Current training provision and training needs in oral health for UK general practice trainees: survey of General Practitioner Training Programme Directors

Abstract

BackgroundIn the UK the incidence of oral cancers has risen by a third in the last decade, and there have been minimal improvements in survival rates. Moreover, a significant proportion of the population no longer access dental health services regularly, instead presenting their oral health concerns to their General Medical Practitioner. Therefore, General Practitioners (GP) have an important role in the diagnosis of oral health pathologies and the earlier detection of oral cancers. This study aims to understand the current provision of training in oral health and cancer for GP trainees and to identify how unmet training needs could be met.MethodsA cross-sectional survey of GP Training Programme Directors using an online questionnaire asking about current oral health education training (hospital placements and structured teaching), the competencies covered with trainees and ways to improve oral health training. Quantitative data were analysed using descriptive statistics and content analysis was undertaken of free text responses.ResultsWe obtained responses from 132 GP Training Programme Directors (GPTPDs), from 13 of the 16 UK medical deaneries surveyed. The majority of respondents (71.2 %) indicated that their programmes did not provide any structured oral health training to GP trainees and that ≤ 10 % of their trainees were undertaking hospital posts relevant to oral health. GPTPDs were of the view that the quality of oral health training was poor, relative to the specified competencies, and that teaching on clinical presentations of ‘normal’ oral anatomy was particularly poor. It was envisaged that oral health training could be improved by access to specialist tutors, e-learning programmes and problem-based-learning sessions. Respondents highlighted the need for training sessions to be relevant to GPs. Barriers to improving training in oral health were time constraints, competing priorities and reluctance to taking on the workload of dentists.ConclusionsThis UK-wide survey has identified important gaps in the training of GP trainees in relation to oral health care and cancer detection. Addressing these knowledge and skill gaps, particularly in the identification of oral cancers, will help to improve oral health and, more importantly, the timely diagnosis of oral cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0663-8) contains supplementary material, which is available to authorized users.

Perceptions and practices of general practitioners on providing oral health care to people with diabetes - a qualitative study

“…Consistent with another study in the UK [37], none of the GPs who participated in this study received any structured oral health training as part of their university curriculum. Similarly, GPs reported very limited knowledge on the bidirectional relationship of diabetes and periodontal diseases.…”

Primary care physicians and nurses: Targets for basic periodontal education

“…One of the most interesting findings of this investigation is the worrying lack of knowledge of both primary care physicians and nurses about the most frequent periodontitis‐related signs and symptoms. This is an important barrier to PDDs diagnosis, given both the reported burden of oral conditions represent on general medical practice and the fact that many patients would consult their physician about common oral problems rather than their dentist . As a European directive establishes common requirements for basic medical and nursing training, this problem may well be found elsewhere in the European Union.…”

“…This is an important barrier to PDDs diagnosis, given both the reported burden of oral conditions represent on general medical practice 20 and the fact that many patients would consult their physician about common oral problems rather than their dentist. [23][24][25] As a European directive 47 establishes common requirements for basic medical and nursing training, this problem may well be found elsewhere in the European Union. This is also important because many patients, when experiencing gingival bleeding, may be advised to use over the counter chemical plaque control agents which may mask a more serious underlying periodontal problem, 17 delaying treatment and favoring disease progression.…”

“…21,22 This circumstance may also have an influence on treatment delay of periodontal disorders, as many patients with oral health concerns initially ask their physician rather than their dentist. [23][24][25] Mainly because of the heavy workload experienced by healthcare systems in many countries, chronic disease services have shifted from secondary to primary care, and from physicians to nurses. 26 In fact, nurses have proved to be efficient in lifestyle counseling 27 without the barriers often described for physicians, such as insufficient time and lack of specific training and skills.…”

Patients’ reasons for consulting a GP when experiencing a dental problem: a qualitative study

“…3 In many cases, this will require the provision of operative dental treatment such as a dental extraction or endodontic (root canal) treatment. 3 GPs are unlikely to have either the skills or facilities to diagnose and manage such problems, 4 which may explain the high rates of antibiotic prescribing in dental consultations. 2,5 However, because antibiotics alone rarely result in definitive resolution of most acute dental conditions, 6 their use in these consultations gives cause for concern.…”