NHS general dental practitioner claims in the South West for provision of topical fluoride, fissure sealants, radiographs, fillings and extractions for children born in 2009: an analysis of a five-year period.

Introduction Clinical guidelines related to diagnosis and preventive interventions for children are well established; however, childhood caries incidence remains high.Methods Secondary analysis of routinely collected data from the NHS Business Services Authority for children treated by general dental practitioners across a five-year period in four local authorities in South West England was used to assess whether children of primary school age attending general dental practices were receiving radiographs, fluoride varnish and fissure sealant applications in line with current guidelines.Results In total, 40,780 claims had been submitted in the five-year time period for the 4,805 children included in the study: 4.9% of children had ten or more claims that indicated fluoride varnish application; 4.0% of children had claims indicating they had been provided with four or more fissure sealants; and 7.6% of children had claims indicating two or more radiographs had been exposed. Increased filling experience was associated with increased fluoride varnish applications. For the children that had ten or more examinations and five or more fillings provided in the five-year time period, 27.2% had ten or more fluoride varnish applications, 7.6% had four or more teeth fissure sealed and 17.2% had two or more radiographs exposed in the five-year time period.Conclusion The claim data did not provide reassurance that guidelines relevant to prevention and diagnosis for children had consistently been followed.

A review of outcome measures used in cleft care.

This article provides a summary of the main outcome measures currently available and in use within modern cleft care. The fact that there are such a diverse range, including surgical, orthodontic, dental, speech and patient satisfaction measures, is a reflection of the complex, multidisciplinary and longitudinal nature of the care provided. The use of such measures of outcome is essential in the auditing and drive for continued improvements in the standards of care for patients affected with cleft lip and palate.