RESUMEN
OBJECTIVE: To investigate the availability of facilities, including parking, accessibility and toilet amenities, for physically disabled people at dental practices in Leicestershire, and views relating to the provision of treatment, as reported by general dental practitioners. BASIC RESEARCH DESIGN: A cross-sectional postal questionnaire-based study. SETTING: General Dental Service practices in Leicestershire, United Kingdom. PARTICIPANTS: Questionnaires were sent to all General Dental Service practices (n=123) within Leicestershire. MAIN OUTCOME MEASURES: Facilities for physically disabled people as reported by general dental practitioners and views of practitioners in relation to provision of treatment. RESULTS: The response rate from general dental practices was 80%. The views of 120 (42%) of the 284 dentists approached relating to the provision of treatment to people with a physical disability were recorded. Although up to 77% of the dental practices were considered by practitioners to be accessible to someone using a wheelchair, only 7% also had suitable parking and toilet facilities. The majority of responding dentists treated patients with a physical disability, but 76% of practitioners found it difficult to provide treatment to this group. Concerns regarding the financial cost of providing treatment were raised. There is evidence that conditions are less than optimal in general practice settings for patients with a physical disability receiving treatment. Only nine of the 123 practices in Leicestershire had appropriate parking, access and toilet facilities for physically disabled people. CONCLUSION(S): Facilities for physically disabled people at general practices in Leicestershire are limited. If inequalities in dental health among the physically disabled are to be successfully reduced, steps must be taken to make practices more easily accessible with suitable facilities, and to increase awareness of services offered by appropriate dental practices.
Asunto(s)
Actitud del Personal de Salud , Atención Dental para la Persona con Discapacidad/estadística & datos numéricos , Odontología General/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Accesibilidad Arquitectónica/estadística & datos numéricos , Estudios Transversales , Consultorios Odontológicos , Inglaterra , Tamaño de las Instituciones de Salud , Disparidades en el Estado de Salud , Humanos , Estacionamientos/estadística & datos numéricos , Encuestas y Cuestionarios , Cuartos de Baño/estadística & datos numéricosRESUMEN
OBJECTIVE: To determine the future intentions and motivations of general dental practitioners (GDPs) relating to NHS dental practice in South Yorkshire. DESIGN: Focus group discussions. SETTING: General dental practices providing NHS care within South Yorkshire, United Kingdom. SUBJECTS (MATERIALS) AND METHODS: Twenty-nine dental practitioners were purposively sampled and invited to take part in a series of focus groups. Focus groups were transcribed and data analysed to identify themes and concepts. MAIN OUTCOME MEASURES: Themes and concepts relating to the current and future provision of dentistry and the proposed 'new ways of working' of the new dental contract. RESULTS: The data fell into three broad categories: the organisational structures of dentistry; the future of dentistry; and the CDS. This paper focuses largely on the second category, the future of NHS dentistry. The first category related to the organisational structures of dentistry, and encompassed perceptions that dentistry was not a high priority for the Government and that current changes were politically motivated and to be implemented by PCTs with a lack of capacity for the management of such wide-reaching changes. The second category covered the future of NHS dentistry. For some, NHS dentistry was in a precarious and uncertain position, coupled with a lack of clarity and information on the 'new ways of working' and exacerbated by problems in the recruitment and retention of future dental practitioners. The last category dealt with views in connection with the CDS. CONCLUSION(S): In this 'snapshot in time' there was considerable uncertainty and instability within the general dental service against a backdrop of major organisational change. There was a need for information, guidance, openness and communication between the Government, PCTs and GDPs surrounding the implementation of the new contract.
Asunto(s)
Actitud del Personal de Salud , Odontología General/organización & administración , Odontología Estatal/organización & administración , Odontología Comunitaria/organización & administración , Contratos , Inglaterra , Femenino , Grupos Focales , Predicción , Humanos , Masculino , Pautas de la Práctica en Odontología , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To determine the impact of multiple sclerosis (MS) on patient attendance at dental practices and maintenance of oral health. DESIGN: A cross-sectional postal questionnaire-based study. SETTING: Leicestershire, United Kingdom. SUBJECTS AND METHODS: People with MS in Leicestershire identified from local health authority records (n = 476). MAIN OUTCOME MEASURES: Number registered at dental practice, frequency of attendance, issues and perspectives relating to attendance and maintenance of oral health. RESULTS: A response rate of 61% (n = 289) was obtained. When compared to the general population, a higher number of people with MS were registered with a dentist (49%:88%) and displayed more frequent practice attendance (71%:81%) in the past year. People with MS reported difficulties in attending a dentist and maintaining oral health, which were exacerbated by deterioration in general health. Problems relating to reduced personal mobility had the greatest impact on attendance. CONCLUSIONS: MS has a negative impact on perceived patient attendance and maintenance of oral health. Patients with a progressive disability could benefit greatly from the provision of preventive oral health care. The importance of seeking care earlier rather than later needs to be emphasised to both professionals and patients alike. Further efforts are required to increase awareness of the importance of oral health to the quality of life of people with MS and ensure that individuals with physical disabilities receive the same access to dental services as the able-bodied.
Asunto(s)
Atención Dental para Enfermos Crónicos/estadística & datos numéricos , Esclerosis Múltiple , Higiene Bucal/estadística & datos numéricos , Accesibilidad Arquitectónica , Estudios Transversales , Inglaterra , Femenino , Accesibilidad a los Servicios de Salud , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Salud Bucal , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To investigate the association between multiple sclerosis, dental caries, amalgam fillings, body mercury and lead. DESIGN: Matched case-control study. SETTING: Leicestershire in the years 1989-1990. SUBJECTS: Thirty-nine females with multiple sclerosis (of recent onset) were matched with 62 controls for age, sex and general practitioner. METHODS: Home interview of cases and controls within which there was an assessment of the DMFT index and blood and urine mercury and lead levels. RESULTS: The odds of being a MS case increased multiplicatively by 1.09 (95% CI 1.00, 1.18) for every additional unit of DMFT index of dental caries. This represents an odds ratio of 1.213 or a 21% increase in risk of MS in relation to dental caries in this population. There was no difference between cases and controls in the number of amalgam fillings or in body mercury or lead levels. There was a significant correlation between body mercury levels and the number of teeth filled with amalgam (controls: r = +0.430, P = 0.006, cases: r = +0.596, P = 0.001). CONCLUSION: There was evidence of excess dental caries among MS cases compared with the controls. This finding supports the strong geographical correlation between the two diseases. A further study of this association is recommended.