December 2013

Objective: To report the findings of an evaluation of an NHS dental practice-based minor oral surgery service. Basic research design: Service evaluation. Clinical setting: NHS specialist practice in England. Participants: Patients and referring practitioners. Interventions: analysis of activity, patient and referring practitioner satisfaction data. Main outcome measures: Numbers and case-mix treated; nonattendance; antibiotic prescribing; complication rates; patients and referring practitioner satisfaction. Results: 5,796 treatment appointments were arranged, with a median waiting time from receipt of referral to treatment of 35 days. Treatment provided included: surgical removal of third molars and non-third molars, surgical endodontics and other surgical and oral medicine cases (28.3%, 53.3%, 3.5%, and 15.0% of cases, respectively). Antibiotics were prescribed at 13.1% of all treatment appointments and 2.5% required appointments for post-operativecomplications. All but one patient reported overall satisfaction and over 98% strongly agreed/agreed with positive attitudinal statements about the oral surgeon’s communication/information giving, technical competence and understanding/acceptance. 70.1% of patients were seen on time and under 1% were seen more than 15 minutes late. Some 83.1% felt the standard of service was better than expected from a hospital and none felt it was worse. More than 85% of referring practitioners agreed that: waiting times were shorter than at the hospital; urgent problems were seen quickly; and, the referral process was easy and understandable. Over 98% either strongly agreed or agreed that they were happy with the service provided. Conclusions: A range of minor oral surgery procedures can be provided with low complication rates, short waiting times, acceptable accessibility and high levels of patient and referring practitioner satisfaction from a specialist NHS dental practice-based service. Key words: service evaluation; specialist services; primary care; oral surgery