Prioritising NHS dental treatments: a mixed-methods study

Abstract

Objectives To determine the priorities of patients and dental professionals concerning NHS dental treatments, the factors influencing prioritisation and the willingness to contribute towards the cost of NHS dental treatments.Methods Focus groups and interviews involving patients and practitioners informed the development of a piloted questionnaire concerning the priorities for NHS dental treatments. Patients attending three purposively selected dental settings in London and Kent, as well as dental professionals working within a large London dental hospital were recruited to participate in this initial qualitative phase. Qualitative interviews were audiotaped, transcribed verbatim and analysed using the framework approach. Subsequently, another sample of patients and dental professionals within the three dental settings and dental hospital completed a questionnaire. Regression models were used to determine the predictors of perceived priorities and willingness to contribute to NHS dental costs based on the questionnaire data.Results Three focus groups (n = 9) and one semi-structured interview with patients and one focus group of dental professionals (four general dental practitioners and two dental nurses) were conducted. Participants prioritised NHS dental treatments that improve quality of life and social wellbeing. Factors influencing the prioritisation of NHS dental treatments included: individual responsibility for oral health care; concerns about self-esteem and confidence; age-related issues; and the role of treatment in prevention of future dental and general health problems, with financial concerns underpinning these themes. Out of the 455 questionnaires completed, 414 (383 patients and 31 general dental practitioners) were included in the analysis. The provision of emergency dental treatment for children was afforded the highest priority among both patients (59%) and dentists (74.2%). Both groups of participants felt that full funding for most NHS dental treatments should be prioritised for children (<18 years old) rather than adults (p <0.05).Conclusion Participants prioritised NHS dental treatments that would improve social wellbeing and quality of life, with an emphasis on full coverage for NHS treatment for children and young people. Policy makers should account for these preferences in the planning of NHS dental services.