June 2006

Objective: Primary Care Trusts (PCTs) assumed new responsibilities for dentistry in 2005. In dental education it has been suggested that more emphasis is made of primary care outreach schemes. The paper considers the service quality implications of dental outreach teaching for PCTs with particular reference to access and acceptability. Research Design and Clinical Setting: A pilot of outreach teaching for Manchester undergraduates in relation to adult dental care began in 2001. Six groups of eight students, working in pairs, spent one day per week in one of three community dental clinics in socially deprived areas. The evaluation of the first year used data from 908 patient treatment summaries, 139 patient questionnaires, and records of patient attendance. Main Outcome Measures: Access and acceptability measured by patients’ demographic characteristics, patients’ attendance at the clinics; patients’ reasons for attendance, use of services and satisfaction with the service. Results: In terms of access, the new service was used by local patients. Their main reasons for attending were convenience, a dental problem, free treatment, lack of access to a dentist, and lay referral. Some 41 percent attended initially because of an emergency, 30 percent said that if they had not attended the clinic they would have gone nowhere or did not know where they would have gone, and 49 percent had not attended a dentist for more than two years. In terms of acceptability most patients were positive about being treated by a student, 96 percent thought the quality of care excellent or good, and the same percentage said they would return to the clinic. The main areas of criticism were waiting times and appointments. Conclusions: Students can provide an accessible and acceptable local primary care dental service for adult patients in socially deprived areas as part of their undergraduate learning, and in a way that complements the existing services. Key words: Primary care, service quality, undergraduate teaching