Reminding patients using postal or manual telephone techniques is effective at improving attendance. All of the reminder methods, telephone and postal, provided net cost savings rather than additional costs.
Objective The purpose of the study was to determine if the intra-alveolar application of topical metronidazole gel could reduce the incidence of alveolar osteitis (dry socket) following routine tooth extraction in molar and premolar extraction sites. Design This was a multicentre, double blind, randomised, placebocontrolled clinical trial. A total of 302 patients took part, of which 23 returned with alveolar osteitis. Of these, eight had received the metronidazole gel and 15 the placebo. Setting The study was carried out in three general dental practices by general dental practitioners working in England over the period [2000][2001][2002][2003]. Main outcome measures Following extraction of either a molar or premolar tooth, either a 25% metronidazole gel or KY Jelly was syringed gently into the socket. A painful post operative complication was recorded if either a dry socket was present or the patient returned with pain. Results and conclusions The difference in the incidence of alveolar osteitis between the placebo and the active gel groups was not significant and it was concluded that 25% topical metronidazole gel was not effective in reducing the incidence of alveolar osteitis. It was found that the incidence of alveolar osteitis reduced with increasing age and was more likely to occur in a patient with a previous history of the condition.
Patients exempt from dental charges (mainly children and those receiving income support) were more likely to have failed to attend for their appointment. Whereas the attendance of children may be outside their control in some cases, we hypothesise that factors such as poverty in the group receiving income support may be an important influence in whether these patients feel able to attend for their appointments.
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