Guidance
Implementation in the NHS
In general
Local health communities should review their existing practice for dental recall against this guideline. The review should consider the resources required to implement the recommendations, the people and processes involved, and the timeline over which full implementation is envisaged. It is in the interests of patients that the implementation timeline is as rapid as possible.
Relevant local clinical guidelines, care pathways and protocols should be reviewed in the light of this guidance and revised accordingly.
This guidance contains tools and suggestions to facilitate implementation and review (see appendix G of the full guideline). These are designed to help NHS dental practices and their patients get used to what will be for many a new way of planning and receiving routine NHS dental care.
NHS clinical care pathways
NHS clinical care pathways are being developed to further the aims outlined in the Department of Health's strategy document NHS Dentistry: Options for Change (2002). The first clinical care pathway for NHS dentistry is being developed by the Dental Health Services Research Unit at the University of Dundee and deals with the initial oral health assessment and subsequent oral health reviews. It is being tested by NHS Options for Change field sites, which include dental practices, primary care trusts and strategic health authorities who volunteered to test the modernisation proposals outlined in Options for Change. The pathway accommodates the NICE recommendations on recall intervals and this should help a seamless move into modernised, preventive NHS dental care.
Audit
Patient records should show that appropriate recall intervals have been identified, based on the assessment of risk in discussion with the patient. The following criteria can be used to audit adherence to the guideline recommendations:
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At the end of each oral health review there is a record for each patient of an assessment of disease and disease risk.
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At the end of each oral health review, or at completion of treatment, there is a record for each patient of the recall interval recommended by the dentist for the next oral health review.
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The interval agreed each time, for each patient is:
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3, 6, 9 or 12 months for patients younger than 18 years, or
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3, 6, 9, 12, 15, 18, 21 or 24 months for patients aged 18 years or older.
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Where there is disagreement between the dentist and the patient over the recall interval, the reason for this is recorded.
Further information on local and national audit is available in the full guideline.