title: Reasons for referral of very elderly patients to the community dental service in rural England and the implications for developing oral health care services.
abstract: OBJECTIVE
  To analyse the medical conditions and dental treatment requirements.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Rural South West Surrey, England.
  
  
  METHODS
  100 patients aged 75 or over who were referred for dental treatment to the Community Dental Services (CDS) because of various medical disabilities.
  
  
  METHODS
  Age, sex, medical history including drug intake, dental treatment provided, time taken for treatment.
  
  
  RESULTS
  Two-thirds of the patients required domiciliary care; two-thirds had problems of mental confusion. In addition, 89% were dependent on carers. Treatment requirements indicate that the majority of dental care, although time consuming, were simple in nature and within the technical scope of a competent general dental practitioner (GDP).
  
  
  CONCLUSIONS
  This study implies that the reasons for referral are other than lack of dental skills and may be due to perceived difficulties in managing patients. Further research is recommended to establish whether aspects of patient management are problematic so that resources, including appropriate training programmes, can be developed to enable a quality service to be provided. In the evolving health care system in the United Kingdom (UK) these issues will need to be considered when developing contracts at a local level.
authors.affiliation: Dept. of Conservative Dentistry, St. Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, London.
authors.forename: J E
authors.initials: JE
authors.lastname: Fenwick
authors.forename: P A
authors.initials: PA
authors.lastname: Batchelor
authors.forename: D Y
authors.initials: DY
authors.lastname: Samarawickrama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000458:organization & administration*; D016321:Dental Care for Aged / Q000458:organization & administration / Q000706:statistics & numerical data*; D017742:Dental Care for Chronically Ill / Q000458:organization & administration / Q000706:statistics & numerical data; D003752:Dental Health Services / Q000458:organization & administration*; D004739:England; D005260:Female; D016330:Frail Elderly; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D009735:Nursing Homes; D016730:Program Development; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019035:Rural Health Services