Urgent dental care use in the North East and Cumbria: predicting repeat attendance

Abstract

Introduction Around one-third of the UK population are 'problem-orientated dental attenders', only seeking care when suffering with dental pain and often on a repeated basis to secondary care. Little is known about attendance in primary care. The aim here was to examine the period prevalence of repeat urgent care attenders and establish predictors of repeat attendance in primary care.Methods Data on urgent and emergency dental care attendances in primary dental care in the North East and Cumbria were analysed from 2013-2019. Variables included: patient sex; ten-year age band; lower super output area; and Index of Multiple Deprivation. Period prevalence was calculated and data were considered year by year to identify trends in attendances. Analysis was with descriptive statistics and predictors of repeat attendance were identified using logistic regression modelling.Results Over the six-year period, there were 601,432 attendances for urgent primary dental care, equating to a period prevalence of 2.76% for the geographic population studied. In total, 16.15% of attendances were repeat attendances (period prevalence 0.45%) and predictors included being a woman and residence in deprived and rural areas. All urgent care attendances decreased over the six-year period, with one-off attendances beginning to increase again in 2019, while repeat attendances stabilised.Conclusion Interventions to encourage regular dental attendances should be targeted at patients from the most deprived and rural areas of the North East and Cumbria; however, a decrease in repeat attendance was noted in these areas.

The financial and quality of life impact of urgent dental presentations: A cross‐sectional study

“…The North‐East also has a large teaching hospital and Northern Dental PBRN practices involved in data collection were largely urban. The findings of this study may not translate to other regions of the UK, including rural areas where UDC attendances are higher (Currie, Stone, Pearce, et al, 2022), availability of NHS care may be limited, distances travelled will be further. A power calculation to compare multiple groups was not possible prior to commencing the study, therefore the Satterthwaite unpooled t ‐test was used.…”

“…Although the cost was lowest for unemployed and retired individuals, a sum of around £20 resulting from transport and medication use could be extremely impactful to the most vulnerable in our society. Furthermore, given that around 1‐in‐3 and 16% of patients are repeated attenders for UDC in secondary and primary care clinics respectively (more than one visit in the last 12 months), the cumulative cost could be significantly more (Currie et al, 2015; Currie, Stone, Pearce, et al, 2022), which will disproportionately affect lower socio‐economic groups. Given that work is reported as a barrier to dental care seeking (Currie, 2022; Harris et al, 2017; van der Zande et al, 2021) with the knock‐on effect of loss of earnings, consideration should be given to the importance of changing the current governmental guidance for time off work for medical and dental appointments.…”

“…Other countries report even higher prevalence, including 11.6%–16.2% in Australia, 19.4% in South Africa and 24.2% in Hong Kong, highlighting the global importance of access to acute dental care (Ayo‐Yusuf & Naidoo, 2016; McMillan et al, 2006; Peres et al, 2019). Adults often avoid attending the dentist for regular ‘check‐ups’ and preventive advice, with pain ultimately being the driver for problem‐orientated attenders to present for dental care (Cohen et al, 2007; Currie, Stone, Pearce, et al, 2022; Morris et al, 2011; Nayee et al, 2015; Pau et al, 2000). Although it is acknowledged that acute dental pain places a significant burden on individuals, society and healthcare services, both pain and the impact on oral health‐related quality of life (OHRQoL) remain incompletely explored, whilst personal financial costs are not known.…”

Persistent Orofacial Pain Attendances at General Medical Practitioners

“…Patients presented from across all quintiles of WIMD with no obvious social gradient present. This is in contrast with patients presenting with acute dental pain, where there is a clear social gradient with patients from the most deprived areas being more likely to experience acute dental pain (Vargas et al 2000;Steele et al 2011;Currie, Stone, Brocklehurst, Slade, Durham, et al 2022;Currie, Stone, Pearce, Landes, and Durham 2022). Chronic painful conditions, such as migraine (Burch et al 2021), also tend to exhibit a social gradient, however there is mixed evidence within the persistent OFP literature (Von Korff et al 1988;Andersson et al 1993;Goulet et al 1995;Aggarwal et al 2003;Slade et al 2013) and it is generally agreed that there is little association between persistent OFP and socioeconomic status.…”