This research project, which has now finished, entitled, "Understanding the systems, organisational, and patient barriers and facilitators to quality improvement in dental care: Prevention and management of caries in general practice" was funded by the Scottish Government's Chief Scientist Office.
In Scotland, vast numbers of children and adults suffer with dental decay. Dental decay is largely preventable but remains a widespread, costly public health problem impacting quality of life, attendance and productivity in school or work, and general health. In spite of several Scottish Government initiatives and the identification of proven clinical strategies to prevent and manage decay, it remains the leading cause of tooth loss among children and adults in Scotland.
Aims and Objectives
This study aimed to identify the patient, organisation, and system level factors that influence the successful delivery of recommended care to prevent and manage tooth decay.
Design and Techniques
This mixed methods study comprised a questionnaire, database review, and practice case studies including observation, interviews, and focus groups. Organization level factors were investigated through a postal questionnaire sent to a random sample of 651 General Dental Practitioners (GDPs) providing care in NHS Scotland. GDPs were asked to consent for research team access to their treatment provision information in the Management Information and Dental Accounting System (MIDAS) database to help create a more thorough picture of what occurs in general practice. Based on questionnaire responses, a series of eight case studies were conducted to further investigate practice level influences on guidance recommended care and to consider patient level factors. Case studies included observation of routine adult recall visits, interviews with dental team members (e.g. dental nurses or hygienists), and patient interviews and focus groups. System level factors were identified using a series of interviews with key stakeholders at the national policy, education, and programme planning levels.
The findings from this study are being used to identify appropriate future strategies to promote routine practices that are consistent with national guidance recommendations for the prevention and management of tooth decay. A paper outlining the main study findings has been submitted to Implementation Science.
Templeton, A, on behalf of the TRiaDS-PMC Study Team (2013) Prevention and management of caries in general dental practice: CSO HCI grant. Theoretical Domains Framework Strategy Day, 4 June 2013
Templeton, A, on behalf of the TRiaDS-PMC study group (2012) Patient, organisation, and system level influences on the prevention and management of caries. Improving quality in healthcare: Translating evidence into practice. TRiaDS Conference, 7 November 2012
Templeton, A on behalf of the TRiaDS-PMC study group (2012) The whole tooth of the matter: Patient, organisation, and system level influences on the prevention and management of caries. Improving quality in healthcare: Translating evidence into practice. Social Dimensions of Health Institute Conference 25-26 June 2012
Templeton, A, on behalf of the HCI Management Team (2012) Prevention and management of caries in general dental practice: CSO HCI grant update. TRiaDS Research Methodology Group 15 May 2012
Professor Jan Clarkson, Co-Director DHSRU
Dr Linda Young, Research Manager (NES), Member DHSRU
Dr. Douglas A Stirling, Honorary Senior Lecturer
Dr Debbie Bonetti, Senior Research Fellow
Dr Anna Templeton, Research Fellow
Mrs Heather Cassie, CSO Research Fellow
Ms. Gillian Forbes, Research Fellow
Mrs Darienne Tosh, Administrative Assistant
Dr Alison Bish, Consultant