J Foley1. 1. Department of Paediatric Dentistry, Dundee Dental Hospital, Dundee, DD1 4HN, UK. jennifer.i.foley@tuht.scot.nhs.uk
Abstract
AIM: To determine the implementation of national clinical guidelines in relation to the targeted prevention of dental caries in the permanent teeth of 6-16-year-olds presenting for dental care amongst training grade staff working within the Hospital Dental Service. METHODS: Patient records were reviewed prospectively with regard to caries risk assessment, behaviour modification and tooth protection. Following dissemination of the results and reinforcement of fundamental points from the guideline, a second audit was conducted one month later. The results were assessed by chi2 (chi2) analysis. RESULTS: One hundred patient records were reviewed in both Audit One (M:52; F:48) and Audit Two (M:61; F:39). Caries risk assessment was poorly recorded in both Audits One and Two (13% and 17%, respectively). There was an improvement in radiographic reporting between the first and second audit, from 53% to 80% (chi2 = 16.36, P = 0.001). Dietary advice and toothbrushing instruction were recorded in 36% and 41% of records in Audit One, whilst in Audit Two this had improved to 68% and 92%, respectively (chi2 = 20.51, P = 0.001 and chi2 = 58.38, P = 0.001). There was a statistically significant improvement in the prescription of fissure sealants in Audit Two (chi2 = 38.97, P = 0.001), although not in the prescription of topical fluoride application (chi2 = 1.71, P = 0.192). CONCLUSION: Amongst training grade staff, there appears to be failure of implementation of certain aspects of SIGN guidelines for caries prevention. Clinical audit, however, would appear to improve guideline implementation.
AIM: To determine the implementation of national clinical guidelines in relation to the targeted prevention of dental caries in the permanent teeth of 6-16-year-olds presenting for dental care amongst training grade staff working within the Hospital Dental Service. METHODS:Patient records were reviewed prospectively with regard to caries risk assessment, behaviour modification and tooth protection. Following dissemination of the results and reinforcement of fundamental points from the guideline, a second audit was conducted one month later. The results were assessed by chi2 (chi2) analysis. RESULTS: One hundred patient records were reviewed in both Audit One (M:52; F:48) and Audit Two (M:61; F:39). Caries risk assessment was poorly recorded in both Audits One and Two (13% and 17%, respectively). There was an improvement in radiographic reporting between the first and second audit, from 53% to 80% (chi2 = 16.36, P = 0.001). Dietary advice and toothbrushing instruction were recorded in 36% and 41% of records in Audit One, whilst in Audit Two this had improved to 68% and 92%, respectively (chi2 = 20.51, P = 0.001 and chi2 = 58.38, P = 0.001). There was a statistically significant improvement in the prescription of fissure sealants in Audit Two (chi2 = 38.97, P = 0.001), although not in the prescription of topical fluoride application (chi2 = 1.71, P = 0.192). CONCLUSION: Amongst training grade staff, there appears to be failure of implementation of certain aspects of SIGN guidelines for caries prevention. Clinical audit, however, would appear to improve guideline implementation.