An audit of the implementation of guidelines in relation to the prevention of dental caries.
OBJECTIVE
To determine the implementation of national clinical guidelines in relation to the targeted prevention of dental caries in the permanent teeth of 6-16-year-olds presenting for dental care amongst training grade staff working within the Hospital Dental Service.


METHODS
Patient records were reviewed prospectively with regard to caries risk assessment, behaviour modification and tooth protection. Following dissemination of the results and reinforcement of fundamental points from the guideline, a second audit was conducted one month later. The results were assessed by chi2 (chi2) analysis.


RESULTS
One hundred patient records were reviewed in both Audit One (M:52; F:48) and Audit Two (M:61; F:39). Caries risk assessment was poorly recorded in both Audits One and Two (13% and 17%, respectively). There was an improvement in radiographic reporting between the first and second audit, from 53% to 80% (chi2 = 16.36, P = 0.001). Dietary advice and toothbrushing instruction were recorded in 36% and 41% of records in Audit One, whilst in Audit Two this had improved to 68% and 92%, respectively (chi2 = 20.51, P = 0.001 and chi2 = 58.38, P = 0.001). There was a statistically significant improvement in the prescription of fissure sealants in Audit Two (chi2 = 38.97, P = 0.001), although not in the prescription of topical fluoride application (chi2 = 1.71, P = 0.192).


CONCLUSIONS
Amongst training grade staff, there appears to be failure of implementation of certain aspects of SIGN guidelines for caries prevention. Clinical audit, however, would appear to improve guideline implementation.
Foley
J
J
Department of Paediatric Dentistry, Dundee Dental Hospital, Dundee, DD1 4HN, UK. jennifer.i.foley@tuht.scot.nhs.uk
D000293:Adolescent; D002648:Child; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014099:Toothbrushing