Patients’ reasons for consulting a General Medical Practitioner with a dental problem: a cross-sectional study.
Principal / Lead investigator
Dr Anwen Cope, Cardiff University
Co-investigators / research team
- Prof Ivor Chestnutt, Cardiff University
- Dr Nick Francis, Cardiff University
- Prof Fiona Wood, Cardiff University
Type of study
Clinical guidelines recommend that the first line treatment for acute dental conditions should be an operative intervention (such as exodontia or endodontic treatment) by a dental practitioner. Despite this, there is evidence that some patients seek care from their General Medical Practitioner (GMP) instead. However, GMPs lack the specialist knowledge, skills, and facilities necessary to undertake operative treatment. Patients who visit their GMP with tooth-related problems have a higher likelihood of being prescribed a systemic antibiotic than individuals who consult a dentist due a similar problem. Not only may this contribute to patient morbidity from untreated dental disease, high rates of antibiotic use may result in an increased risk of adverse reactions and can contribute to the emergence of antimicrobial resistance.
In a cohort study conducted by our research team, there were approximately 6.06 dental consultations per 1,000 patient-years in general medical practice in the UK between 2004 and 2013. The average general medical practice of 7,000 registered patients would therefore expect to see approximately 30-48 patients presenting with dental problems every year. Across the UK this could amount to approximately 388,000 consultations annually, which puts a considerable burden on the resources of NHS general medical practices.
Psychosocial factors such as dental anxiety, financial costs, perceptions of need, and lack of access can act as barriers to obtaining dental care. Furthermore, atypical presentation of dentoalveolar pain, and patients' preferences regarding healthcare practitioners may affect choice of primary care practitioner during episodes of dental problems. However to date there has been little research quantifying the extent to which these factors motivate patients to seek care from a GMP instead of a dentist.
This study seeks to explore the reasons patients with dental problems consult a GMP, and to understand patients’ expectations for treatment when consulting their doctor with a dental problem. The findings of this study will inform the development of an intervention to support patients in accessing appropriate dental care when experiencing a dental problem.
Two patient representatives have been recruited through the National Institute for Social Care and Health Research Involving People. Both have recent experience of accessing dental care for acute conditions. They will advise on recruitment techniques and be involved in writing the questionnaire.
Who is the study sponsor?
RCPS Glas - Young Investigator
Total grant value
How could this research potentially benefit patients?
This will be the largest study to date to explore why patients suffering from a dental problem have consulted a GMP instead of a dentist. Results will inform the design of an intervention to support patients in accessing appropriate dental care when experiencing an acute problem. This would potentially reduce morbidity associated with acute dental conditions and will be more efficient use of existing healthcare resources.
Findings will also highlight the feasibility of using of media and online advertisement as participant recruitment tools in studies of acute dental conditions. These recruitment techniques have previously been successfully employed in studies of common dermatological conditions and antenatal services, and have been demonstrated to be a cost-effective means of recruitment, particularly in difficult-to-reach populations (8, 9). If they are found to be effective in the recruitment of patients with acute dental conditions they could be utilised in future studies to reduce study costs and increase participation in research.
Further information (e.g. related web link)
Outputs generated (Reports / Publications / Impact)
- Publication: Cope AL, Wood F, Francis NA, Chestnutt IG. (2015) General Practitioners’ attitudes towards the management of dental conditions and use of antibiotics in these consultations: a qualitative study. British Medical Journal Open 5:e008551
- News article: 'Thousands seeing GP for dental problems', Cardiff University News, 23 October 2018.
- Blog post by Anwen Cope: 'UK unveils plan to tackle antimicrobial resistance: but where do dentists fit in?', British Dental Association, 28 January 2019.
- Animation video for public dissemination of findings: https://youtu.be/e3z8f5MZ5eA