Can Dental Care Professionals Screen For Dental Diseases (Final Results)?

Over half of the patients who attend general dental practice in the United Kingdom (UK) do not require any treatment other than a scale and polish and any necessary radiographs. Despite this, the bulk of this service provision is provided by General Dental Practitioners (GDPs) and represents a substantial cost to the National Health Service (NHS). Dental Care Professionals (DCPs) are a group of “mid-level” providers in the UK who are now allowed to undertake diagnosis and treatment planning within their Scope of Practice. The use of DCPs to screen asymptomatic patients within an integrated model of care delivery has the potential to release resources in the NHS and increase the capacity to care for those who do not currently access services. The aim of this study was to compare the diagnostic test accuracy of DCPs with GDPs when screening for dental caries and periodontal disease in asymptomatic adults aged over eighteen years of age. 

Method:

DCPs and GDPs screend 2,000 consecutive asymptomatic adult patients across the North-West; the GDP being the reference standard and the DCP the index test. A screen positive case for caries was defined as a patient with frank cavitation or dentinal caries, whilst a screen positive for periodontal disease was defined as a patient with any site scoring a Basic Periodontal Examination of three or above.  

Result:

The sensitivity of a DCP screen for caries and periodontal disease was 0.79 and 0.90 respectively and their specificity was 0.88 and 0.79. Positive predictive values were 0.78 and 0.85; negative predictive values 0.88 and 0.85.

Conclusion: This study provides evidence that DCPs can screen for caries and periodontal disease. This has the potential to release resources and increase the capacity to care.