A public perception of access to NHS dentistry

Access to NHS dentistry in South Cheshire: a follow up of people using telephone helplines to obtain NHS dental care

OBJECTIVE

To follow up calls made to NHS Direct and South Cheshire Dental Helpline concerning getting access to an NHS dentist in South Cheshire.

DESIGN

Contact details of callers who had consented to a follow up call were passed by helpline staff to a researcher at regular intervals. In a structured interview, callers were asked why they had telephoned the helpline and whether they had subsequently obtained NHS dental care. Follow up calls continued until a total of 200 replies had been gathered, either by telephone or post (for those where telephone contact could not be made). Follow up calls were made between September 2001 and March 2002.

RESULTS

During the study period only three callers from South Cheshire contacted NHS Direct with a dental access query and consented to a follow up call, compared with 219 callers to South Cheshire Dental Helpline. Only 10% were not contacted either by telephone or post. A comparison with figures for calls made to South Cheshire Dental Helpline between April 2000 and March 2001 suggests that during the study period a year later the access problem has improved. However, there were still a few areas in South Cheshire where significant numbers of dental access queries were being received. Twenty five per cent of unregistered and 22% of registered callers still felt that they had problems getting access to NHS dental care after using information from the helplines.

CONCLUSION

A small but significant number of people in South Cheshire have problems accessing NHS dental care.

Who has difficulty in registering with an NHS dentist?--A national survey

AIMS

The aims of this paper are first, to determine the extent of difficulties the public are experiencing in obtaining a dentist undertaking NHS dental care. Second, to describe the personal and socio-demographic details of these groups using data from a national study.

METHOD

The vehicle for this study was the Office for National Statistics Omnibus Surveys, undertaken in June and July of 1999. A random probability sample of 5,385 addresses was selected from the British Postcode Address File. Respondents were interviewed in their homes about how difficult they found it to obtain an NHS dentist.

RESULT

A total of 3,739 adults took part in this study and the response rate was 69%. Nineteen per cent (705) claimed they found it difficult to get an NHS dentist. Bivariate analysis revealed that difficulty in obtaining an NHS dentist [excluding those who claimed they did not seek NHS dental care (781) and those who refused to answer or did not know (66)] was associated with age group (P < 0.01), gender (P < 0.05), social class (P < 0.01) and area of residency (P < 0.01). Moreover, difficulty in obtaining NHS dental care was also associated with time since last dental visit (P < 0.01), method of payment for last dental visit (P < 0.01) and use of 'out of hours' emergency dental services (P < 0.01). Further analysis revealed that among the socio-demographic variables, area of residency emerged as the most important factor in determining difficulty in obtaining an NHS dentist. Those who lived in the South of England (London, South-East or South West) were more than twice as likely to experience difficulty in obtaining an NHS dentist, OR = 2.40, 95% CI 2.00-2.88 compared with those who lived elsewhere in Great Britain.

CONCLUSION

One in five adults in Britain claim that they are experiencing difficulties in finding a dentist who will provide NHS dental care. In particular, those using private dental services and residents of the South of England have experienced such difficulties.

The trend and risk factors of perceived toothache among Finnish adolescents from 1977 to 1997

Toothache is a subjective oral health indicator that should become uncommon when oral health is improving. The aim of this study was to assess changes in perceived toothache between 1977 and 1997 among Finnish adolescents. In the Adolescent Health and Lifestyle Survey, a self-administered questionnaire was mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns every second year. The sample sizes in the surveys varied from 2422 to 11,105, making a total of 35,349 subjects in the entire study. The incidence of toothache during the previous 2 years was requested in 1977, 1985, 1991, 1995, and 1997, and the prevalences were 31%, 25%, 28%, 29%, and 37%, respectively. The increase between 1995 and 1997 was highest among 16- and 18-year-olds. There was no tendency for perceived toothache to decline over the study period, despite the decrease in caries experience. Toothache varied by age, socioeconomic status (SES), place of residence, and toothbrushing frequency. The increase in the incidence of toothache reported after 1995 could be a warning signal that economic recession in Finland has caused changes in the dental care system.