Jennifer Foley

AIM: To evaluate the operational and financial efficacy of sending short message service (SMS) mobile telephone text message to patients with outpatient clinic appointments. STUDY DESIGN: Patients scheduled to attend an outpatient appointment at the Dept. Paediatric Dentistry, Edinburgh Dental Institute, Scotland, during October 2007 and who had mobile telephone contact details were sent a reminder SMS text 24hr prior to their appointment. An historical control group were selected from October 2006. RESULTS: Data were available for 276 (F: 146; M: 130) and 433 (F: 228; M: 205) patient attendances during 2006 and 2007 respectively. Overall, 10.4% and 23.9% of the SMS and historical group failed to attend (FTA) respectively and the difference was statistically significant (Chi Square = 6.95, p = 0.008, 1 d.f). There was a reduction in the FTA rate for the specialist paediatric staff dentists from 29.2% to 24.4% for 2006 and 2007 respectively. The cost of sending text messages was £28.15 (approx. €0) for October 2007. CONCLUSIONS: The use of SMS text messages as a reminder may reduce the failure to attend rate for outpatient paediatric dental appointments.

Aim: To develop baseline data in relation to paediatric minor oral surgical procedures undertaken with both general anaesthesia and nitrous oxide inhalation sedation within a Hospital Dental Service. Study Design: Data were collected prospectively over a three-year period from May 2003 to June 2006 for patients attending the Departments of Paediatric Dentistry, Dundee Dental Hospital and Ninewells Hospital, NHS Tayside, Great Britain, for all surgical procedures undertaken with either inhalation sedation or general anaesthetic. Both operator status and the procedure being undertaken were noted. In addition, the operating time was recorded. Results: Data for 166 patients (F: 102; M: 64) with a median age of 12.50 (inter-quartile range 10.00, 14.20) years showed that 195 surgical procedures were undertaken. Of these 160 and 35 were with general anaesthetic and sedation respectively. The surgical removal of impacted, carious and supernumerary unit(s) accounted for 53.8% of all procedures, whilst the exposure of impacted teeth and soft tissue surgery represented 34.9% and 11.3% of procedures respectively. The median surgical time for techniques undertaken with sedation was 30.00 (inter-quartile range 25.00, 43.50) minutes whilst that for general anaesthetic was similar at 30.00 (inter-quartile range 15.25, 40.00) minutes (not statistically significant, (Mann Whitney U, W = 3081.5, P = 0.331). Conclusions: The majority of paediatric minor oral surgical procedures entail surgical exposure or removal of impacted teeth. The median treatment time for most procedures undertaken with either general anaesthetic or nitrous oxide sedation was 30 minutes.

Aim: To determine an overview of opinions and knowledge of paediatric dentistry amongst a group of recently-qualified dentists working within the Scottish Hospital Dental Service. Study design: A prospective questionnaire-based survey undertaken at Dundee Dental Hospital and School, NHS Tayside, Scotland. The survey evaluated dentists’ opinion of managing the child patient and the location of dental treatment as well as knowledge of trauma, minor oral surgery, developmental disorders, mixed dentition problems and joint paediatric/orthodontic scenarios. Results: Data were available for 15 dentists (M: 7; F: 8), median age 25.00 (interquartile range 25.4, 27.2) years. Of the respondents, 73.3% enjoyed treating children, although concerns regarding the management of both dental trauma and paediatric minor oral surgery cases were noted by 93.3% and 100% of dentists respectively. Concerning the location of treatment for the child patient, 66.7% believed that this should be ‘shared-care’ between the general dental practitioners (GDP) and Community Dental Service (CDS), whilst 20.0% and 13.3% observed that this should be undertaken within the CDS and by the GDP respectively. None of the dentists felt that treatment should be undertaken either privately or within the hospital services. Overall, dentists were best able to answer questions relating to mixed dentition and paediatric/orthodontic problems and least able to do so for minor oral surgical conditions. Conclusion: This pilot study offers baseline data regarding both opinions and also knowledge of paediatric dentistry amongst a group of recently-qualified dentists. Further educational opportunities in this discipline at the postgraduate level may be beneficial.

Aim: To gain an overview of knowledge of local analgesia, pulpal therapy and restorative procedures in the primary dentition amongst dental undergraduate students (DS), dental therapy students (DTS), recently-qualified dentists (QD) and dental therapists (DT), working within a Dental Hospital setting. Study Design: A survey undertaken at Dundee Dental Hospital and School, NHS Tayside, United Kingdom to determine current knowledge regarding the use of local analgesia, pulp anatomy and pulp therapy techniques in addition to restoration of primary teeth. Results: Data were available for 24 individuals (DS: 5; QD: 6; DTS: 8; DT: 5). Deficiencies in knowledge regarding the maximum safe dose for local analgesia, pulp canal anatomy, pulp therapy medicaments and the preparation required prior to placement of a pre-formed metal crown were noted in both student and staff groups. Conclusions: The knowledge of basic dental procedures for children amongst a group of dental students, student dental therapists and recently qualified dentists and dental therapists, was found to be imperfect. These findings indicate that more research is needed on the educational procedures used in the transfer of such knowledge and skills. Deficiencies in knowledge were identified in all areas assessed. Courses should be designed at both the pre- and postgraduate level to address and avoid such gaps in knowledge.

Objective.  The aim of this paper was to determine the use of theatre time for all procedures performed under general anaesthetic on a paediatric dental list.Methods.  A prospective study of paediatric dental general anaesthetic procedures was undertaken at Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK. Data were collected prospectively for 71 operating lists over a 3‐year period from April 2003 to March 2006. Both operator status and the procedure being undertaken were recorded. In addition, pre‐anaesthetic, anaesthetic, operating and disconnection times were recorded.Results.  Of the 71 lists examined, 61 either finished early or on time, with a median unused time of 32.50 min (interquartile range = 19.50, 50.00 min), whilst 10 lists finished late with a median overrun time of 30.50 min (interquartile range = 9.25, 45.50 min). Comparing lists which finished late with those which were completed within time, the median pre‐anaesthetic time was significantly longer (Mann–Whitney U‐test, W = 20.05, P = 0.048). Overall, the theatre was in use for 78.22% of time combining pre‐anaesthetic, anaesthetic, operating and disconnection times; hence, there was poor time utilization of theatre for 21.78% of the total theatre time.Conclusions.  Overall, 85.9% of theatre sessions for dental procedures under general anaesthetic in children finished early or on time. Where lists finished late, the duration of the pre‐anaesthetic time appeared to be the significant factor.