The owner of a London dental practice talks about the subject of dental check-ups: how regularly should you return for one?
Earlier this month (April 2011) there was much media coverage given to a government warning that many dentists are advising patients to come back for check-ups far sooner than may actually be needed.
The warning comes seven years after health watchdog NICE recommended that traditional six-month dental check-ups for adults should be brought to an end.
In 2006, government guidance endorsed the view that it was safe for most patients to have a recall interview just once every two years.
However, newly-released Department of Health figures suggest that 71 per cent of NHS patients are called back to the dentist’s surgery within nine months.
In the period April to September of last year, 13 per cent of these patients returned within three months.
The figures prompted England’s chief dental officer to send a letter to all dentists to remind them of the NICE recommendations.
The health watchdog still recommends that the shortest interval between oral health reviews for all patients should be three months. It believes that the longest period should be 24 months.
But a British Dental Association spokesman, commenting on the issue, said: “Many patients want to be seen more regularly.”
Private London dentist Ethicare has a policy that “examinations should only be carried out when needed”. Its website states that check-ups should “not necessarily mean every six months but instead the interval should be tailored to a patient’s individual requirement”.
We asked Glafcos Tombolis, who runs the practice with his wife Klaudia, about the issue of dental check-up intervals.
Question: “How do you determine when a patient should come back and see you for another check-up?
Glafcos Tombolis: “It depends on the oral health of the patient. We do carefully consider the state of a patient’s mouth before recommending when they should next return.”
Q: Do you have a formal check-list or ‘points’ system to determine when a patient should come back?
GT: No, there are just too many variables to take into account to compile a check-list – for instance consideration of patient’s history of decay and their dietary habits. We evaluate on a case-by-case basis.
Q: So, there’s no ideal one-size-fits-all check-up interval?
GT: No, sometimes it might be appropriate for a patient to be seen every three months. But if a patient’s mouth is free of decay then coming back in a year or even two years’ time could be fine. Sometimes, preventative measures such as an appointment with one of our hygienists can be more beneficial than a dental check-up as it keep bacterial levels low.
Q: On average, how often do patients come back to see you?
GT: 6-12 months tends to be the average check-up interval.
Q: Are patients’ financial considerations taken into account when you arrange the date for them to have their next check-up?
GT: Yes, we are always happy to give patients a clear idea of how much treatment will cost and how it will help them – we fully respect that it is the patient’s prerogative to accept or reject our recommendations.
We also try to offer affordable treatment which gives patients the options of making regular monthly payments so that they can spread the cost of their dental care over a year. For instance, the Ethicare Dental Plan bronze plan includes one consultation per year and two hygiene appointment, our Gold Plan offers two consultations per year and four hygiene appointments.
Q: What happens if someone doesn’t come back for a check-up for a few years, do they have to re-join?
GT: No, you won’t be de-registered after a fixed period of time and we know that long gaps between check-ups can mean that people forget the date of their next appointment, so we send out text reminders and e-mails.
Interestingly, Glafcos has heard little anecdotal evidence from new patients that their old dentists had asked them to come back for check-ups more often than was necessary.
Could it be time for the 2004 NICE recommendations about dental appointment intervals to be given another check-up?