Evaluation of dental therapists undertaking dental examinations in a school setting in Scotland

O'Keefe, E. J., McMahon, A. D. , Jones, C. M., Curnow, M. M. and Macpherson, L. D. (2016) Evaluation of dental therapists undertaking dental examinations in a school setting in Scotland. Community Dentistry and Oral Epidemiology, 44(6), pp. 515-522. (doi: 10.1111/cdoe.12244) (PMID:27381380)

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Objective: To measure agreement between dental therapists and the Scottish gold-standard dentist undertaking National Dental Inspection Programme (NDIP) examinations. Methods: A study of interexaminer agreement between 19 dental therapists and the national gold-standard dentist was carried out. Pre-calibration training used the caries diagnostic criteria and examination techniques agreed by the British Association for the Study of Community Dentistry (BASCD). Twenty-three 5-year-old children (Primary 1) and 17 11-year-old children (Primary 7) children were examined. Agreement was assessed using kappa statistics on d 3 mft and D 3 MFT for P1 and P7 children, sensitivity and specificity values, and kappa statistics on d 3 t/D 3 T and ft/FT. Calibration data on P1 and P7 children from 2009–2012 involving dentists as examiners were used for comparison. Economic evaluation was undertaken using a cost minimization analysis approach. Results: The mean kappa score was 0.84 (SD 0.07) ranging from 0.69 to 0.94. All dental therapists scored good or very good agreement with the gold-standard dentist. This compares with historic NDIP calibration data with dentists, against the same gold-standard dentist, where the mean kappa value was 0.68 (SD 0.22) with a range of 0.35-1.00. The mean sensitivity score was 0.98 (SD 0.04) (range 0.88-1.0) and mean specificity score was 0.90 (SD 0.06) (range 0.78-0.96). Health economic analysis estimated that salary costs would be 33.6% lower if dental therapists were substituted for dentists in the year 2013, with an estimated saving of approximately £103 646 per annum on the national budget. Conclusion: We conclude that dental therapists show a high level of interexaminer agreement, and with the appropriate annual training and calibration, they could undertake dental examinations as part of the NDIP programme.

Item Type:Articles
Glasgow Author(s) Enlighten ID:O'Keefe, Mrs Emma and Macpherson, Professor Lorna and McMahon, Dr Alex
Authors: O'Keefe, E. J., McMahon, A. D., Jones, C. M., Curnow, M. M., and Macpherson, L. D.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Journal Name:Community Dentistry and Oral Epidemiology
ISSN (Online):1600-0528
Published Online:06 July 2016
Copyright Holders:Copyright © 2016 Wiley
First Published:First published in Community Dentistry and Oral Epidemiology 44(6):515-522
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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