Tooth retention has been one of the main aims of oral care which in turn could have contributed to the social oral health divide. To investigate this issue further, data collected for a group audit was used to study the reasons for tooth extraction for patients attending for routine treatment at four dental practices. The practices served populations in areas with different levels of deprivation in South Wales. In 558 teeth extracted over 417 visits, the reasons for extractions were: caries 59%, periodontal disease 29.1%, pre-prosthetic 1%, wisdom teeth 4.6%, orthodontic 5.5%, trauma 1.2%, patient request 2.4% and 6.2% other reason. The number of extraction visits per day within the group of dental surgeons varied with three practitioners performing more than three extraction visits per day while one practitioner had only 0.51. These reasons did not significantly depend on levels of deprivation. However, significantly more teeth were extracted for caries in the most deprived group in comparison to the least deprived. Therefore, could there be a case for appropriate extractions in the quest for equitable care?

No abstract

This study aimed to explore the views of health visitors and school nurses with regard to their role in oral health promotion and their understanding of the issues surrounding the delivery of effective oral health promotion in their daily practice. A focus group was conducted with school nurses (n=6) and health visitors (n=3) who had recently completed the Evidence-Based Public Health core module as part of their higher degree specialist community public health nurse (SCPHN) programme of study in 2014. A 12-item focus group interview schedule was devised in which face and content validity were established. A thematic analysis was then undertaken in which themes and subthemes were identified. Although health visitors and school nurses are best placed to take the lead on oral health promotion in children and young people, several barriers were identified, which prevented them from performing this role effectively and confidently. A recommendation is made for more training, focused on behaviour change principles of concordance and setting realistic targets tailored to the needs of those children and young people who need it most.

The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

We conclude by drawing attention to wider benefits of such software tools in the dental profession and outline a research agenda to take these issues further.