and the personal dental service, never has it been more necessary to establish a reliable means for defining and measuring changes in oral health. This paper sets out to define criteria by which these may be assessed, with the ultimate goal of promoting excellence in dental care delivery attained.
This study strives to establish a minimum set of indicators which may be recorded easily and accurately at the chairside, and incorporated into a modern clinical computer system to record and quantify oral health, and changes brought about over time. These principles are designed to be relevant to all branches of the profession, both NHS and private within the UK. For acceptance it was recognised that consensus and ease of application were paramount.
Clinicians working in all branches of primary care were asked to review and rank in order of importance a number of clinical indicators of oral health drawn from a number of established data sets in use both in the UK and in the rest of Europe. The clinicians drawn from the GDS, PDS and CDS ranked the importance of the indicators on a scale of 1 (low priority) to 9 (high priority). Using the Delphi process some indicators were promoted in importance and others demoted until consensus was achieved. From this it was possible to agree a core group of indicators and guidelines for the clinical recording of these indicators.
From the 38 clinical indicators derived from the review of existing data sets, a final set of 10 'core indicators' and 27 'additional indicators' were established, which could be used to measure the oral health of the nation. It was also agreed that these indicators should be reviewed periodically and amended to fit changes within the population.
It was felt that this could prove to be the first step in standardising the measurement of oral health in primary dental care. The agreed CMDS therefore could become a tool allowing self-audit, and comparison of outcomes of treatment from practitioner to practitioner. By this method it is hoped that the quality of dental care may be promoted and improved, allowing the modification or discontinuation of sub optimal treatment interventions, and promoting sound evidence based quality procedures in primary dental care.
