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An investigation into how general dental practitioners in Leeds manage complex tooth wear cases

British Dental Journal volume 228, pages 366–370 (2020)Cite this article

Abstract

Introduction Restoring complex tooth wear (TW) cases is technically challenging and not well-remunerated under the NHS General Dental Service (GDS) contract. Therefore, numbers of referrals to secondary care are increasing, but these are often rejected as dental hospitals have a high workload. This may make it difficult for patients with TW to access appropriate care unless paying privately, which may be costly for them.

Aim The aim of this investigation was to understand how general dental practitioners (GDPs) in Leeds manage complex TW cases.

Methods A postal questionnaire was designed and piloted before postal distribution to all GDPs with a Leeds postcode (n = 289). Non-responders were sent reminders to complete the questionnaire. The questionnaire included questions on the place of qualification and experience of the dentists, their management of an example complex TW case and the potential barriers to management of similar cases. The resulting data were statistically tested using Kruskal-Wallis and Mann-Whitney tests.

Results A total of 148 (51%) responded to the questionnaire. There was low confidence in restoring complex TW cases with a mean score of 4.65 out of 10 (0 being not confident at all and 10 being very confident). Only 30 respondents (21%) reported that they would treat complex TW cases under the current NHS GDS contract, and 90 (62%) reported that they had experienced difficulty referring these cases to hospital. Kruskal-Wallis testing showed increased confidence in restoring by those with a diploma or MSc (p = 0.004 and p = 0.014 respectively). Mann-Whitney testing showed those undertaking a higher percentage of NHS work were less likely to restore these cases (U = 2,100; p = 0.02).

Conclusion These results suggest that Leeds patients with complex TW may have difficulty in accessing appropriate care under the current NHS GDS contract. The results highlight the benefits of postgraduate education on confidence in restoring complex TW cases.

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Acknowledgements

The authors would like to thank Dr Rachael Bedford of the Institute of Psychiatry, Psychology and Neuroscience, King's College London for her assistance with the statistical analysis. They would also like to thank all of the participants for their kind collaboration.

This study was performed in partial fulfilment of an MSc degree awarded by the University of Kent.

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Authors and Affiliations

  1. General Dental Practitioner, Farsley Dental Practice, Town St, Farsley, LS28 5HX, UK

    Matthew Condon

  2. Visiting Professor, University College London and Honorary Professor, University of Kent, UK

    Kenneth Eaton

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  1. Matthew Condon
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  2. Kenneth Eaton
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Contributions

MC designed the study, collected the data and drafted the manuscript. KE advised on all aspects of the study, supervised it and edited the manuscript.

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Correspondence to Matthew Condon.

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The authors are unaware of any conflicts of interest.

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Condon, M., Eaton, K. An investigation into how general dental practitioners in Leeds manage complex tooth wear cases. Br Dent J 228, 366–370 (2020). https://doi.org/10.1038/s41415-020-1316-1

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