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Care pathways and provision in bariatric dental care: an exploration of patients' and dentists' experiences in the North East of England


Introduction Levels of obesity in the UK are increasing. The suitability and safety of dental care delivery can be affected by obesity. When patients' weight exceeds that of a normal dental chair, referral to specialist settings can be appropriate, yet no research has explored the process of care for this group.

Aims This study aimed to explore the experiences of patients and dentists regarding referral to bariatric dental care facilities.

Method Semi-structured interviews were completed with patients referred to a bariatric dental service and referring dentists. Interview transcripts were analysed thematically.

Results Twelve dentists and eight patients participated. Both groups were aware that obesity influenced care and had concerns about the safety of treatment. Dentists were cautious about discussing weight though patients were willing to discuss this. The challenges in identifying weight and organising appropriate care were key issues affecting both patients and dentists.

Conclusion Dentists should engage in discussions regarding obesity without hesitation, where appropriate. Redesigned patient-focused care pathways to direct patients to accessible services would help reduce stigma and improve safety for patients with obesity.

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Fig. 1


  1. 1.

    World Health Organization. Fact Sheet: Obesity and overweight. 2018. Available at (accessed June 2019).

  2. 2.

    Twedell D, Lansing R, McGuire J, Palmersheim P, Baird G. Providing holistic care to bariatric patients. J Contin Educ Nurs 2009; 40: 438-439.

  3. 3.

    Rouleau C R, Rash J A, Mothersill K J. Ethical issues in the psychosocial assessment of bariatric surgery candidates. J Health Psychol 2016; 21: 1457-1471.

  4. 4.

    Guh D P, Zhang W, Bansback N, Amarsi Z, Birmingham C L, Anis A H. The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health 2009; 9: 88.

  5. 5.

    Flegal K M, Kit B K, Orpana H, Graubard B I. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013; 309: 71-82.

  6. 6.

    Reilly D, Boyle C A, Craig D C. Obesity and dentistry: a growing problem. Br Dent J 2009; 207: 171-175.

  7. 7.

    Marshall A, Loescher A, Marshman Z. A scoping review of the implications of adult obesity in the delivery and acceptance of dental care. Br Dent J 2016; 221: 251-255.

  8. 8.

    British Dental Association. Evidence summary: Obesity and oral health. London: British Dental Association, 2015.

  9. 9.

    Anderson C A, Curzon M E J, Van Loveren C, Tatsi C, Duggal M S. Sucrose and dental caries: a review of the evidence. Obes Rev 2009; 10 (Spec Iss): 41-54.

  10. 10.

    Suvan J, D'Aiuto F. Assessment and Management of Oral Health in Obesity. Curr Obes Rep 2013; 2: 142-149.

  11. 11.

    British Dental Association. Evidence summary: Dental problems and their management in patients with dementia. London: British Dental Association, 2014.

  12. 12. Equality Act 2010. Available at (accessed June 2019).

  13. 13.

    Public Health England. Health Matters: Obesity and the food environment. London: Public Health England. 2017. Available at

  14. 14.

    NHS England. Five Year Forward View. 2014. Available at (accessed June 2019).

  15. 15.

    ten Have P. Understanding Qualitative Research and Ethnomethodology. London: Sage, 2010.

  16. 16.

    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Pyschol 2006; 3: 77-101.

  17. 17.

    Malterud K, Ulriksen K. Obesity, stigma, and responsibility in health care: A synthesis of qualitative studies. Int J Qual Stud Health Well-being 2011; 6: 8404.

  18. 18.

    NHS England. Guides for commissioning dental specialties - Special Care Dentistry. London: NHS England, 2015. Available at (accessed June 2019).

  19. 19.

    Sharma A E, Knox M, Mleczko V L, Olayiwola J N. The impact of patient advisors on healthcare outcomes: a systematic review. BMC Health Serv Res 2017; 17: 693.

  20. 20.

    NHS England. Involving people in their own health and care: statutory guidance for clinical commissioning groups and NHS England. 2017. Available at (accessed June 2019).

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Correspondence to Andrew Geddis-Regan.

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Andrew Geddis-Regan and Abisola Asuni are both funded by NIHR Academic Clinical Fellowships. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. This research was kindly funded by a research grant from the British Society for Disability and Oral Health.

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Geddis-Regan, A., Asuni, A., Walton, G. et al. Care pathways and provision in bariatric dental care: an exploration of patients' and dentists' experiences in the North East of England. Br Dent J 227, 38–42 (2019).

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