Abstract:
:Background There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational research modelling provides the opportunity to examine and test future scenarios for National Health Service (NHS) care.Aim The aim of this research was to explore the required skill-mix of the dental team to meet future need and demand of older people in England to 2028 utilising operational research methods and to examine a range of future scenarios.Method A three-stage computer model was developed to consider demand for dental care, workforce supply and skill-mix. First, the demand model combined population demography and a marker of oral health with attendance and treatment rates based on NHS activity data. Monte Carlo simulation was used to give an indication of the uncertainty surrounding this projected demand. Second, projections on workforce supply and other assumptions relating to clinical hours, NHS commitment and workforce whole time equivalents (WTEs) were analysed to produce a range of estimates for the current and future workforce. Third, staff skill-mix competencies were examined and the data fed into an optimisation model. Linear programming was used to give the optimal workforce makeup and predictions for workforce requirements. Five future scenarios were run from 'no skill-mix' through to 'maximum skill-mix' in the dental team, and the outputs compared.Results The results indicate that by 2028 there will be an increase in demand for care among older people of over 80% to almost 8.8 million hours; however, Monte Carlo simulation suggests considerable uncertainty surrounding the demand model outputs with demand deviating from the average in terms of treatment hours by as much as 22%. Modelling a healthcare system with 'no skill-mix' resulted in the lowest volume of clinical staff equivalents (dentists: 8,668) providing care for older people, whereas maximum skill-mix involved more staff (clinical staff = 10,337, of whom 2,623 were dentists, 4,180 hygienist/therapists and 3,534 clinical dental technicians) if all care is provided at the relevant level of competence.Conclusion The model suggests that with widening skill-mix, dental care professionals can play a major role in building dental care capacity for older people in future. The implications for health policy, professional bodies and dental teamworking are discussed.
journal_name
Br Dent Jjournal_title
British dental journalauthors
Falcon Hdoi
10.1038/sj.bdj.2010.132subject
Has Abstractpub_date
2010-02-13 00:00:00pages
116-7issue
3eissn
0007-0610issn
1476-5373pii
sj.bdj.2010.132journal_volume
208pub_type
杂志文章abstract::Antibiotic prescribing practices are frequently inappropriate in endodontic therapy. ...
journal_title:British dental journal
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abstract:AIM:To ascertain general dental practitioners' views on the use of stainless steel (pre-formed metal) crowns to restore carious primary molars. METHOD:Ninety-three general dental practitioners were selected at random from those practising in Lancashire, Cheshire and Greater Manchester in 2003 and interviewed separatel...
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abstract::The British Association of Oral and Maxillofacial Surgeons and the Royal Colleges have rightly responded over the years to pressures within, and outside dentistry for higher levels of training in oral and maxillofacial surgery. There has been adoption of a series of qualification as, at first desirable, then mandatory...
journal_title:British dental journal
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doi:10.1038/sj.bdj.4807667
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abstract::This report describes an unusual case of blanching of the facial and palatal soft tissues following the administration of an inferior dental block injection. Possible anatomical explanations for the clinical observations are discussed. ...
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doi:10.1038/sj.bdj.4808847
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abstract::The incidence of oral and oropharyngeal cancer is rising in the UK, its aetiology is changing and early detection and referral saves lives. This article covers how and to what depth oral and oropharyngeal cancer is taught to dental students and other preregistration dental care professionals and examines the threats i...
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abstract::Decontamination of dental instruments has recently been the subject of considerable debate. However, little information is available on the potential bacterial colonisation of dental appliances returning from dental laboratories and their need for decontamination. This study investigated the extent and nature of micro...
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doi:10.1038/sj.bdj.2011.675
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abstract::Infant oral mutilation (IOM) is a primitive traditional practice involving the 'gouging out' of an infant's healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/ AIDS, septicaemia and death. Other complications include eradication and/ or malformation of the child's permanent ...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2016.264
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abstract:OBJECTIVE:To assess the long-term follow-up of patients successfully treated for disc displacement with anterior repositioning splint therapy and patients successfully treated for pain dysfunction syndrome with stabilisation therapy. DESIGN:Retrospective analysis. SETTING:Dental school clinic unit. METHODS:Maintenan...
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doi:10.1038/sj.bdj.4809495
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abstract::The Community Dental Service has been encouraged to refer regular attending patients to General Dental Practice whilst maintaining a monitoring system to ensure that referred patients do not 'fall through the net'. The referral and monitoring system run by Halton Health Authority for one year is described. During this...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.4807400
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abstract::Since January 1993 general dental practitioners have been able to prescribe dietary fluoride supplements in the form of drops or tablets for their child patients within the conditions of service of the General Dental Service. Many GDPs may already have taken advantage of this to the benefit of their patients. However,...
journal_title:British dental journal
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abstract::The international migration of dentists is an issue of pressing significance that poses several complex policy challenges. Policy-making is mainly constrained by the lack of workforce surveillance, research evidence and political advocacy - all three are required to work together, yet with different purposes. We first...
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abstract::The difference between paediatric dentistry and most other branches of dentistry is that in the child the occlusion is changing. Consequently 'Good Occlusal Practice' in children is a matter of making the right clinical decisions for the future occlusion. The clinician needs to be able to predict the influence that di...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.4801261a
更新日期:2001-12-22 00:00:00
abstract::This paper describes the three successive and successful DentEd projects, funded by the European Union, that established a productive thematic network which identified common content within the dental curriculum. It then developed an agreed professional profile, with a defined set of competences and a modular curricul...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2008.698
更新日期:2008-08-23 00:00:00
abstract:UNLABELLED:There is significant evidence to support the regular review of patients with chronic periodontitis. There is, however, comparatively little evidence to demonstrate how often such reviews should take place. This paper looks at the periodontal healing period, the risks of periodontal progression and current th...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2011.868
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abstract::Does this tool offer a robust method for seeking out evidence or merely gives credence to quackery? ...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2017.312
更新日期:2017-04-07 00:00:00
abstract::As it approaches its 60th anniversary, the UCL Eastman Dental Institute continues to go from strength to strength. This article takes a brief look at the history and achievements of the Institute, from its establishment in 1948 to its present position as one of the premier international centres for dental research and...
journal_title:British dental journal
pub_type: 历史文章,杂志文章
doi:10.1038/bdj.2007.1040
更新日期:2007-11-10 00:00:00
abstract:OBJECTIVES:To investigate by questionnaire, the use and selection of materials and techniques for the placement of direct restorations and the provision of endodontics and bleaching by dental practitioners in the North West of England and Scotland. METHODS:A questionnaire was sent to 1,000 general dental practitioners...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.4811905
更新日期:2004-12-25 00:00:00
abstract:AIM:To evaluate final year dental students' knowledge acquisition and experiences during their intravenous sedation (IVS) clinical attachment within the sedation department at Newcastle School of Dental Sciences (NSDS). METHODS:Students attending IVS clinical attachments in the period September 2012 - April 2013 compl...
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pub_type: 杂志文章
doi:10.1038/sj.bdj.2015.198
更新日期:2015-03-01 00:00:00
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journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2008.735
更新日期:2008-09-13 00:00:00
abstract::Even dentures exhibiting superb aesthetics are of no use if they visibly move during speech and social intercourse. In this, the second paper of three on removable denture aesthetics, we describe impression making and shaping the wax occlusal record rims. Not only are the impressions important for producing dentures w...
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更新日期:1998-09-12 00:00:00
abstract:AIM:To use nationally available data sets to undertake an equity audit to support the targeting of resources to meet the needs of patients from deprived communities, in areas where levels of poor oral health remain higher than the rest of the population as a whole. METHODS:Postcodes of 224,107 patients in County Durha...
journal_title:British dental journal
pub_type: 评论,杂志文章
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更新日期:2010-08-14 00:00:00
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pub_type: 杂志文章,评审
doi:10.1038/s41415-019-0782-9
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journal_title:British dental journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1998-06-13 00:00:00
abstract:OBJECTIVE:To investigate job satisfaction among hygienist-therapists. Increasing numbers of hygienist-therapists work in UK primary dental care teams. Earlier studies suggest a clinical remit/clinical activity mismatch, without investigating any link with job satisfaction. METHODS:A UK-wide survey of dental hygienist-...
journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/sj.bdj.2011.116
更新日期:2011-02-26 00:00:00
abstract::This study describes a pilot project in which peer assisted learning (PAL) is used to teach dental clinical skills. A cluster randomised controlled trial compared opinions of Bachelor of Dental Surgery (BDS) students from peer-led groups versus staff-led groups in a clinical (impression taking) and a pre-clinical (han...
journal_title:British dental journal
pub_type: 杂志文章,随机对照试验
doi:10.1038/sj.bdj.2015.722
更新日期:2015-09-25 00:00:00
abstract:OBJECTIVE:To determine the sensitivity of conventional sensory assessment in monitoring lingual nerve recovery subsequent to third molar surgery and to evaluate if the assessment methods can be predictive of injury outcome. METHOD:A prospective case series of 94 patients presenting with lingual nerve injuries evaluate...
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pub_type: 杂志文章
doi:10.1038/sj.bdj.4813584
更新日期:2006-05-27 00:00:00
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journal_title:British dental journal
pub_type: 杂志文章
doi:10.1038/bdj.2007.636
更新日期:2007-07-28 00:00:00
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更新日期:2005-12-24 00:00:00
abstract::The oral rehabilitation of head and neck cancer patients is a vital and pivotal part of their care pathway, helping to restore function, aesthetics and improve patient well-being and quality of life. Patient-reported outcome data demonstrates that such patients consider that many of their continued and unmet needs rel...
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pub_type: 杂志文章
doi:10.1038/sj.bdj.2018.927
更新日期:2018-11-09 00:00:00