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Timings and skill mix in primary dental care: a pilot study

Abstract

Aim The aim of this pilot study was to explore the time taken to complete key contemporary dental procedures by dentists and dental hygienists/therapists (DH/DTs) working in primary dental care and their views on the factors that influence the length of time taken to complete individual dental procedures.

Materials and methods An exploratory mixed methods study of linear design, involving a questionnaire survey followed by focus group discussions exploring time required to complete dental procedures and influences, was conducted using a purposive sample of dental professionals working in primary dental care within the south east of England. Descriptive analysis of absolute timings was performed, together with thematic analysis of their reported influences.

Results Twenty-nine dental professionals completed the questionnaire survey, 11 of whom participated in subsequent focus group discussions to explore the initial findings. While dentists reported higher average times and a wider range for clinical examination and treatment planning, DH/DTs reported spending longer on prevention. Average timings for restorations and extractions were similar across both professional groups. Perceived influences on the length of time required to complete dental procedures were patient complexity, system of care, type of remuneration system and philosophy of care emphasising quality, together with practice environment, including the level of nursing support and surgery-location within the building; individual clinician factors relating to the type of dental professional, their interests and expertise were also identified. Whilst there was general agreement amongst respondents over the range of influencing factors, DH/DTs reported being particularly affected by the current type of remuneration system and level of support within practice.

Conclusions Within the limits of a pilot study, this research suggests patterns in timings of the delivery of primary dental care procedures and identifies multiple diverse influences. Further research at national level is required to develop a deeper understanding of the time taken to deliver primary dental care and the impact of various influences to confirm the findings and inform human resource considerations in addressing population oral health needs.

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Acknowledgements and Author contributions

Acknowledgements

Ethical Approval was given by the Biomedical Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (REC Reference Number: LRU16/174012). We would also like to acknowledge British Dental Association, British Society of Dental Hygiene and Therapy as well as Department of Undergraduate Dental Education, King's College London and Department of Dental Hygiene Therapy, King's College London for their support and facilitating this research.

Authors' contributions

SGG participated in study design, sought ethics approval, conducted the research, and prepared the manuscript. JWA and JEG contributed to the study design, supervised the research and provided very important inputs to the manuscript. All authors read and approved the final manuscript.

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Correspondence to Suruchi G. Ganbavale.

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G. Ganbavale, S., W. Aukett, J. & E. Gallagher, J. Timings and skill mix in primary dental care: a pilot study. Br Dent J 227, 907–913 (2019). https://doi.org/10.1038/s41415-019-0938-7

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