title: Dentists with enhanced skills (Special Interest) in Endodontics: gatekeepers views in London.
abstract: BACKGROUND
  Dentists with a special interest hold enhanced skills enabling them to treat cases of intermediate complexity. The aim of this study was to explore primary dental care practitioners' views of dentists with a special interest (DwSIs) in Endodontics in London, with reference to an educational and service initiative established by (the former) London Deanery in conjunction with the NHS.
  
  
  METHODS
  A cross-sectional postal survey of primary care dentists working across different models of care within London was conducted, with a target to achieve views of at least 5 % of London's dentists. The questionnaire instrument was informed by qualitative research and the dental literature and piloted prior to distribution; data were analysed using SPSS v19 and STATA v12.0.
  
  
  RESULTS
  Six per cent of London's primary care dentists (n = 243) responded to the survey; 53 % were male. Just over one third (37 %; n = 90) were aware of the DwSI service being provided. Most practitioners reported that having access to a DwSI in Endodontics would support the care of their patients (89 %; n = 215), would carry out more endodontic treatment in the NHS primary dental care if adequately reimbursed (93 %; n = 220), and had more time (76 %; n = 180). Female respondents appeared to be less confident in doing endodontic treatment (p = 0.001). More recently qualified respondents reported greater need for training/support for performing more endodontic treatment in the NHS primary dental care (p = 0.001), were more dissatisfied with access to endodontic service in the NHS primary dental care (p = 0.007) and more interested to train as a DwSI in endodontics (p = 0.001) compared with respondents having a greater number of years of clinical experience since qualification.
  
  
  CONCLUSIONS
  The findings lend support to the concept of developing dentists with enhanced skills as well as ensuring additional funding, time and support to facilitate more routine endodontics through the NHS primary care to meet patient needs. More recently qualified dentists working in London were more concerned regarding endodontic service access, expressed need for training/support for undertaking more endodontic treatment in the NHS primary dental care and a desire to train as a DwSI in endodontics.
authors.affiliation: King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK. swapnil.ghotane@kcl.ac.uk.
authors.forename: Swapnil G
authors.initials: SG
authors.lastname: Ghotane
authors.affiliation: Faculty of Education & Health, University of Greenwich, Avery Hill Road, London, SE9 2UG, UK. M.Al-Haboubi@greenwich.ac.uk.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Al-Haboubi
authors.affiliation: NHS South West London and NHS London, based at Public Health Directorate, Floor 13, Leon House, 233 High Street, Croydon, CR9 1XT, UK. nick.kendall@phe.gov.uk.
authors.forename: Nick
authors.initials: N
authors.lastname: Kendall
authors.affiliation: NHS Westminster, 15 Marylebone Road, London, NW1 5JD, UK. claire.robertson@phe.gov.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Robertson
authors.affiliation: King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK. jenny.gallagher@kcl.ac.uk.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Gallagher
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003815:Dentists / Q000523:psychology*; D004497:Education, Dental; D004708:Endodontics / Q000193:education; D000072218:Endodontists; D004739:England; D005260:Female; D020793:Gatekeeping; D005792:General Practice, Dental; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D008131:London; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D012051:Reimbursement Mechanisms; D012390:Root Canal Therapy; D013218:State Dentistry; D013997:Time Factors