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RETURN Randomized Controlled Trial to Increase Adult Routine Dental Visits
R V Harris1, V Lowers1, J Green1
1University of Liverpool, Liverpool, UK.
Journal of Dental Research
|May 6, 2026
Summary
The RETURN intervention, a nurse-led program, showed small benefits in increasing planned dental visits and improving oral health for disadvantaged adults. It significantly boosted attempts to schedule routine appointments, supporting behavioral support integration.
Area of Science:
- Public Health
- Behavioral Science
- Health Services Research
Background:
- Low socioeconomic status is linked to reduced planned dental visits, despite routine care preventing caries and tooth loss.
- Behavioral interventions in urgent dental settings may reduce health inequalities.
- The RETURN intervention was developed to address these issues through nurse-led conversations and support materials.
Purpose of the Study:
- To evaluate the effectiveness of the RETURN intervention in increasing planned dental visits.
- To assess the intervention's impact on oral health outcomes and dental anxiety.
Main Methods:
- A randomized controlled trial involving 1,176 adults attending urgent dental services.
- Intervention group received nurse-led support (videos, booklets, goal-setting); control group received usual care.
- Co-primary outcomes: planned dental visits (BSA data) and Oral Health Impact Profile (OHIP) scores at 12 months.
Main Results:
- RETURN participants showed a 20% greater odds of planned care (OR=1.21, P=0.217) but this was not statistically significant.
- Both groups improved in OHIP scores; RETURN showed a significant reduction in dental anxiety (P=0.027).
- RETURN significantly increased attempts to make appointments, with odds increasing over time (18 months: OR=3.39, P=0.0001).
Conclusions:
- The RETURN intervention demonstrated small, consistent benefits for routine visits, oral health, and dental anxiety, even with limited service availability.
- The intervention significantly increased attempts to schedule routine dental appointments in a disadvantaged population.
- Integrating behavioral support with service reforms can aid transitions to continuing care and optimize resource use.
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