OPTIMISE - Optimising value-based, preventive care delivery in NHS General Dental Services

Principal / Lead investigator
Co-investigators / research team
  • Professor Paul Harper, Professor of Operational Research, School of Mathematics, Cardiff University.
  • Mr Anup J. Karki, Consultant in Dental Public Health, Public Health Wales.
  • Mr Michael Allen, Consultant in Special Care Dentistry; Dental Practice Advisor, Cardiff and Vale University Health Board.
  • Dr Anwen Cope, Specialty Trainee and Honorary Lecturer, Cardiff and Vale University Heath Board.
  • Mrs Sarah Peddle, Patient and Public Involvement Representative, PRIME 
  • Mrs Brenda Walters, Patient and Public Involvement Representative, PRIME
  • Dr Christian A. Bannister, Research Associate, Cardiff University
Type of study
  • Workpackage 1: secondary analysis of NHS General Dental Service data; development of evidence-informed pathways of care
  • Workpackage 2: longitudinal questionnaire survey of dental professionals.
  • Workpackage 3: creation of a computerised optimisation tool

It is possible to prevent dental conditions such as tooth decay, gum disease, and mouth cancer. This can be done by supporting patients to change their lifestyle (such as improving tooth brushing, giving up smoking etc.) or by preventive dental treatments (such as fluoride varnish, a strengthening coating which can be painted onto teeth). Another advantage of preventive care is that it can often be successfully delivered by other members of the dental team such as dental hygienists or dental nurses. We call the use of other members of the dental team ‘skill-mix’ and we believe this has the potential to use NHS resources more efficiently and increase access to care.

We are developing new ways of providing NHS dental care which focus on the prevention of disease and use of the skills of the wider dental team. As part of OPTIMISE we are developing a computer programme that will show service planners and dental practices the benefits of changing their ways of working.

This project has three parts. In the first part, we will describe the treatments adult and child patients currently get when they see an NHS dentist in Wales. We will do this using routinely collected data. We will then show how this would change if we were to increase the amount of preventive care given if current preventive guidelines were followed. We will then talk to dental professionals and patients to gain consensus on what an ideal care-pathway would look like.

In the second part of the study, we will work out how long the additional preventive advice and care would take. We will do this by conducting surveys of dental professionals working in Wales.

In the third part, we will put this information together in a computer programme to show how preventive care could best be delivered using the dental staff we currently have in NHS Wales.

Lay involvement

Two service users are involved in the design and delivery of this proposal as co-investigators. Their contribution has directly impacted on the proposed observation methods and the involvement of patients in the development of new preventive care pathways. We have also incorporated feedback from PRIME Centre Wales’ SUPER group.

Who is the study sponsor?

Cardiff University

Does the study involve commercial partnership activity?



Health and Care Research Wales 

Total grant value


Start date


End date


How could this research potentially benefit patients?

Not only does this study have the potential to benefit current patients by trying to ensure that disease is prevented where possible, it also encourages the more efficient use of dental resource, which will hopefully allow more people in Wales to access NHS dental care.

Outputs generated (Reports / Publications / Impact) 

To follow