title: A case-control study of differences between regular and causal adult attenders in general dental practice.
abstract: OBJECTIVE
  To assess whether adults attending a dental practice for regular dental care have better oral health than adults attending casually in response to a dental problem, and to explore the barriers to asymptomatic attendance.
  
  
  METHODS
  An observational case-control study comparing the characteristics of 100 regular attenders with 100 causal attenders in one general dental practice in North Staffordshire. All study subjects were aged 18 years or over. Sociodemographic characteristics of the two groups were collated, including age, gender, social class, marital status, employment status and smoking status. The primary outcome measure was the observed number of teeth with dentinal caries diagnosed using bitewing radiographs.
  
  
  RESULTS
  Regular attenders were observed to have better oral health with respect to dental caries and tooth mobility (p < 0.05). This was not explained by the observation that causal attenders were more likely than regular attenders to be male, aged 18-44 years, in social class III or IV. Secondary outcomes, including number of subjects with mobile teeth and teeth with > 30% bone-loss, were also significantly worse in the casual attenders. However, the median number of teeth present in both groups was 27. In regular attenders, the most common reason for attending was to 'keep the teeth' (96%). In casual attenders, 'fear/dislike of dental treatment' was the most frequent indicator of non-attendance (56%).
  
  
  CONCLUSIONS
  In our study, adults who regularly attended general dental practice were shown to have better oral health, including less overall tooth decay, mobility and bone-loss, compared with adults who did not attend on a regular basis. Assuming this result to be externally valid, a challenge for the dental profession in the future will be to develop effective oral health promotion initiatives.
authors.affiliation: Primary Care Sciences Research Centre, School of Postgraduate Medicine, Keele University, Stoke-on-Trent. dianadental@mersinet.co.uk
authors.forename: C
authors.initials: C
authors.lastname: Bullock
authors.forename: E
authors.initials: E
authors.lastname: Boath
authors.forename: M
authors.initials: M
authors.lastname: Lewis
authors.forename: K
authors.initials: K
authors.lastname: Gardam
authors.forename: P
authors.initials: P
authors.lastname: Croft
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000453:epidemiology; D000704:Analysis of Variance; D001294:Attitude to Health; D016022:Case-Control Studies; D003729:Dental Care / Q000523:psychology / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014086:Tooth Mobility / Q000453:epidemiology