Provision of domiciliary dental care by Scottish dentists: a national survey

Demand for domiciliary dental care is increasing as a result of a growing population of elderly and functionally dependent patients, legislative pressure and an increasingly dentate population.

To estimate the amount and types of dental care currently being undertaken on a domiciliary basis in Scotland and to examine the barriers to the provision of such care.

A descriptive study, involving a self-administered postal questionnaire was employed. All general dental practitioners (n = 1,995) and community dental officers (n = 200) in all Health Board areas across Scotland were included in the postal survey. Data were analysed in SPSS.

The valid response rate was 66%. Sixty-seven percent of dentists undertook at least one domiciliary visit per year, mainly for elderly patients. Prosthetic treatment was undertaken most commonly. Other types of treatment were delivered mainly by the community dental service. Many dentists did not carry a light source or emergency essential drugs and half of the dentists overall were not confident to administer emergency drugs. Significant problems were identified in relation to the packaging and carriage of contaminated instruments and clinical waste. Of those respondents not providing domiciliary care, 19% stated that they would never consider doing so. Barriers to the provision of domiciliary care included time, poor remuneration, concerns about infection control, emergency drugs and lack of suitable equipment, and the difficulties of carrying equipment.

Staff training, specialist equipment and new service models for the delivery of domiciliary care are required.