The effectiveness of out-of-hours dental services: I. Pain relief and oral health outcome.
OBJECTIVE
To compare the effectiveness of four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services.


METHODS
Questionnaire survey of patients attending weekend emergency dental services, with measurement of self-reported oral health status and dental pain (at attendance and follow-up) and retrospective judgements of change in oral health status.


METHODS
Two health authorities in South Wales, UK.


METHODS
A total of 783 patients who completed questionnaires at attendance, and 423 who completed follow-up questionnaires.


RESULTS
For patients who saw a dentist there were no consistent differences in the effectiveness of the four services, whether measured as pain relief, oral health gain or using patients' retrospective transition judgements about feeling better after their episode of emergency dental care. The proportion of patients reporting no improvement (transition judgements), either an hour after or the day after seeing the dentist, was surprisingly high (30-40% and 23-38% respectively). Although the 'rotas for all' - a telephone-access GDP-provided service for both registered and unregistered patients - achieved both the highest reductions in pain scores and the greatest improvements in dental health status between attendance and follow-up, this effect may reflect health gains due to care received after the episode of emergency dental care.


CONCLUSIONS
Neither the setting where emergency dental patients are seen, nor the type of dentist who sees them, appear to have any significant effect on patient-reported health outcomes. Although further exploration of the factors that predict poor pain relief or low oral health gain is required, future research on these services should focus on the process of care and accessibility.
Anderson
R
R
Centre for Health Economics Research and Evaluation, University of Technology, Sydney, PO Box 123, Broadway NSW 2007, Australia. rob.anderson@chere.uts.edu.au
Thomas
D W
DW
Phillips
C J
CJ
D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000458:organization & administration*; D000368:Aged; D002648:Child; D003752:Dental Health Services / Q000458:organization & administration*; D019232:Dental Restoration Failure; D003953:Diagnosis-Related Groups; D004638:Emergency Treatment; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D012008:Recurrence; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D018677:Tooth Injuries / Q000628:therapy; D014098:Toothache / Q000628:therapy*; D016896:Treatment Outcome; D014852:Wales