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Primary Care Dentists’ management of permanent dentition traumatic dental injuries in 7-16-year-olds: a sequential mixed-methods study

Lookup NU author(s): Greig Taylor, Oliver Sumner, Dr Richard Holmes, Dr Paula Waterhouse

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background/Aims Primary care dentists’ play a pivotal role in the management of traumatic dental injuries in children, despite little evidence on the barriers they face in providing care. The aim of this study was to explore and contextualise the knowledge and attitudes of general dental practitioners regarding their management of permanent dentition traumatic dental injuries in children aged 7-16 years old. Material and Methods A two-phase sequential mixed-methods study included a questionnaire that was disseminated to all 619 primary care dentists, identified via a triangulated sampling strategy, based across the north-east of England (Phase I). Statistical analyses were performed using Mann-Whitney U, Kruskal-Wallis tests, Spearman’s correlation and Chi-square test. Multivariate factor analysis, with principal components extraction was used to test between multiple ordinal variables. Respondents were invited to a face-to-face or telephone semi-structured interview (Phase II). Interviews were transcribed verbatim and analysed using inductive thematic analysis. Results Primary care dentists were less confident in managing complex dental trauma. Inadequate financial remuneration was the main reason for not providing care, often prompting a referral to the local dental hospital. This was more apparent for those who qualified before 2000. More recently qualified dentists felt the long-term costs, related to traumatic dental injuries, were insufficiently remunerated. Most still provided emergency management, irrespective of remuneration, as long as they had the requisite knowledge and skills. Four major themes arose: impact of traumatic dental injuries on patients, parents, and primary care dentists; barriers to providing treatment; educational opportunities for primary care dentists; and interactions between primary and secondary care services. Conclusions There is high confidence in managing simple traumatic dental injuries but less for complex injuries. A lack of sufficient financial remuneration associated with the long-term management of dental trauma was the main barrier for dentists to manage these cases.


Publication metadata

Author(s): Taylor GD, Sumner O, Holmes RD, Waterhouse PJ

Publication type: Article

Publication status: Published

Journal: Dental Traumatology

Year: 2021

Pages: epub ahead of print

Online publication date: 31/03/2021

Acceptance date: 04/03/2021

Date deposited: 09/03/2021

ISSN (electronic): 1600-9657

Publisher: Wiley

URL: https://doi.org/10.1111/edt.12676

DOI: 10.1111/edt.12676


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