Quality in Primary Care Open Access

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Abstract

A survey of oral and dental disease presenting to general medical practitioners

Michael C Bater, Darren Jones, Mark G Watson

Background In some areas of the country it is now virtually impossible to register as a new patient with an NHS dentist. As a consequence it is inevitable that patients with oral and dental problems will seek advice from general medical practitioners (GPs),who on the whole have had no formal training in this area.Aim To quantify the frequency and type of oral conditions presenting to GPs, and, if a second opinion was sought, to document to whom these patients were referred.Method We carried out a postal questionnaire survey of 156 GP principals in the districts of Doncaster and Bassetlaw.Results There were 114 (73%) responses with 52 (46%) GPs seeing between two and five patients with oral symptoms/conditions weekly. Dental or denture problems were seen by 48 (42%) GPs on a weekly basis, while other pathology seen at least monthly included oral ulceration (n = 104, 91%), candidiasis (n = 98, 86%) and a dry mouth (n = 83, 73%). Although referrals were commonly made to oral and maxillofacial surgery (n = 39, 34%), many patients were also frequently asked to attend a dentist (n = 28, 25%).Conclusion The results confirmed our suspicions that a surprisingly high number of patients attended their GP with oral and dental conditions. The reasons for this are multifactorial, but it inevitably leads to an increased workload in general practice. Thissituation is not likely to improve within the near future unless access to NHS dentistry improves. When a specialist opinion was sought, patients were most likely to be referred to their local oral and maxillofacial department, or be asked to return to their dentist.