Cost efficiency of removing third molars in a practice specialising in minor oral surgery was compared to that of a hospital oral surgery department. A total of 100 patients treated in each locality were prospectively audited during the financial year 1989-90. Surgical complexity, waiting time, complications and patient satisfaction were compared. The hospital cases were costed individually and compared to fees received for the patients treated in the practice. The practice fees were also compared to average expenses as assessed by the Dental Rates Study Group Inland Revenue Enquiry. Patients were treated more promptly and at a lower cost in the specialist practice with no adverse effect on quality as assessed by complications and patient satisfaction. Surgical complexity was not a contraindication to practice treatment but some patients may be better treated in hospital because of medical or social circumstances. Patient charges for treatment carried out under General Dental Service regulations are a serious impediment to the viability of a specialist oral surgery practice.
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