Key Points
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Most patients are unaware of the training that dentists receive in non-dental orofacial diseases.
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General medical practitioners have provided an effective oral health service for many years with little acknowledgement, support or training.
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Dentists with support and continuing postgraduate development may contribute to a more comprehensive provision of oral healthcare.
Abstract
Objective To determine patients' preferences regarding consultation of medical or dental practitioners for various orofacial symptoms, including patients' perceptions of practitioners' training and ability to diagnose and treat these symptoms.
Method Patients attending oral and maxillofacial clinics in Dumfries & Galloway, Scotland in relation to a variety of complaints were invited to complete a questionnaire.
Results From a sample size of 254 patients, 220 correctly completed questionnaires were received. This showed 69% of patients regarded medical practitioners as being better trained to diagnose and treat non-dental orofacial symptoms. Eighty percent of patients regarded medical practitioners as being more accessible when booking an appointment. Seventy-eight percent of patients did not regard charges for dental care as being an important factor when deciding which practitioner they should consult.
Conclusion Despite the significant differences between medical and dental practitioners in undergraduate and postgraduate training in orofacial disease, most patients would choose to visit a medical rather than dental practitioner. While these results suggest the need for postgraduate educational support for medical practitioners in treating orofacial pain and oral mucosal disease, they also imply a need for change in the concept of provision of oral healthcare by general dental practitioners.
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References
Rodgers J M, Macpherson L M D, Smith G L F, Crighton A J, Carton A T M, Conway D I . Characteristics of patients attending rapid access clinics during the West Of Scotland Cancer Awareness Programme oral cancer campaign. Br Dent J 2007; 202: E28.
Gill Y, Scully C . Mouth ulcers: a study of where members of the general public might seek advice. Br Dent J 2007; 202: E16.
Mansour M H, Cox S C . Patients presenting to the general practitioner with pain of dental origin. Med J Aust 2006; 185: 64–67.
Lockhart P B, Mason D K, Konen J C, Kent M L, Gibson J . Prevalence and nature of orofacial and dental problems in family medicine. Arch Fam Med 2000; 9: 1009–1012.
Madrid C, Bouferrache K, Moller P . Why try a doctor when you need a dentist? Oral health and primary care medicine: what are the issues? Rev Med Suisse 2006; 2: 2737–2743.
Land T . What patients think of dental services. Br Dent J 2000; 189: 21–24.
Finch H, Keegan J, Ward K . Barriers to the receipt of dental care. London: National Centre for Social Research, 1988.
Scully C, Bell C, Porter K, Porter S . Views of dental patients about the education and practice of dentists. Community Dent Oral Epidemiol 1994; 22: 112–113.
The General Dental Council. The context of undergraduate dental education. In The first five years. 2nd edition. Part 1 pp 10. London: General Dental Council, 2002. http://www.qub.ac.uk/cd/docs/first5years.pdf
The General Dental Council. Subjects and topics. Specific learning outcomes. In The first five years. 2nd edition. Part 2 pp 28–35. London: General Dental Council, 2002. http://www.qub.ac.uk/cd/docs/first5years.pdf
McCann P J, Sweeny M P, Gibson J, Bagg J . Training in oral disease, diagnosis and treatment for medical students and doctors in the United Kingdom. Br J Oral Maxillofac Surg 2005; 43: 61–64.
Holmes J D, Dierks E J, Homer L D, Potter B E . Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis? J Oral Maxillofac Surg 2003; 61: 285–291.
Allison P, Locker D, Feine J S . The role of diagnostic delays in the prognosis of oral cancer: a review of the literature. Oral Oncol 1998; 34: 161–170.
Diamanti N, Duxbury A J, Ariyaratnam S, Macfarlane T V . Attitudes to biopsy procedures in general dental practice. Br Dent J 2002; 192: 588–592.
Thomson P J . Specialist opinion. Br Dent J 2006; 200: 242.
Glaros A G, Glass E G, Hayden W J . History of treatment received by patients with TMD: a preliminary investigation. J Orofac Pain 1995; 9: 147–151.
Warnakulasuriya K A, Johnson N W . Dentists and oral cancer prevention in the UK: opinions, attitudes and practices to screening for mucosal lesions and to counselling patients on tobacco and alcohol use: baseline data from 1991. Oral Dis 1999; 5: 10–14.
Sharp G, Durham J A, Preshaw P M . Attitudes regarding specialist referrals in periodontics. Br Dent J 2007; 202: E11.
Brennan D S, Spencer A J . Trends in service provision among Australian private general dental practitioners over a 20 year period. Int Dent J 2006; 56: 215–223.
Assel L A . Should dentists become 'oral physicians'? No, dentistry must remain dentistry. J Am Dent Assoc 2004; 135: 439, 441, 443 passim.
Giddon D B . Should dentists become 'oral physicians'? Yes, dentists should become 'oral physicians'. J Am Dent Assoc 2004; 135: 438, 440, 442 passim.
Baum B J . The dental curriculum: what should be new in the 21st Century? J Public Health Dent 1996; 56: 286–290.
Hendricson W D, Cohen P A . Oral healthcare in the 21st century: implications for dental and medical health education. Acad Med 2001; 76: 1181–1206.
Mason D . The changing role of the dentist. Br Dent J 1994; 176: 5–9.
Scott J . Dental education in Europe: the challenges of variety. J Dent Educ 2003; 67: 69–78. http://www.jdentaled.org/cgi/reprint/67/1/69.pdf
Kelly M, Steele J G, Bradnock G et al. Adult dental health survey. Oral health in the United Kingdom 1998. London: The Stationery Office, 2000. http://www.statistics.gov.uk/ssd/surveys/adult_dental_health_survey.asp
Pine C M, Pitts N B, Steele J G, Nunn J N, Treasure E . Dental restorations in adults in the UK in 1998 and implications for the future. Br Dent J 2001; 190: 4–8.
Nunn J, Morris J, Pine C, Pitts N B, Bradnock G, Steele J . The condition of teeth in the UK in 1998 and implications for the future. Br Dent J 2000; 189: 639–644.
Steele J G, Treasure E, Pitts N B, Morris J, Bradnock G . Total tooth loss in the United Kingdom in 1998 and implications for the future. Br Dent J 2000; 189: 598–603.
Chadwick B L, White D A, Morris A J, Evans D, Pitts N B . Non-carious tooth conditions in children in the UK, 2003. Br Dent J 2006; 200: 379–384.
Fraser J . The management of oral conditions. Practitioner 2004; 248: 330, 333–336, 340.
Dental practitioners' formulary. In British national formulary 55. London: BMJ Group and RPS Publishing, 2008. http://www.bnf.org
Haughney M G, Devinnie J C, Macphearson L M, Mason D K . Integration of primary care dental and medical services. Br Dent J 1998; 184: 343–347.
The Consumers Association. Scottish dental care. London: Consumers Association, 2002. http://www.which.co.uk/files/application/pdf/0206scotsdentistry_br-445-55676.pdf
Spedding R L, McKinney L A, Boyd R C, el-Attar A, McGaffin J H . Public knowledge of dental registration and management of common dental problems. Dent Update 1999; 26: 303–306.
Acknowledgements
For assistance with data collection and analysis, thank you to Angela Chalmers, Project Administrator, Clinical Governance Department, NHS Dumfries & Galloway. For development and planning, thank you to Dr Gwen Baxter, Research Scientist, Research and Development Unit, NHS Dumfries & Galloway.
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Bell, G., Smith, G., Rodgers, J. et al. Patient choice of primary care practitioner for orofacial symptoms. Br Dent J 204, 669–673 (2008). https://doi.org/10.1038/sj.bdj.2008.523
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DOI: https://doi.org/10.1038/sj.bdj.2008.523
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